Life and Health News June 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.

New Jersey adopted a regulation pertaining to accelerated death benefit provisions of individual and group life insurance policies. It makes accelerated death benefit rules more consistent with the Interstate Insurance Product Regulation Commission (IIPRC) standards.     Rule 11:4-30.2+

Kentucky issued an advisory opinion clarifying coverage requirements for Autism Spectrum Disorders.     Advisory Opinion 2012-4

Michigan created an autism coverage reimbursement program to encourage health insurers to provide autism coverage.     Senate Bill 981

New Jersey adopted a regulation setting forth the admission procedures and financial reporting requirements for captive insurers.     Rule 11:28-1.1+

Delaware issued an additional amendment to its Bulletin providing guidance for the implementation of the Civil Union and Equality Act of 2011, and deleted the requirement for "annually thereafter" notice.     Domestic Foreign Insurers Bulletin 46 (Amended) (#2)

Illinois issued a bulletin clarifying that product submission filing fees will no longer be billed.  Filing fees will be required to be submitted via EFT for all SERFF filings.     Bulletin CB2012-03

Idaho amended regulations which supplement permitted mortality tables for use in determining minimum standard of valuation for annuity and pure endowment contracts.  The amendments incorporate the 1994 GAR Table and Annuity 2000 Mortality Table by reference.     Rule 18.01.46

Washington updated its general calculation requirements for basic reserves and premium deficiency reserves.     WAC 284-74-340

Alabama enacted legislation pertaining to insurance fraud, which among other things, requires a fraud warning on certain forms, defines fraud, provides requirements on confidentiality, mandatory reporting requirements and fraud units.     House Bill 323

Colorado has amended its regulations concerning the reporting of suspected insurance fraud.     3 CO ADC INS 6-5-1

Delaware issued a bulletin informing insurers that the Insurance Fraud Prevention Bureau's fee assessment amount has been increased to $750.00 from $550.00. All companies are required to submit the additional payment of $200.00 on or before June 15, 2012.     Bulletin 49

Maryland issued a bulletin regarding recent changes in requirements pertaining to fraud disclosure statements on insurance applications.  The bulletin notes that the change is a substantive change and requires that insurance applications bearing the prior fraud disclosure statement be revised and submitted for approval.     Bulletin 12-07

Oklahoma amended its regulation relating to notification of suspected fraud.     Senate Bill 1060

Oklahoma enacted legislation pertaining to insurance fraud, which among other things, modifies penalties, expands the investigatory scope of the anti-fraud unit and provides for immunity for persons reporting insurance fraud.     Senate Bill 1439

New Hampshire amended its group disability insurance claim standards.     Ins Rule 3901

New Hampshire readopted a rule the provides the minimum requirements for processing group disability benefits.     Ins 3900

Maine enacted legislation pertaining to rating on the basis of group size in the small group health insurance market.     S.P. 569

Texas amended its premium contribution and participation requirements applicable to guaranteed issue small employer health benefit plans.     28 TAC § 26.8

Alabama has amended its Life and Disability Insurance Guaranty Association law providing that payees under a structured settlement annuity are covered based on residency of the payee.     House Bill 403

Georgia amended various sections of the Georgia Life and Health Guaranty Association Act.     House Bill 786

Iowa issued a bulletin to clarify when a summary document is required as explained in Bulletin 12-02.  It is not intended to be furnished with policies or contracts from companies which are not members of the Iowa Life and Health Insurance Guaranty Association.     Bulletin 12-03

Arizona enacted legislation providing the subtraction from adjusted gross income for long-term care insurance.     House Bill 2713

Louisiana enacted legislation to provide for prompt payment of long-term care insurance claims.     House Bill 564

Vermont issued a bulletin notifying managed care organizations how the Department handles confidentiality requests included with managed care filings.     Bulletin 168

Oklahoma increased from $25 to $100 the allowable aggregate value of inducements offered in connection with any insurance transaction.     Senate Bill 1152

Oklahoma revised the time frame for the financial examination of every domestic insurer licensed in the state and allows the Commissioner to adopt rules setting forth criteria and factors which may require an examination prior to the end of the examination time frame.     House Bill 2318

Florida enacted legislation regarding the effect of divorce, dissolution, or invalidity of marriage on disposition of certain assets at death.     House Bill 401

Louisiana authorized domestic insurers to invest in certain master limited partnerships.     House Bill 229

Maryland issued a bulletin reminding insurers of reporting requirements for slavery era insurance policies.  An insurer that fails to comply with the reporting requirement may be subject to appropriate enforcement action, including but not limited to the assessment of a monetary penalty.     Bulletin 12-08

Oklahoma amended legislation relating to confidentiality of information.     Senate Bill 1371

West Virginia amended its law setting forth rules and procedural requirements for insurance holding companies based on the NAIC model.     Rule 114-35

Georgia enacted legislation applicable for individual health insurers offering comprehensive health insurance.  This new legislation prescribes coverage through child-only health policies, establishes a uniform open enrollment period, provides for guaranteed-issue coverage regardless of health status and prohibits pre-existing exclusions for children under the age of 19.     House Bill 1166

Massachusetts enacted legislation requiring select or limited network health plans to continue to provide coverage for medically necessary services that are part of an ongoing treatment program for a patient, prior to joining the network under certain circumstances.     Senate Bill 2148

