Life and Health News February 2011

The following is a brief review of selected items that may be of current interest to First Consulting & Administration, Inc. clients and friends.  Please feel free to copy it for distribution to your staff.  Contact us for more details about any item.  We welcome your comments and suggestions on this letter.  Please call our office.

Kansas adopted by reference its policies and procedures for use of senior-specific certifications and professional designations in sale of life insurance and annuities dated August 25, 2010.     Regulation K.A.R 40-9-23

New York adopted an emergency regulation that establishes standards and requirements for use of senior-specific certifications and designations in the sale of life insurance and annuities.     Emergency Regulation 199 (11 NYCRR 225)

Maryland issued a bulletin regarding contact information. The bulletin also requested a company's plan of operations in the event of a disaster or catastrophic event.  All insurers need to reply back to the Department by April 15, 2011. 

New Jersey repealed the subchapter requiring insurers to annually submit premium data to the Department of Banking and Insurance submitted for the purpose of compiling an annual Term Life Comparison guide.   The Department also repealed its requirement that critical illness/specified disease advertising be filed for approval.     Repeal Of Rule 11:4-31

Oregon amended its rule regarding the filing requirements for annual statements and reports.     Rule 836-011-0000

Texas adopted by reference the March 2010 version of the NAIC Statements of Statutory Principles Manual, and substantive and non-substantive updates to the Manual issued by the NAIC in calendar year 2010.     Rule 28 TAC §7.18

Texas issued a bulletin informing stipulated premium companies of the new risk based capital and minimum capital and surplus requirements that must be met to comply with Texas law.     Bulletin #B-0005-11

Louisiana issued an Advisory Letter to announce that all authorized insurers are required to file an initial anti-fraud plan between 1/1/2011 and 4/1/2011.  If an insurer has already filed its anti-fraud plan in Louisiana prior to 1/1/2011, the insurer is required to re-file in the format described in the Advisory Letter.  The letter also describes annual reports that will be required in future years.     Advisory Letter No. 2010-02

Maryland issued a bulletin reminding Health Maintenance Organizations participating in the individual or group markets in Maryland, of the annual provider rate schedule certification that is required to be filed with the Commissioner each year.     Bulletin 2011-1

Michigan enacted legislation amending provisions regarding HIV-testing and consent laws.     House Bill 4583

Indiana amended requirements regarding long-term care provisions, disclosure forms and requirements, outlines of coverage, shoppers guide and long-term care personal worksheets.     Rule 760 IAC 2-4-1, 760 IAC 2-4-2, 760 IAC 2-8-4, 760 IAC 2-17-1, 760 IAC 2-18-1, 760 IAC 2-19.5-1

California issued a bulletin regarding the transaction of insurance in other States and Territories.   The bulletin lists the 28 states and territories that are recognized as 'reciprocal states' and asks that the DOIs of the reciprocal states inform California of violations by California insurers that occur in their jurisdictions.     Bulletin 2010-3

Washington adopted a rule ensuring that insurers use their legal name when conducting insurance business.     Rule WAC 284-30-670

Massachusetts issued a bulletin highlighting new provisions related to coverage of Autism Spectrum Disorder.     Bulletin B-2010-15

Missouri issued a bulletin providing guidance to health insurers on mandated insurance coverage requirements for various treatments for autism and autism spectrum disorders.     Bulletin 2011-01

Nevada issued a bulletin reminding health carriers of the requirements to provide information about claims paid on behalf of the policyholder.     Bulletin 2011-001

Ohio adopted a rule amending required enrollment periods during which carriers in the individual health insurance market may offer coverage to children under nineteen years of age on a guaranteed issue basis without any limitations or restrictions based on the health status of the child.     Rule 3901-8-14

Alaska adopted a bulletin that notifies insurers using the 2001 CSO Preferred Class Mortality Structure Table of the exemption from the statistical reports filing requirement.     Bulletin B 10-09

California adopted a regulation, following the recent changes to NAIC Model regulations, which removes restrictions on calculating required annual reserve valuations of life insurance products and requires an appointed actuary to make an annual statement regarding the adequacy of reserves.     Regulation 2542.4

California adopted new regulations, which in a large part follow NAIC model regulations, establishing requirements for use of mortality tables reflecting differences in mortality between preferred and standard lives in determining minimum reserve liabilities.     Regulation 2582+

