Life and Health News
Welcome to our latest newsletter! As a thought leader in the Insurance Industry for over 48 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
Connecticut issued a bulletin regarding a moratorium on the health insurance provider fee created by the Affordable Care Act. Bulletin HC-119
AGENT / PRODUCER CONTINUING EDUCATION
Nebraska amended its law to change continuing education requirements. LEGISLATIVE BILL 486
New Mexico amended its regulation regarding continuing education requirements by revising definitions, the requirements for licensees and the number of continuing education hours required. 184.108.40.206 NMAC+
AGENT / PRODUCER LICENSING AND APPOINTMENT
Alaska issued a bulletin advising that the renewal window for licensees and registrants was extended from 60 to 90 days effective February 9, 2018. Any licensed or registered entity may renew their credentials up to 90 days prior to the respective expiration date. Bulletin B 18-03
Hawaii published a memorandum to announce that all active licensees may now print their active insurance licenses at no cost online. The change became effective on February 5, 2018. Memorandum 2018-1LIC
South Dakota revised certain licensing renewal procedures for business insurance producers. House Bill 1033
Delaware issued a bulletin to captive insurance companies advising that this year's annual reporting and tax premium payment deadlines have been extended from March 1, 2018 to April 15, 2018. Captive Insurance Bulletin 9
Vermont amended its law to require that specified captive insurance companies submit to the Commissioner an annual report of its financial condition by March 15 of each year. House Bill 694
CERTIFICATE OF AUTHORITY FILINGS
Vermont issued a bulletin regarding revised criteria for companies seeking authorization to transact insurance in the state. Bulletin 43 (Revised)
CLAIMS / CLAIMS ISSUES
Indiana issued a bulletin to all accident and sickness insurers to clarify and update the interest rate for failure to pay a clean claim. Bulletin 240
New Mexico issued a bulletin regarding the interest rate applicable to certain unpaid claims 45 days after required proof of loss has been provided. Bulletin 2018-002
CONFIDENTIALITY / PRIVACY
Nebraska amended its law to require additional reasonable security procedures and practices regarding personal information. Entities that own, license, or maintain computerized data that includes personal information about a resident of Nebraska must maintain certain security procedures and practices. LEGISLATIVE BILL 757
Virginia amended its law relating to the disclosure of health records. House Bill 301
CREDIT FOR REINSURANCE
Tennessee amended its regulation regarding credit for reinsurance and no longer allows credit for reinsurance to a domestic ceding insurer as either an asset or a deduction from liabilities. 0780-1-63-.01+
New Hampshire readopted its regulation pertaining to credit life and credit accident and health insurance with some minor amendments. Ins 1201.01+
DISASTER / CATASTROPHIC EVENT
Ohio issued a bulletin that pertains to all insurance companies requesting that they allow their insureds impacted by the state of emergency declared on February 24, 2018 to defer premium payments coming due and extend any and all provisions imposing time constraints within which insureds must take certain action. Bulletin 2018-01
Rhode Island issued a bulletin providing the language for the life insurance buyer's guide. Bulletin 2018-2
The Securities and Exchange Commission published interpretive guidance to assist companies in preparing disclosures about cybersecurity risks and incidents. Interpretive Guidance dated February 26, 2018
DRUG / PRESCRIPTION COVERAGE
Mississippi enacted legislation to require an individual or group health insurance policy providing prescription drug coverage to apply a prorated daily cost-sharing rate to prescriptions that are dispensed by a network pharmacy for a partial supply under certain circumstances. Senate Bill 2296
New Mexico enacted legislation establishing guidelines relating to step therapy for prescription drug coverage. Senate Bill 11
Vermont published a bulletin to provide clarification on the out-of-pocket maximum for prescription drug coverage under health plans. Bulletin 171
Virginia amended its definition of electronic communication in the Virginia Freedom of Information Act. House Bill 906
Colorado issued a bulletin to clarify that certain products must not be marketed or represented as substitutes for health benefit plans. It also provides guidance on excepted benefits. Bulletin No. B-4.72
