Life and Health News
August 2018
Welcome to our latest newsletter! As a thought leader in the Insurance Industry for over 49 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!
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ADJUSTERS
Nevada amended prelicensing and continuing education requirements for applicants for a license as an adjuster or an associate adjuster. NAC 684A (R028-18)
AGENT / PRODUCER CONTINUING EDUCATION
Nebraska issued a bulletin stating that insurance producers are eligible to receive up to six continuing education credits for active participation in a professional insurance association. The bulletin defines what active participation means and what qualifies as a professional insurance association in order to earn these continuing education credits. Bulletin CB-141
Rhode Island has amended regulations regarding continuing education for insurance producers. Amendments were made to approved courses as well as approved providers and course submissions. 230-RICR-20-50-2.7; 230-RICR-20-50-2.8
AGENT / PRODUCER LICENSING AND APPOINTMENT
California issued a notice regarding individual tax identification numbers now accepted for individual license applications and license renewals, and prelicensing and continuing education. Notice dated May 31, 2018
Hawaii issued a memorandum announcing postponement of the effective date of requirements regarding elimination of producer-to producer appointments and terminations of appointments. Memorandum 2018-3LIC
Michigan has issued a bulletin warning against "insurance sliding" by insurance producers. "Sliding" is defined in the bulletin as failure to disclose all products and services included in an insurance transaction, resulting in excessive charges to the customer. Bulletin No. 2018-12-INS
Utah issued a bulletin exempting licensing fees for certain military individuals, or their spouses, serving in the armed forces of the United States. Instructions for processing these applications and renewals are given in the bulletin. Bulletin 2018-3
AGENT / PRODUCER TERMINATION
Colorado issued a bulletin regarding the standardized form for insurers to use to notify the Department of termination for cause for any licensed producer. Bulletin No. B-1.32
AUTISM SPECTRUM DISORDERS
North Dakota issued a bulletin regarding coverage of treatments for autism spectrum disorder. Bulletin 2018-1
CLAIMS / CLAIMS ISSUES
Louisiana amended and re-enacted the non-discrimination provision for the selection of treatment and reimbursement for chiropractic services, effective August 1, 2018. Directive 212; La. R.S. 22:995
New Mexico issued a bulletin stating any insurer issuing any policy, certificate or contract of insurance which fails for a period of 45 days, after required proof of loss has been furnished, to pay to the person entitled the amount due shall be liable for the amount due and unpaid with interest at 1.5 times the prime lending rate as determined by the superintendent. Effective 07-01-18, the interest rate is 7.125%. Bulletin 2018-006
CONFIDENTIALITY / PRIVACY
California enacted the Consumer Privacy Act of 2018, effective January 1, 2019. AB 375; Civ s 1798.100+
CYBERSECURITY
South Carolina's governor has signed into law the Insurance Data Security Act. The purpose of the act is to establish standards for data security and for the investigation of and notification to the director of a cybersecurity event. The Department of Insurance issued a bulletin concerning implementation of this legislation. Notice of May 8, 2018, Bulletin 2018-02
DEFERRAL OF CASH SURRENDER BENEFITS
Idaho issued a bulletin regarding rate of interest on deferred payment of cash surrender values for life insurance and annuities. Bulletin 18-05
DRUG / PRESCRIPTION COVERAGE
Hawaii enacted legislation establishing a working group to address reimbursement by health insurance for medical cannabis for qualifying patients. S.B. NO. 2488
Hawaii enacted legislation relating to medication synchronization. HB 2145, 431:10A+
Maryland lifted its prescription medication refill waiver and waiver of the time restriction on the replacement of durable medical equipment or supplies, eyeglasses, and dentures for health insurance. Bulletin 18-14
Rhode Island enacted a law concerning full year coverage for contraception for health insurance contracts, effective April 1, 2019. HB 7625; 27-18-57; 27-19-48; 27-20-43; 27-41-59