Nebraska issued a bulletin regarding the Patient Protection and Affordable Care Act.  The Department is opting to retain the current statutory grouping of 1-50 for purposes of all small group health insurance issues, except for purposes of the medical loss ratio (MLR) calculation. The Department will allow companies to use 1-100 employees for purposes of determining the MLR for small group health insurance.     Notice 1-5-2011

Ohio issued a bulletin regarding the waiver of annual limit restrictions that is valid until September 23, 2011.     Bulletin 2011-4

Texas issued a bulletin regarding the requirement that group health plans and health insurance issuers offering group or individual health insurance coverage provide notice of the availability of the Texas Consumer Health Assistance Program to enrollees.     Commissioner's Bulletin B-0051-10

Washington issued an emergency rule that establishes the requirements health carriers must follow for open enrollment periods and special enrollment periods resulting from a qualifying event for persons under age 19, due to the Patient Protection and Affordable Care Act.     Directive 11-EX-2

The Texas Insurance Commissioner issued an Order setting the rates for maintenance taxes and fees assessed on gross premiums for calendar year 2010.     Commissioner's Order No. 10-1069

Michigan issued a Bulletin to emphasize the responsibilities of resident and non-resident insurance producers to safeguard customers’ nonpublic personal information.     Bulletin 2010-21-INS

New Jersey adopted a rule amending insurance producer conduct requirements.     Rule 11:17A-1.2+

North Carolina issued a memorandum reminding insurers of the e-mail address requirement and e-mail address procedure for resident and non-resident applicants and for all active licensees.     Memorandum 1-3-2011

Oregon adopted and amended its rules regarding the process for applying for an insurance producer license.  The applicant must now complete all other steps in the licensing process before submitting the application to the Insurance Division.  The rules also amend the fee schedule for examinations.     Rule Chapter 836+

Rhode Island established standards and requirements for the use of senior specific certifications and professional designations in the offer, sale, or purchase of securities that are similar to the NAIC model.     Regulation 501-1

Utah adopted a rule amending licensing requirement provisions for variable contract producers.     Rule R590-133-1+

Utah amended its regulation regarding requirements for insurers and producers in the replacement of life insurance and annuities.     Rule R590-93-1+

Maine issued a bulletin that establishes disclosure standards regarding the payment of life insurance benefits to a beneficiary by means of a retained asset account.     Bulletin 376

New Jersey issued an Order setting forth minimum requirements for the use of retained asset accounts (RAAs).  The Order amends a previous order and clarifies information to be provided in consumer disclosures.   The Order also sets out filing requirements for any forms discussing RAAs.     Order No. A11-101

Ohio issued a bulletin establishing best practices for disclosure standards when retained asset accounts are used to fund life insurance benefits     Bulletin 2011-01

Ohio issued a bulletin providing guidance regarding questions to be included on life applications to prevent and identify stranger-originated life insurance.  Also provides application filing requirements.     Bulletin 2011-02

Colorado enacted legislation, which among other things, amends annuity suitability provisions related to producer training, adds requirements for determining suitability of annuity transactions and defines replacement and suitability information.     Repeal And Repromulgation Of Regulation 4-1-11

New York adopted a new emergency regulation establishing standards and procedures to determine a consumers' suitability before recommending or selling annuities. This emergency regulation is substantially similar to the NAIC Suitability in Annuity Transactions Model Regulation.  Emergency Regulation 187 (11 NYCRR 224)

Rhode Island adopted a regulation amending annuity suitability requirements to follow the NAIC model regulation, with certain exceptions.     Regulation 12

The District of Columbia adopted a new rule, which among other things, establishes duties of insurers and insurance producers, producer training and recordkeeping all regarding suitability in the sale of annuities.     Rule 8400+


The dates for this year’s Advertising Compliance Seminar will be August 8 – 9, 2011, in Kansas City, Missouri.

 What Past Participants Liked:
 Tools to make advertising review easier and more consistent
 Industry Best Practices
 Advertising Laws and Regulations with state twists
 Internet Advertising and Social Media compliance concepts
 Peer Networking


For complete information about this year’s seminar,
or to pre-register, please click here


Jerry L. Wickersham
1-800-927-2730, ext.2743



The Outside View of Your
Operational Compliance Program

With the First Consulting in your camp, your company can meet internal and external standards more efficiently. We can help you

1. Identify key risks in your regulatory and internal compliance;
2. Strengthen policies and procedures that are highest on the risk scale; and
3. Design monitoring safeguards for ongoing effectiveness.

Learn more by calling C. J. Rathbun, 
at 816-391-2730 (800-927-2730 X 2740) 
 or email her at

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