Life and Health News
We are celebrating over 25 years of providing selected items of current interest to our clients and friends. The items contained in this newsletter are derived from bulletins, regulations and legislative activity affecting the insurance industry. Please feel free to share this newsletter with others that may be interested. Contact our office for further details about any of the items contained in the newsletter.
AGENT / PRODUCER LICENSING AND APPOINTMENT
Connecticut released a notice announcing the rollout of a new online payment portal for processing financial transactions of licensees. All producer requests for letters of certification and clearance letters will be processed through the portal and fees can be paid by credit card. Notice dated November 18, 2016
Mississippi issued a bulletin regarding administrative licensing notices to be issued via electronic mail. Bulletin 2016-12
Puerto Rico issued a ruling to all producers, authorized representatives, adjusters, consultants, and general agents advising that the individual must use the name on their insurance license, which is the name registered with the Vital Statistics Registry. Ruling CN-2016-205-SR
ANNUITIES / ANNUITY CONTRACTS
Delaware extensively updated its Senior Protection in Annuity Transactions regulation, with Section 4 (Duties of Insurers and Insurance Producers) being rewritten. Regulation 1214
DOL RULE IMPLEMENTATION HELP
If seeing the first DOL Rule implementation dates on the calendar left you uneasy
about your own DOL implementation timeline, let First Consulting help!
Click here to learn more.
Puerto Rico issued a ruling to all domestic and foreign insurers, and service contract providers stating all insurance policies and service contracts currently in effect, must be amended to include arbitration clauses. Ruling Letter CN-2016-206-AP
Rhode Island promulgated regulations setting forth procedures for filing the Corporate Governance Annual Disclosure (CGAD). 161-RICR-200-45-11
Massachusetts issued a bulletin to all insurers writing Credit Life and Credit Accident and Health Insurance that is sold by Motor Vehicle Dealers providing the deviated case rates for January 1, 2017 through December 31, 2019. Bulletin 16-15
DRUG / PRESCRIPTION COVERAGE
New York amended its law in relation to standards for prior authorization requests for a utilization review of prescription drug coverage. Senate Bill 4721
Nebraska issued a bulletin to all insurers writing hospital indemnity policies or other fixed indemnity policies sold in the individual market. It is intended to provide guidance regarding the Department of Insurance's implementation and enforcement of the recently released rules and guidance from the federal government regarding hospital indemnity or other fixed indemnity polices. Bulletin CB-132 (Amended)
North Carolina issued an advisory memorandum to provide guidance to insurers offering hospital indemnity or other fixed indemnity products in the individual market. The attestation in the application that the insured has other health coverage that is minimum essential coverage and the notice that the policy is not a substitute for major medical coverage may be removed from the application. To avoid sending the amended applications for approval, insurers must send a "Note to Reviewer” no later than February 1, 2017 as explained in the memorandum. Advisory Memorandum Dated November 30, 2016
FILING REQUIREMENTS / PROCEDURES
Louisiana amended the filing requirements for health, life and annuity policy forms and the filing of amendatory riders or endorsements, provides variable material and statement of variability requirements, and revises the time periods and requirements for compliance review of basic insurance policy forms. LAC 37:XIII.10107, LAC 37:XIII.10109
Louisiana amended its law pertaining to the Guaranty Association Notice that is required to be provided with all life, health and annuity contracts. Louisiana also revised the maximum amount the Louisiana Life And Health Insurance Guaranty Association will pay for health insurance benefits to $500,000 and updates the Louisiana Association’s address as well as other language that is to be provided in the notice. LAC 37:XIII.903, LAC 37:XIII.907
What Would You Ask The DOI?
