Life and Health News
August 2023
Welcome to our latest newsletter! As a thought leader in the Insurance Industry for over 50 years we are always excited to share the latest sampling of insurance compliance related bulletins, regulations, and legislative activity. Please feel free to share this newsletter with others that may be interested. Contact Us with any questions on the items in this newsletter or with any other compliance related matter we can assist you with. Enjoy!
AFFORDABLE CARE ACT
The Federal Departments of Labor, Health and Human Services, and Treasury jointly issued FAQs dealing with surprise medical bills under the No Surprises Act, transparency disclosures, and their interaction with the Affordable Care Act (ACA). Part 60 of ACA FAQ's
AGENT / PRODUCER LICENSING AND APPOINTMENT
Alabama made updates to its regulation governing producer licensing, including the removal of the service representative license and the removal of prelicensing education requirements. 482-1-147
ANNUITIES / ANNUITY CONTRACTS
New York’s Life Bureau issued a Filing Guidance Note regarding Withdrawal Rates for Guaranteed Living Withdrawal Benefits in Annuities. The standards under Section 50-2.9(h)(2) are effective January 1, 2024. Filing Guidance Note dated July 12, 2023
New York's Life Bureau published a Filing Guidance Note regarding Minimum Cap Rates for Non-Guaranteed Index Annuities under 50-2.9(d)(5) of Insurance Regulation 47. Filing Guidance Note dated July 12, 2023
CLAIMS / CLAIMS ISSUES
Nebraska changed its judgment interest rate to 7.494%. If a life insurer does not pay a death claim within 30 days of receiving proof of loss, the insurer must pay interest at the rate in effect on January 1 of the calendar year in which the proof of loss was submitted to the carrier. Memo dated July 6, 2023
CYBERSECURITY
Kentucky adopted regulations addressing the requirements for establishing a cybersecurity program for those subject to the act. The regulation also outlines the procedures for required filings and reports. 806 KAR 3:250
The Texas Department of Insurance advised all regulated entities of addresses to which cybersecurity incidents may be reported. Bulletin B--0009-23
DISCRIMINATION
New Jersey's Commissioner of Insurance notifies insurance companies authorized to issue health benefit plans of requirements concerning nondiscriminatory coverage for health services provided to transgender individuals. Bulletin 23-05
New York's Department of Financial Services, Life Bureau remind insurers they cannot engage in any unfair discrimination in the sale of life insurance or annuities. Circular Letter 2023-6
FILING REQUIREMENTS / PROCEDURES
Colorado adopted amendments to its form filing requirements for certain health benefit plans and dental plans. Changes include filing procedures and certifications. 4-2-41
The New York Life Bureau issued a Filing Guidance Note for life and annuity products. Life Bureau Filing Guidance of July 17, 2023
GROUP HEALTH
Texas passed a new law authorizing Group Family Leave Insurance as a type of disability income insurance. This law applies only to family leave insurance issued by a life, health, and accident insurance company. HB 1996
HEALTH INSURANCE / HEALTH RATES
Alaska enacted an amendment to its regulations repealing the 80th percentile rules for health care providers. As a result, insurers are no longer required to pay out-of-network providers at least the 80th percentile for services rendered. 3 AAC 26.110
Arkansas issued a bulletin confirming that the prior authorization law applies to non-physicians including physical therapists, occupational therapists, and speech pathologists when they are operating within the scope of their practice. Bulletin 12-2023
California amended numerous health care statutes, including prohibiting a health insurer from requiring preauthorization for behavioral health crisis services. AB118
Colorado adopted revisions to the Medical Assistance Rule Concerning Gender-Affirming Care to align policy with the most recent standards of care. MSB 22-12-13-A; 10 CCR 2505-10 s 8.735.1
Colorado enacted legislation requiring insurers and pharmacy benefit managers to count any amount paid by the patient or through a cost-sharing assistance program against the patients out of pocket limit. SB 195
Connecticut adopted a bill amending various sections of its health care laws, including a requirement for health insurers to disclose the standards used for assigning tiers to health care providers. HB 6669
Maine enacted legislation prohibiting the requirement that a patient obtain a second opinion from a provider practicing in the same office as the primary provider. The legislation further prohibits the payment of a higher deductible or coinsurance payment for an out-of-network second opinion when no in-network provider is available. HP 630
Nevada prohibits an insurer from contracting with a vision care provider that requires the use of a specific laboratory as the manufacturer of ophthalmic devices or materials provided to covered persons, among other items. SB 134
HEALTH MAINTENANCE ORGANIZATIONS
Illinois published a bulletin clarifying the requirements of a recent amendment to the HMO Act. P.A. 103-0104 provided that an HMO may voluntarily offer a referral system to contracted providers. The bulletin clarifies that this does not mean such a referral system is required. Bulletin 2023-07
LIFE INSURANCE / LIFE CONTRACTS
New Hampshire provided updated guidance regarding permissible wellness reward programs offered with life insurance products. Bulletin INS 23-023-AB
The New York Life Bureau issued a Filing Guidance Note regarding Universal Life Nonforfeiture Rate and Paid-Up Insurance Option Rate. Filing Guidance Note dated July 12, 2023
MEDICARE SUPPLEMENT INSURANCE
Rhode Island amended its Medicare Supplement Insurance law to allow individuals enrolled in Medicare Parts A and B to apply for a Medicare Supplement plan, regardless of age, and have guaranteed issue rights if certain conditions are met. SB 583
MISCELLANEOUS
Connecticut enacted legislation designed to protect against the financial exploitation of seniors, including immunity from liability for a "qualified person" who discloses suspected exploitation in good faith. Note that the definition of qualified person includes broker dealers and investment advisors. SB 1088
OMNIBUS LEGISLATION
Nebraska enacted an omnibus bill that creates the following: 1) limits reimbursement a covered individual is required to pay for each insulin prescription drug to $35 for a 30-day supply; 2) establishes the Insurance Regulatory Sandbox Act to enable carriers to temporarily test innovative insurance products without being licensed; 3) allows the plan sponsor to consent to all electronic communications for a covered person if certain conditions are met. LB 92
PHARMACY BENEFIT MANAGERS
Florida published a bulletin notifying pharmacy benefit managers of recent changes included in the Prescription Drug Reform Act. Changes include additional reporting requirements and biennial examinations. Informational Memorandum OIR 23-04M
New Jersey established additional data reporting requirements for Pharmacy Benefit Managers and insurers. SB 1615
New York amended Regulation 195 and added Regulation 222 which provides general duties, accountability, and transparency provisions for Pharmacy Benefit Managers. 11 NYCRR 6.2
REPORTS - DATA CALLS & OTHER REPORTS
The New Jersey Insurance Commissioner announced it is conducting the Climate Risk Disclosure Survey for reporting year 2022. Completed surveys are due August 31, 2023. Bulletin 23-06
UNCLAIMED PROPERTY
Illinois enacted legislation amending certain requirements and time frames for certain types of unclaimed property. HB 2224