FILING REQUIREMENTS / PROCEDURES
Puerto Rico published a ruling to provide guidance on health insurance form and rate filing requirements effective for calendar year 2019. Ruling CN-2018-236-AS
Arkansas issued a bulletin advising that the effective date for the use of the accounting practices and procedure manual for Arkansas domestic reporting entities shall be for the Annual Statement as of December 31, 2018, to be filed with the Department on or before March 1, 2019. BULLETIN NO. 2-2018
Nebraska amended its regulation to provide that the audit committee of an insurer is responsible for overseeing the insurer's internal audit function. It provides internal audit function requirements and exemptions. 210 NAC Ch. 56 s 1+
New York published a notice for life insurers advising that the Liquidity and Severe Mortality Inquiry must be completed by the Chief Financial Officer (or highest ranking financial officer) of the insurer and should be submitted via the Department's Portal by May 1, 2018. Liquidity and Severe Mortality Inquiry notice dated February 20, 2018
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HEALTH CARE EXCHANGE / MARKETPLACE
California amended the requirements for the program application for individuals or entities who are seeking certification to be a Certified Plan Based Enrollment Entity (PBEE) or a Certified Plan-Based Enroller (PBE). T. 10 s 6704
The Centers for Medicare & Medicaid Services (CMS) will implement an optional program to allow qualified health plan issuers in the Federally-facilitated Exchange and State-based Exchanges on the Federal Platform to integrate an application for Marketplace coverage through the FFE with the standalone eligibility service to host application and enrollment services on their own website. CMS Notice dated February 21, 2018
HEALTH INSURANCE / HEALTH RATES
Arizona enacted legislation pertaining to health care service plans regarding prior authorization requirements and exceptions. Senate Bill 1001, 20-3401+
Colorado amended its regulation pertaining to the replacement of individual accident and sickness to remove the exception for Medicare supplement insurance and provides additional rules for the replacement of health benefit plans. It provides delivery notice requirements for direct response carriers. 3 CCR 702 Reg. 4-2-1 s 1+
Colorado amended its regulation that sets forth the standardized format for section names and placement of those section names in policy forms issued by health carriers to indicate that the regulation applies to short-term limited duration insurance policies but not travel insurance policies. 3 CCR 702 Reg. 4-2-34 s 3
Colorado issued a bulletin to provide carriers with guidance needed to submit reasonable modifications to existing health benefit plans. The bulletin also includes the elements required for a submission. Bulletin B-4.65
Michigan issued a bulletin that supersedes Bulletin 2016-23-INS. It notifies issuers of fixed indemnity and hospital indemnity plans with effective dates on or after January 1, 2019, that the required disclaimer language must be modified to exclude language relating to the individual shared responsibility penalty. Bulletin No. 2018-04-INS
Nebraska amended its law relating to health insurance to provide requirements for coverage of insureds in temporary jail custody. LEGISLATIVE BILL 480
New Hampshire adopted new rules to standardize and simplify the terms and coverages of individual ancillary health insurance policies, group ancillary health policies and certificates, and blanket policies and certificates providing ancillary health insurance. Ins 6001.01+
New Hampshire amended its law to require insurers of medical or hospital expenses to provide coverage for the costs of blood lead testing under certain circumstances. Senate Bill 247, 415:18-aa, 415:6-v
New Jersey revised its law to require health benefits coverage for donated human breast milk under specified conditions. Senate Bill 2976, 17B:26-2.1kk, 17B:27-46.1qq
South Dakota enacted legislation to require certain health benefit plans to provide coverage to persons with a serious medical condition for certain dental care services. House Bill 1205
Vermont enacted legislation allowing silver-level nonqualified health benefit plans to be offered outside the Vermont Health Benefit Exchange. Senate Bill 19
Washington enacted legislation requiring health plans to cover, with no cost sharing, all preventive services required to be covered under federal law as of December 31, 2016. House Bill 1523, Uncodified HB 1523 s 1 (2017)
