Life and Health News February 2012

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.


ANNUITIES
Florida repealed rule 69B-162.009 pertaining to the sales of variable annuity contracts by licensed agents.     Repeal of Rule 69B-162.009

Kentucky issued a memo that outlines the product specific continuing education and training requirements for any resident insurance producers who sell, solicit, or negotiate the sale of an annuity.     Memo Date December 14, 2011

New Jersey issued a bulletin providing revised guidance concerning the current criteria for approval of equity indexed annuity (EIA) forms.  The bulletin applies not only to fixed (i.e., non-variable) EIA forms, but also to any fixed account option of a variable annuity form where the fixed account contains an equity indexed component.     Bulletin 11-31

Oklahoma issued a bulletin regarding the establishment of training requirements for licensed resident and non-resident producers, who desire to sell, solicit or negotiate the sale of annuities.     Bulletin 1-12-2012


CIVIL UNION
Delaware issued an amended bulletin to provide guidance regarding the implementation of the Civil Union and Equality Act of 2011 (the original bulletin, Bulletin No. 46, was noted in the December, 2011 edition of this newsletter).  The amended bulletin was issued to clarify the Department's expectation concerning how new and existing policy holders are to be notified and allows time for insurer programming changes to be made.   A sample notification document is included with the bulletin.     Bulletin 46 (Amended)


DISASTER OR CATASTROPHIC EVENT
Maryland issued a bulletin to all insurers requiring contact information in the case of a disaster or catastrophic event to be provided by April 16, 2012.     Bulletin 12-01


EXTERNAL REVIEW
Indiana issued a bulletin setting forth the procedure for certification of independent review organizations, including compliance with requirements promulgated under the Health Care and Education Reconciliation Act (ACA) and updates and replaces Bulletin 99.     Bulletin 188

Missouri issued a bulletin to insurers writing health insurance coverage regarding the external review process.     Bulletin 2011-08

Texas issued a bulletin that notifies health insurance issuers and HMOs of the impact of Technical Release 2011-02 on the external review processes.     Bulletin B-0051-11


FILING REQUIREMENTS
Montana issued a memorandum to all insurers explaining that all applications must be submitted to and approved by the Commissioner of Securities and Insurance.     Advisory Memorandum January 9, 2012


FINANCIAL REGULATION
Connecticut issued a bulletin regarding 2011 annual statement requirements.     Bulletin FS-4-2011


FRATERNAL BENEFIT SOCIETIES
New Jersey issued a bulletin to fraternal benefit societies regarding the requirements to file an opinion from a qualified actuary regarding the adequacy of reserves.     Bulletin 11-30


HEALTH BENEFIT PLANS
Massachusetts issued a bulletin regarding open enrollment for individuals in insured health benefit plans.  This bulletin replaces bulletin 2010-13 (‘Open Enrollment for Individuals‘) and bulletin 2011-03 (‘Additional Qualifying Event for Enrollment of Individuals in Merged Market').     Bulletin B-2011-19


HEALTH INSURANCE
New York provided guidance to health insurers as to the Medical Loss Ratio (‘MLR‘) standards that are applicable to the calculation of refunds by insurers with respect to policies of hospital and/or medical expense insurance.     Circular Letter 2011-15


LIFE SETTLEMENT
New York adopted an emergency regulation regarding Life Settlements establishing license fees and financial accountability requirements for life settlement providers and, license fees for life settlement brokers.     Emergency Regulation 198 (11 NYCRR 381)


LONG-TERM CARE
Florida repealed various provisions of long-term care rules because they are duplicative of their corresponding numbered rule in Chapter 69O-157, F.A.C.   The repealed provisions include definition of terms, policy practices and provisions, refund of premiums, required disclosure provisions, required disclosure of rating practices to consumers, prohibition against post-claims underwriting, reporting requirements, filing requirements - out of state groups, nonforfeiture benefit requirement, and standard format outline coverage.     Rule 69B-157.003+

Washington repealed Chapter 85 of Title 284 of the Washington Administrative Code on long-term care partnership policies in its entirety.     Repeal Of Rule 284-85-005


MEDICARE
Massachusetts issued a bulletin providing basic health information to people eligible for medicare.  The bulletin as well as the "2012 Guide to Health Insurance for People with Medicare" must be provided to those people eligible for Medicare pursuant to Regulations 211 CMR 42.09(4) and 211 CMR 71.13(2)(d)4.     Bulletin B-2011-18


MISCELLANEOUS
California issued a bulletin on increases to cost recovery rates for filing or approval of policy forms and other documents.     Bulletin 2011-4

Colorado repealed its rule on compliance with law requiring insurers to maintain an office in Colorado.     Repeal Of Rule 1-1-4

Nevada sent a reminder to life and health insurers that the first set of required industry reports are due March 1, 2012.  Please see http://doi.nv.gov/slh/r_lhrr.aspx for a list of the required industry reports and note that there are separate lists for Life & Health, Long Term Care and Managed Care.     Email Dated January 4, 2012