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HEALTH CARE EXCHANGE / MARKETPLACE
Kentucky established the policies and procedures relating to the transition from the Kentucky Health Benefit Exchange to the Kentucky State Based Exchange on the Federal Platform. 900 KAR 10:200
Wisconsin issued a bulletin to provide guidance regarding guaranteed renewability of individual policies issued through the Exchange. Bulletin dated December 7, 2016
HEALTH INSURANCE / HEALTH RATES
Georgia published a bulletin addressing 2017 Provider Directories and providing contact information for those with questions, suggestions or other feedback. Bulletin 16-EX-3
Nebraska amended its law regarding coordination of benefits by revising the definition of plan and amending the law to apply to all plans and not just group accident and health insurance plans. 210 NAC Ch. 39 s 001, 210 NAC Ch. 39 s 003, 210 NAC Ch. 39 s 004, 210 NAC Ch. 39 s 009
New Jersey amended its definition of small employer in connection with a group health plan. It amends the standards all carriers must meet in offering, issuing and renewing all health benefits plans to any small employer, the small employer's full-time employees, and the dependents of those full-time employees. NJAC 11:21-1.2+
New York amended its law to add a definition of "midwifery birth center" and includes midwifery birth centers under the definition for the term "hospital." I - AB 446
New York modified its law regarding the timeframe a health care plan has to review, make a determination on, and respond to applications submitted by health care professionals to participate in the plan's network. Senate Bill 2545, Pub. Health s 4406-d
Puerto Rico issued a ruling regarding charges in addition to health insurance coverage co-insurance or co-pay charges collected by health services providers. Ruling CN-2016-208-CM
Virgin Islands enacted legislation stating that a carrier offering health care insurance shall provide coverage for the costs of telemedicine services and treatments that are medically necessary. House Bill 466
Virginia issued an administrative letter to provide guidance to carriers offering managed care health insurance plans that include options for plan members to obtain services from non-network providers at discounted rates through a provider discount arrangement. Administrative Letter 2016-09
HEALTH MAINTENANCE ORGANIZATIONS
New Jersey amended its law and requirements for an HMO's optional benefit riders and amendments. NJAC 11:21-3.2
New York amended its law regarding consent for HIV related testing. Pub. Health s 2781, Pub. Health s 2781-a, Pub. Health s 2782
IIPRC / INTERSTATE COMPACT
The Compact published a filing information notice regarding Guaranteed Living Benefit Increases for Qualifying Events, to provide clarification of recent revisions in the GLB Standards that permit an increased guaranteed period withdrawal percentage and guaranteed lifetime withdrawal percentage for qualifying events. Filing Information Notice
INTERNAL AND EXTERNAL REVIEW
New Mexico amended its law for health insurance grievance procedures, and among other things, clarifies that it would not be applicable to self-funded plans that are subject to ERISA and amends the time to respond to an action to three days instead of three working days. 184.108.40.206 NMAC, 220.127.116.11 NMAC
LONG-TERM CARE INSURANCE
New York amended it law for long-term care insurance by requiring insurers to notify any prospective insured who reaches age 65 of their right to designate a third party to receive notices of nonpayment of premiums and potential cancellation due to nonpayment. Notice of cancellation should be sent no later than 30 days prior to cancellation. A senior citizen insured may notify the insurer of a third party designation by sending notice in the same envelope with the premium payment. It also provides that an insurer must include a copy of the third party designation form with each premium statement if the insured has not designated a third party. Senate Bill 2268, Ins s Law 3111 and Ins. Law s 1117
MEDICARE SUPPLEMENT INSURANCE
Nevada revised the requirements for filing certain annual reports for medicare supplement insurance. NAC 687B.283, NAC 687B.370
Missouri established that the annual adjusted rate of interest to be paid on unpaid amounts of taxes during the calendar year of 2017 is four percent (4%). 12 CSR 10-41.010
Puerto Rico issued a circular letter regarding cybersecurity advising that all insurers, as a minimum, must implement certain plans, equipment, and technical features with regard to information systems networks. Circular Letter CC-2016-1889-AF
Puerto Rico issued a circular letter requiring all insurers to have personnel available to handle policy and claim services in the language in which the policy was issued. Circular Letter CC-2016-1895-CM
Puerto Rico issued a circular letter to all international insurers and reinsurers regarding changes to contact information. The circular letter includes the form to be used to notify the commissioner of a change. Circular Letter CC-2016-1894-ARI
South Carolina issued a notice addressing questions regarding Emergency Regulation 69-78 and a related data call, both concerning persons affected by Hurricane Matthew. Notice dated November 17, 2016
Tennessee issued an order declaring a state of emergency effective November 28, 2016, due to wildfires in Sevier County and storms in the southeast portion of the state. Insurers are asked to make reasonable efforts to work with affected policyholders relative to suspending cancellations for non-payment of premiums. Also, the Insurance Commissioner issued a directive requesting at least a 60-day moratorium on such cancellations and allowing for 1 early or replacement refill of prescriptions. Executive Order by the Governor No. 61 and Directive 16-01
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Montana adopted rules recognizing certain mortality tables for use in determining the minimum standard of valuation for annuity and pure endowment contracts. 6.6.5301+
New Hampshire updated its list of mortality tables that are used in determining the minimum standard of valuation for annuity and pure endowment contracts. Ins 307.01+