HEALTH MAINTENANCE ORGANIZATIONS
Michigan amended its law to provide clarification that health maintenance organizations are exempt from the taxes imposed on gross premiums under the Income Tax Act. House Bill 4950, 206.635
Nebraska amended its law to eliminate written informed consent and exemption provisions for human immunodeficiency virus infections. LEGISLATIVE BILL 285
HIV INFORMED CONSENT
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LONG-TERM CARE INSURANCE
New Hampshire amended its regulation regarding the standards and reporting requirements for approved long-term care partnership policies and certificates and inflation protection requirements for long-term care partnership policies. Ins 3602.06, Ins 3602.07
MEDICARE SUPPLEMENT INSURANCE
Arkansas amended its minimum standards for Medicare Supplement benefit plans and the required disclosure provisions for Medicare Supplement plans sold on or after January 1, 2020. Rule and Regulation 27 s 9.1 +
Louisiana revised an advisory letter to provide clarification on the applicability of the provider fee for health care services provided under Medicare advantage plans. Advisory Letter No. 16-01 (Revised)
Missouri issued a bulletin to provide guidance to Medicare Supplement providers regarding potential impacts from the recently enacted federal legislation regarding Social Security Numbers on Medicare cards. Bulletin 18-02
South Dakota amended its law to specify when a domestic mutual insurer may reorganize or convert into a corporation with capital stock. House Bill 1042
South Dakota enacted legislation to authorize certain insurance transactions and policies in languages other than English. House Bill 1093, Uncodified HB 1093 s 1 (2018)+
New Mexico enacted legislation to create the "Insurance Premium Tax Act" that imposes a premium tax at a rate of three and three-thousandths percent of the gross premiums, membership and policy fees received, provides due dates for each calendar quarter and provides certain exemptions. House Bill 223
Colorado advised that Bulletin B-2.9 concerning the use of authorized examiners for the examination of pre-need contract sellers and the appeal process for examination expenses was withdrawn effective March 2, 2018. Bulletin B-2.9
REGULATORY REPORTING REQUIREMENTS
Texas issued a mandatory health care claims reimbursement rate report data call to preferred provider group benefit plans and group health maintenance organization plans. Submissions are due to the Department on May 1, 2018. Bulletin B-0003-18
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REPORTS - ANNUAL / QUARTERLY STATEMENT
Virginia amended its law pertaining to annual reports of domestic and foreign corporations. Senate Bill 387
REPORTS - DATA CALLS & OTHER REPORTS
California issued a notice providing a reminder of the reporting requirements for administrative actions and criminal convictions for all licensees and applicants. Licensing Notice dated February 15, 2018
Iowa amended its law relating to the maximum value of investments in CM3-classified mezzanine real estate loans as a percentage of a life insurance company's or association's legal reserve from two percent to three percent. House File 2175, 511.8
SMALL EMPLOYER GROUPS
New Hampshire issued a bulletin to all health and dental insurers to advise that it is in the best interest of consumers and employers to allow the introduction of new small group plans more frequently than annually, a change from the Department's prior guidance. The Department will now accept form and rate filings for new small group products and plans with effective dates on the calendar quarter beginning July 1, 2018. Bulletin INS-18-006-AB of February 12, 2018
STANDARD VALUATION LAW
Nebraska issued a bulletin advising that for the 2018 reporting year, the Director adopted the updates made to the valuation manual which were fully adopted by the National Association of Insurance Commissioners as of August 9, 2017. Bulletin CB-138
South Dakota enacted legislation to require certain insurance companies to identify and locate beneficiaries on life policies and annuity contracts. House Bill 1034, Uncodified HB 1034 s 1 (2018)+
UTILIZATION REVIEW - HEALTH CARE
Alaska adopted a new regulation pertaining to health care insurers utilization review requirements, procedures for standard and expedited utilization review and benefit determinations, confidentiality requirements, disclosure requirements and grievance reporting procedures. 3 AAC 28.900+
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