New York issued a circular letter to all domestic insurers regarding enterprise risk management.     Circular Letter 2011-14

Puerto Rico outlined the scope of authority the Commissioner of Insurance has to receive and share documents, materials or information.     Ruling Letter 2012-137-D

South Dakota defined examination facilitation in the conduct of examinations including financial, market conduct and agency examinations.     Rule 20:06:12:09

Texas adjusted its law on the rates of assessment for maintenance taxes and fees for 2012 on the basis of gross premium receipts for calendar year 2011.     Rule 28 TAC 1.414


MISCELLANEOUS - HEALTH
Georgia issued a directive to health insurers writing comprehensive major medical group health insurance regarding the confusion among insurers about the definition of small and large group.     Executive Directive 12-EX-1

Michigan issued a bulletin regarding guaranteed renewability of health plans.     Bulletin 2011-17-INS

Michigan issued a bulletin to specify the requirements for notifying the Commissioner of the methodology used to collect the assessment levied under the Health Insurance Claims Assessment.     Bulletin 2011-16-INS

Missouri adopted an emergency regulation regarding grievance review procedures.     20 CSR 100-5.020

New Jersey issued a bulletin regarding the provisions of non-coverage services by limited-panel network physicians.     Bulletin 2012-2

New Mexico issued a bulletin regarding managed health care plans that establishes the 2012 interest rate applied to unpaid claims after 45 days after required proof of loss has been furnished.     Bulletin 2012-01

Texas issued a bulletin calling for reports regarding provider claims processing and additional clarification on reporting requirements for all insurers offering preferred provider health benefits plans and all HMOs.     Bulletin B-0002-12

Texas issued a bulletin to advise carriers that the Texas Department of Insurance is temporarily suspending implementation of preferred provider benefit plan rule amendments until rules implementing recent legislation are adopted.     Bulletin #B-0050-11

Vermont issued a bulletin to notify health insurance companies that comprehensive major medical and long term care rate filings submitted to the Department on or after January 1, 2012 will be posted to the Department’s website and available for public viewing.     Bulletin 167

Wisconsin issued a bulletin to insurers offering accident and disability insurance regarding grievance and independent review requirements.     Bulletin 12-16-2011


MISCELLANEOUS - LIFE
South Dakota repealed its chapter on life and health insurance solicitation.  Also established new provisions for regulation regarding advertisements and solicitations of health and life insurance, which includes among other things, general, disclosure and policy summary requirements.     Repeal Of Chapter 20:06:14, Rule 20:06:10:01+


PATIENT PROTECTION AND AFFORDABLE CARE ACT
Florida informed health insurers and HMOs that no statutory guidance electing to use 50 employees as the upper limit for purposes of reporting small employer medical loss ratios in Florida has been issued.  This memorandum supersedes  memorandum OIR-11-06M.     Memorandum 2011-09M

Louisiana issued a bulletin regarding the change in definition of 'small employer' for the purposes of medical loss ratio (MLR) reporting and rebate requirements under the Patient Protection and Affordable Care Act.     Bulletin 12-29-2011 (#1)

Pennsylvania issued a notice pertaining to external review under the affordable care act.     Notice 12-31-2011


PREMIUMS
Florida amended its regulation on premium taxes.     Rule 12B-8.001+


PRODUCERS
Alabama issued a bulletin regarding the use of temporary insurance producer licenses.  It also reminds insurers making temporary license appointments to adhere to state law.     Bulletin 2012-01

Connecticut issued a bulletin responding to inquiries received regarding regulation on suitability in annuity transactions training for insurance producers.     Bulletin L-18

Kentucky issued an advisory opinion regarding the practice of collection and payment of producer compensation, an overview of the law related to the subject matter, an outline of the emerging practice as it has been made known to the Department, and a statement of the Department's position related to the practice.     Advisory Opinion 2012-1

Kentucky issued an opinion to all insurers/producers that provides an overview of Kentucky law related to insurer collection of commission payments, an outline of the emerging practice as it has been made known to the Department, and a statement of the Department’s position related to the practice.     Advisory Opinion 2012-01


RISK RETENTION GROUPS
Colorado repealed and repromulgated captive insurance regulation to clarify provisions on reinsurance and risk retention groups.     Regulation 2-3-1


RISK-BASED CAPITAL
Alaska issued an order providing information for the adoption of risk based capital Instructions.     Order R2011-6

Colorado repealed and repromulgated its risked-based capital rule.     Repeal and Repromulgation of Regulation 3-1-11


SUITABILITY
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)

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)


UNCLAIMED FUNDS
Ohio amended provisions related to unclaimed funds, which includes among other things, definitions, examination of accounts and the authority to present claims.     Rule 1301:10-1-01


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