NOTICE TO INSUREDS
Alabama amended its regulation regarding annual privacy notices such that an annual notice to a current customer is not required so long as information is provided to nonaffiliated third parties in accordance with Rules 482-1-122-.15, -.16 and -.17; and the licensee has not changed its policies relating to disclosing nonpublic personal information from those that were disclosed in its most recent disclosure sent to customers under Rule 482-122-.05 or -.06. 482-1-122-.06
Georgia published a bulletin providing guidance relative to the annual privacy notices required under the Gramm-Leach-Bliley Act, as recently amended. Bulletin 16-EX-2
Louisiana eliminated the requirement for redundant Gramm-Leach-Bliley Act (GLBA) annual privacy notices due to recent amendments to the GLBA and provides certain exemptions for the annual privacy notice requirement. LAC 37:XIII.9901, LAC 37:XIII.9913
Montana amended its law to provide the information that must be disclosed at the time of application prior to accepting the applicant's initial premium or deposit for a funeral prearrangement that is funded or to be funded by a life insurance policy. 6.6.210
Connecticut issued a bulletin for all accredited reinsurers regarding 2016 and 2017 financial filing requirements. Bulletin Number FS-4AR-16
Montana adopted a rule regarding reinsurance including, among other things, methods of allowing credit for reinsurance, additional restrictions on government obligations and nongovernment obligations, eligibility for certification for assuming insurers and filing requirements. 6.6.3810, 6.6.3828, 6.6.3841, 6.6.3843
Nevada amended its regulation regarding reinsurance. NAC 681A s 2 (LCB File No. R079-16) +
Oklahoma amended its regulations regarding reinsurance including, among other things, credit for reinsurance, annual statements filed by an accredited reinsurer, reinsurers maintaining trust funds, and requirements for reinsurers to become certified reinsurers. It also establishes a new Certificate of Certified Reinsurer to be submitted by certified reinsurers and a new appendix for annual reinsurance review. This is an emergency rule and is effective November 1, 2016 through September 14, 2017. Emergency 365:25-7-60 through 365:25-7-73
REPORTS - ANNUAL / QUARTERLY STATEMENT
Connecticut issued a bulletin regarding annual statement filings for domestic insurers due on or before March 1. Bulletin Number FS-4-16
New York amended it law to provide that the March 2016 version of the NAIC's Accounting Practices and Procedures Manual is to be used in preparing the quarterly statements and the annual statement for 2016, which will be filed in 2017. 11 NYCRR 83.2
Rhode Island promulgated a new regulation addressing Internal Audit Function Requirements within Regulation 87, Annual Financial Reporting. R27-87-003+
REPORTS - DATA CALLS & OTHER REPORTS
Arkansas published a bulletin announcing that the Department had posted its final revised version of the Data Submission Guide for the Arkansas Healthcare Transparency Initiative. It is effective for data files submitted not less than 120 days after the posting of the DSG on the Department website. Bulletin No. 15-2016
Connecticut published a bulletin announcing that, beginning in 2017, it will participate in the Market Conduct Annual Statement data collection system through the National Association of Insurance Commissioners. Any licensed insurer writing at least $50,000.00 of gross premium in the Life, Annuity, Private Passenger Auto or Homeowner's lines of business will be required to file MCAS data with the Department. Bulletin MC-22
Nevada revised the requirements for the filing of certain reports and documentation with the Commissioner for certain life insurance products and long-term care insurance. NAC 686A.4775, NAC 686A.478, NAC 687B.057,
New Hampshire issued a bulletin concerning health claims data submission. Bulletin of November 22, 2016
New Mexico issued a bulletin to all health carriers that offer or administer health related insurance plans on the marketplace to clarify certain reporting requirements. Bulletin 2016-025
Utah promulgated a rule that each carrier covered under subsection R428-12-5 is to compile and submit enrollee satisfaction data (Consumer Assessment of Healthcare Providers and Systems survey or CAHPS) to the Utah Department of Health. Rule R428-12-3
STANDARD VALUATION LAW
Alabama adopted the 2016 version of the NAIC Valuation Manual effective January 1, 2017. 482-1-161-.01
California issued a bulletin announcing that the Valuation Manual and Principle-Based Reserving both take effect January 1, 2017. Bulletin 2016-7
South Dakota adopted a regulation declaring the operative date of the valuation manual as January 1, 2017. 20:06:59:01
Have you started filling out your 2017 calendar yet? If seeing the first DOL Rule implementation dates on the calendar left you uneasy about your own DOL implementation timeline, let First Consulting help!
First Consulting is able to provide:
• DOL Rule Consulting (geared toward your unique challenges under the rule, including what competition
is doing as well as implementation and communication strategy)
• Training (for agents, in-house marketers, management, and Board of Directors)
• Product Drafting/Filing (retooling of annuity products to compete under DOL Rule)
• Policies/Procedures (changes to internal/external policies/procedures)
• Operational Compliance (risk assessments, changes to in-house infrastructure)
• Document Review (point-of-sale documents/disclosures, compliance/suitability guides)
Our staff realizes complying with the DOL Rule takes considerable time and resources. No matter where you are in the implementation process our experienced staff is available to help you prepare for life in a DOL Rule world.
If you would like to discuss your current plans and how First Consulting can be of assistance please give me a call. We are here to help.
Have you ever wanted to ask a regulator a question but were afraid to be put on their radar? We can help.
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C. J. Rathbun, FLMI, CCEP, HIA, AIRC