Life and Health News
May 2022
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
Federal Department of Labor (DOL), Health and Human Services (HHS), and the Treasury released two FAQs dated April 19, 2022, regarding safe harbors for health plans and insurers reporting certain types of in-network rates under the Transparency in Coverage Rules. FAQs About ACA Implementation Part 53
Maine's Insurance Commissioner set the uniform rate and form filing deadline for June 27, 2022, for all non-grandfathered health plans and stand-alone dental plans subject to the Affordable Care Act. This applies to all carriers that will be issuing health plans in the merged individual and small group markets. Detailed instructions for filing are included. Bulletin 463
New Mexico notified health insurers selling health benefit plans in the Small Group Market that meet QHP Standards of the small business health insurance premium relief initiative for coverage active July 1, 2022, until December 31, 2022. The Health Care Affordability Fund reduces premiums for small businesses and their employees. Bulletin 2022-006
Wisconsin's Insurance Commissioner issued a bulletin to all insurers licensed to write health insurance informing them Wisconsin is allowing for the extension of Transitional Health Insurance Plans as outlined by CMS. Detailed filing instructions are included. Bulletin dated April 15, 2022
AGENT / PRODUCER LICENSING AND APPOINTMENT
Arkansas' Insurance Department provides guidance on the annual appointment renewal process for agents and carriers under the Producer License Model Act. Agency appointments are now separate from the producer appointments and are no longer shared appointments. Bulletin 8-2022
AUTISM SPECTRUM DISORDERS
Iowa amends the major medical insurance law regarding autism spectrum disorder to define coverage and change definitions. HF 2167
Virginia's Commissioner of Insurance informs carriers and HMOs writing Accident and Sickness insurance of new requirements for coverage of autism spectrum disorder. This Bulletin also sets forth requirements of the federal Mental Health Parity and Addition Equity Act of 2008 (MHPAEA). Administrative Letter 2022-02
CLAIMS / CLAIMS ISSUES
New Mexico's Superintendent of Insurance notifies all insurance companies that it will no longer publish bulletins setting the interest rate to be used for unpaid claims. Insurers must refer to the Wall Street Journal to obtain the applicable prime lending rate. Bulletin 2022-005
CYBERSECURITY
Kentucky enacted an insurance data security law. Licensees with more than 50 employees must comply with the new law which takes effect on January 1, 2023. Licensees must develop a written information security program, investigate, and report cybersecurity events to the insurance commissioner within 3 days, and conduct risk assessments. HB 474
Maryland passes the Insurance Data Security Law effective October 1, 2022. This law established new cybersecurity and data protection requirements, provides for development of a written security program and a written incident response plan, among other items. SB 207
DISASTER / CATASTROPHIC EVENT
Louisiana's Governor extended the state of emergency provisions for Hurricane Laura once again through May 25, 2022. The Commissioner of Insurance can suspend the laws regarding cancellation, termination, nonrenewal and reinstatement provisions, rate increases, and other requirements. Proclamation 59 JBE 2022
DISCRIMINATION
Connecticut issued a notice to all entities and persons licensed by the insurance department advising of the requirement to use technology and big data in full compliance with anti-discrimination laws. A signed data certification is due by September 1, 2022, and annually thereafter. The notice contains a link to the data certification form. Notice dated April 20, 2022
FEE SCHEDULES
Arkansas implemented administrative and financial regulation fees as established in the State Insurance Department Trust Fund Act. This rule applies to all licensed insurers, domestic, foreign, or alien. The fees are due before June 1 each calendar year and are based on direct written premiums or annuity considerations, both new and renewal, written in the state during the previous calendar year. Rule 56
Arkansas promulgated a rule creating a new antifraud assessment for all licensed insurers and HMOs. The assessment is due before June 1 each calendar year and is based on the amount of direct premiums and/or annuity considerations written or received in Arkansas during the previous calendar year. Rule 5
FILING REQUIREMENTS / PROCEDURES
Colorado amended its regulation dealing with form filings for certain Limited Benefit Health Plans, Credit Life, and Health, Preneed Funeral Contracts, Excess Stop Loss Insurance forms, Sickness and Accident insurance and other Limited Benefit Health Plans. A required notice must be placed on the face page of Limited Benefit Health coverage and on certain dental plans. Certain annual certifications are required, and filing instructions are included. 3 CCR 702-4, Regulation 4-2-40
HEALTH INSURANCE - COMPREHENSIVE
Arkansas issued rules for health insurers outlining coverage for craniofacial anomaly reconstructive surgery and recommended treatment. Rule 111
Nebraska requires an individual or group sickness and accident policy to cover screening coverage for a colorectal cancer examination and laboratory tests for cancer for any non-symptomatic person aged 45 (previously 50) or older. 44-7,102
HEALTH MAINTENANCE ORGANIZATIONS
Illinois amended the Managed Care Reform and Patient Rights Act. The amendments require a health care plan to apply any third-party payments, financial assistance, product vouchers, discounts, or any other reduction in out-of-pocket expenses for prescription drugs to an individual's co-pay or deductible. HB 4433; 215 IL:CAS 134/30
HOLDING COMPANIES
Nebraska passed a law requiring certain Holding Companies to file an annual group capital calculation and liquidity stress test. LB 863; 44-2138
Ohio enacted the requirement for certain holding companies to file a group capital calculation with the lead state commissioner no later than June 1, 2023. Exemptions from filing are set forth. SB 256; 3901.33
MENTAL HEALTH PARITY
Maine amends the Health Plan Improvement Act to apply federal mental health parity laws. HB 1355; 24-A 4320-R
NONFORFEITURE
Ohio changed the minimum standard nonforfeiture percentage for individual deferred annuities from 1% to 0.15%. SB 256; 3915.073
REGULATORY REPORTING REQUIREMENTS
Arkansas informs all licensed insurers and HMOs that are required to report and pay premium taxes, Antifraud Fee, or Companies Financial Regulation Fee that the use of OPTins is mandatory. Paper checks and forms will be returned. Bulletin 7-2022
TRADE PRACTICES
Ohio enacted a law making it an unfair trade practice for a producer to offer or provide insurance as an inducement to the purchase of another policy of insurance. Further, the use of the words "free" or "no cost" or words of similar import cannot be used in an advertisement. SB 256; 3901.21
TRAVEL INSURANCE
Iowa passed the Travel Insurance Model Act. This law covers all aspects of travel insurance from benefits and policy form language to limited lines travel insurance producers, plus other requirements. HF 2540
Ohio amended its travel insurance law to define policy benefits, rate filings, advertising, pre-existing conditions, disclosures, cancellation, and limited lines agent licensing, among other items. 3905.065