FINANCIAL EXAMINATIONS
Pennsylvania issued a notice updating its schedule of per diem charges for financial examinations conducted by the Insurance Department. Notice 2018-06
GROUP HEALTH
Hawaii amended its regulation regarding association health plans. Association health plans are required to comply with the laws of Hawaii regardless of the situs state for the association. H.B. NO. 2208; 431:3-203; 431:8-201
GUARANTY ASSOCIATION
Alaska amended its regulations relating to the Alaska Life and Health Insurance Guaranty Association, effective July 1, 2018. Among other things, the revisions add definitions and exclusions, and require hospitals, medical service corporations and HMOs to become members of the association. HB 403
HEALTH CARE EXCHANGE / MARKETPLACE
Rhode Island enacted legislation allowing the state Health Benefit Exchange to seek a waiver under the Affordable Care Act to allow small business owners to purchase health plans offered by the exchange to the small group market. SB 2019; 42-157-5.1
The Federally-facilitated Exchange and Federally-facilitated Small Business Health Options Program Enrollment Manual is effective as of June 26, 2018, and all enrollments should be processed in accordance with the standards in this manual. All previous versions are superseded by this manual. Regulatory Activity FFE FFSHOP Enrollment Manual
HEALTH INSURANCE / HEALTH RATES
California amended its regulation regarding family temporary disability insurance benefits, effective January 1, 2019. Assembly Bill No. 2587; UIC s 3303.1
Hawaii amended its regulation regarding extension of dependent coverage, prohibition of preexisting conditions exclusions, and prohibition of discrimination in premiums or contributions based on gender, effective July 5, 2018. S.B. 2340
Hawaii enacted a law regarding short-term limited-duration health insurance. Companies are prohibited from renewing a short-term limited-duration health insurance policy if the individual is eligible to purchase health insurance through the federal marketplace. Uncodified HB 1520 s 1 (2018); 431:10A-102.5
Montana issued an informational bulletin extending the Centers for Medicare & Medicaid Services transitional policy to policy years beginning on or before October 1, 2019. Informational Bulletin dated June 29, 2018
Rhode Island amended its law regarding insurance coverage for mental illness and substance abuse. HB 7806 Substitute A; 27-38.2-1; 42-14.5-3
Rhode Island enacted a law regarding mastectomy treatment coverage. HB 7002; 27-18-39; 27-19-34; 27-20-29; 27-41-43
Rhode Island enacted the Rhode Island Market Stability and Reinsurance Act to provide greater financial certainty to consumers of health insurance, effective July 2, 2018. 42-157.1-1; 42-157.1-2; 42-157.1-3; 42-157.1-4; 42-157.1-5; 42-157.1-6; 42-157.1-7
Vermont enacted a law relating to copayment limits for chiropractic care and physical therapy. SB 1; T. 8 s 4088a; T. 8 s 4088k
MARKET CONDUCT EXAMINATIONS
Pennsylvania issued a notice updating its yearly schedule of per diem charges for market conduct examinations by the Department. Notice 2018-07
MISCELLANEOUS HEALTH / ACCIDENT
Vermont issued a bulletin regarding transitional guidance for Health Benefit Associations for matters relating to board composition and official documents. Bulletin 201
NOTICE TO INSUREDS
Rhode Island enacted a law regarding a required notice regarding alternatives to the lapse and surrender of life insurance policies. 2018 - S 2048 Substitute A; 27-4.10-1; 27-4.10-2
PREMIUM TAX
New Mexico issued a bulletin regarding application of medical insurance pool credits to premium tax liability. Bulletin 2018-005; NMSA 1978 Sections 59A-6-5(B) and 59A-54-10
New Mexico issued a bulletin requiring all premium tax reports to be filed electronically, in accordance with OSI forms and instructions. This is effective immediately. Bulletin 2018-007
UNCLAIMED BENEFITS
Hawaii adopted the National Conference of Insurance Legislators' Model Unclaimed Life Insurance Benefits Act, effective July 10, 2018. SB 208 s 1:431-A+
UTILIZATION REVIEW - HEALTH CARE
Alaska issued a bulletin concerning utilization review, benefit determinations, grievance procedures, and external review regulations. Bulletin B 18-10