Oklahoma amended the Small Employer Health Insurance Reform Act, which among other things, exempts certain health benefits plans and provides that a small employer carrier is not required to offer a health benefit plan to certain small employers.     Senate Bill 1621

Vermont enacted legislation regarding health insurance plan providing coverage for naturopathic physicians under certain circumstances.     Senate Bill 415

Vermont enacted legislation requiring health insurance coverage for early childhood developmental disorders, including autism spectrum disorders.     Senate Bill 223

Florida amended legislation regarding the Commissioners Standard Ordinary (CSO) Preferred Mortality Tables for determining reserve liabilities for ordinary life insurance.     Rule 69O-162.203

Georgia enacted legislation which amended, among other things, provisions regarding admissibility of examination documents as evidence, premium taxes and credit for reinsurance.     Senate Bill 385

Minnesota enacted legislation, which among other things, revised provisions related to health care, continuing care and chemical dependency.     House Bill 2294

Oklahoma amended provisions, which among other things, are related to producer licensing examinations, eligible investments, termination of certain group employee insurance coverage, carrier notice requirements and the right to continuation of health insurance coverage in certain circumstances.     House Bill 2453

New Mexico issued a bulletin to all life and health insurers that issue or renew health benefit policies subject to the Patient Protection and Affordable Care regarding health rate change filings requirements.     Bulletin 2012-006

Washington extended and updated its emergency rules bringing requirements for nongrandfathered health plans into compliance with the Patient Protection and Affordable Care Act for the review of adverse benefit determinations.     WAC 284-43-500, WAC 284-43-505, WAC 284-43-510, WAC 284-43-515, WAC 284-43-520, WAC 284-43-525

Indiana issued a bulletin extending the expiration date of the Hoosier Business Investment Tax Credit to December 31, 2016.     Bulletin 95

Michigan issued a bulletin that establishes the annual rate of interest due on underpayments and overpayments for the period beginning on July 1, 2012, and ending on December 30, 2012.     Bulletin 2012-3-RAB

Connecticut enacted legislation which provides for the assignment of a death benefit payable under an individual or group life insurance policy for the purpose of funding a funeral service contract.     House Bill 5498

The District of Columbia amended its regulation pertaining to pre-need funeral contracts, which among other things, include provisions for the types of pre-need funeral contracts, contents of valid pre-need funeral contracts, recordkeeping requirements, reports to the Board of Funeral Directors, cancellation of contracts, pre-need funeral contract funding, deposit of pre-need funds, and new definitions.     Rule T. 17 §17-3117+, 17-3199

Hawaii amended its producer training requirements.     Senate Bill 2768

The District of Columbia enacted legislation, which, among other things, authorizes the Insurance Department to require fingerprint-based national criminal background history record checks of applicants for certain charters, licenses, and registrations.     Bill 19-198

West Virginia amended its regulation on continuing education for individual insurance producers and its regulations concerning producer license requirements.    Rule 114-42, Rule 114-2-1+

Pennsylvania amended legislation providing for filing of a RBC report that indicates the insurer's total adjusted capital is greater than or equal to its company action level RBC but less than the product of its authorized control level RBC and 3.0.     House Bill 2134

Vermont established a procedure and substantive standards for the application and court approval of transfers of structured settlement payment rights. It also defines applicable terms and clarifies the rights and responsibilities of the parties involved during and after such a transfer.     House Bill 778

Kentucky amended its regulation regarding suitability in annuity transactions.     806 KAR 12:120

Washington updated its requirements on disclosures and the suitability of sales of annuities, as well as its duties of insurers and insurance producers.     WAC 284-17-265, WAC 284-23-390

Alabama enacted legislation requiring unclaimed death benefits to revert to the state under the state's unclaimed property laws when certain conditions are met. Insurers are required to search the death master file for unreported deaths of insureds, notify the State Treasurer if no one entitled to claim payment can be found, and to submit any unclaimed life insurance benefits or unclaimed retained asset account, plus interest, to the State Treasurer.     House Bill 126

Maryland enacted legislation requiring insurers to perform a comparison of their in-force life insurance policies, annuity contracts, and retained asset accounts against a specified death master file in order to identify any death benefit payments that may be due as a result of the death of an insured, annuitant, or account holder.     Senate Bill 77

Oklahoma enacted legislation regarding actions denying or refusing to accept an application for life insurance, or refusing to renew, cancel, restrict or otherwise terminate a policy of life insurance, or charge a different rate based upon the lawful travel destination.     House Bill 1968

Product Filings 

Our team can handle state insurance department filings, as well as Interstate Compact filings. We process any size form or rate filing from nationwide to a single insurance department.

Whether your company’s need is a rush filing, or the development of a new product, First Consulting is the answer for truly professional assistance from drafting to approval.

Contact me today to see how we can serve as a resource for your product development and filing needs.


Sean Cox


First Consulting can help with UCAA filings 

If your Company is planning action such as a name change, re-domestication, acquisition, merger, or adding of a new jurisdiction or line of business, these actions will require a change in your certificate of authority.

Our experienced staff can help with the Uniform Certificate of Authority Application (UCAA) developed by the NAIC and we are familiar with the various state-specific requirements that exist. First Consulting can handle these services and free your staff for other functions and projects.

Call or email me today to get more details about our services.


Scott Sheffer


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