Life and Health News

December 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!


AFFORDABLE CARE ACT

The Department of the Treasury adopted a rule regarding religious exemptions and accommodations for coverage of certain preventive services, including contraceptive coverage, under the Affordable Care Act, effective January 14, 2019.     26 CFR 54.9815-2713 Dated 11-15-2018


CERTIFICATE OF AUTHORITY FILINGS

New Mexico issued a bulletin that withdraws and replaces Bulletin 2017-011.  To address concerns presented by insurers and the Office of Superintendent of Insurance (OSI) staff relating to the scope of previously and prospectively issued Certificates of Authority (COA), the National Association of Insurance Commissioners, in coordination with OSI, will modify the OSI-specific State Based System architecture to accommodate COA designations that identify the lines and types of authority that an insurer may transact.     Bulletin 2018-015


CONFIDENTIALITY / PRIVACY

Connecticut amended regulations relating to the required annual privacy notice provided to consumers. The change adds language that exempts the annual disclosure requirement in certain situations.  The change was effective October 5, 2018.     38a-8-108

Nevada adopted regulations requiring licensees to implement programs of security for customer information.  The regulations also exempt licensees from providing annual notices of privacy policies and practices to customers under certain circumstances.     NAC 679B, 679B.800, 679B.844


CORPORATE GOVERNANCE

Pennsylvania amended Title 40 of the Pennsylvania Consolidated Statutes providing for corporate governance annual disclosure; and, in reserve liabilities, further providing requirements for small company exemption.     SB 1205; 40-3901 thru 40-3911, 40-7142

Tennessee issued rules regarding filing corporate governance annual disclosures.     0780-01-35

Washington adopted rules setting forth the procedures and required contents for filing the corporate governance annual disclosure.     284-07-700 thru 284-07-740


CREDIT INSURANCE

South Carolina issued an order regarding rates for credit accident and health insurance sold in conjunction with loans.     Order 2018-05


CYBERSECURITY

South Carolina issued a bulletin regarding exemptions from the information security program requirements.     Bulletin 2018-12


DRUG / PRESCRIPTION COVERAGE

California approved SB 1021 regarding prescription drug coverage. The bill extends certain provisions until January 1, 2024 including prohibiting a drug formulary from containing more than 4 tiers and provides that the insured is not required to pay more than the retail price for a prescription drug if a pharmacy’s retail price is less than the applicable copayment.     SB 1021


FILING REQUIREMENTS / PROCEDURES

Virginia issued an Administrative Letter announcing a new online Company Assessment Filing Portal for electronic submissions for special assessment filings and payments. The portal must be used beginning January 1, 2019.     Administrative Letter 2018-15


FRAUD / ANTI-FRAUD

Michigan Executive Order 2018-9 gives authority to the Department of Insurance and Financial Services to establish an Anti-Fraud Unit to investigate fraud and obtain the information required to enforce Michigan Law.     Executive Order 2018-9


HEALTH CARE EXCHANGE / MARKETPLACE

Maryland issued a bulletin to provide guidance to carriers regarding required filings for an exemption from participation in the Maryland Health Benefit Exchange in 2019.     Bulletin 18-21


HEALTH INSURANCE / HEALTH RATES

California approved AB 2193 which requires that, by July 1, 2019, licensed health care practitioners who provide prenatal or postpartum care offer to screen a mother for maternal mental health conditions, and requires that health insurers develop a maternal mental health program.     AB 2193

Connecticut issued Bulletin HC-124 which rescinds and replaces Bulletin HC-109 Maximum Cost Sharing that was issued on February 5, 2016. The purpose of this bulletin is to eliminate maximum copayment amounts for specified categories of benefits for health insurance plans, with the exception of those cost sharing maximums set by statute, and instead using the federal Actuarial Value (AV) calculator.     Bulletin HC-124

Delaware adopted emergency regulation 1320 to provide minimum standards for Short-term, limited duration (STLD) health insurance plans.     Regulation 1320

New Hampshire readopted a rule regarding Ancillary Health Minimum Standards for Hospital Confinement Fixed Indemnity and Other Fixed Indemnity Coverage, effective November 5, 2018.     Ins. 6202

New Jersey issued a bulletin to advise carriers and brokers, that newly adopted federal regulations (83 Fed. Reg. § 38212) do not preempt New Jersey’s laws and regulations as they relate to short-term, limited-duration insurance policies.     Bulletin No. 18-12

Washington adopted regulations clarifying standards relative to the filing and sale of short-term limited duration medical plans in Washington.     WAC 284-43-8000, 284-43-8010, 284-43-8020, 284-43-8030


IIPRC / INTERSTATE COMPACT

The Interstate Compact Commission issued a revised Filing Information Notice to explain the process for filing and review of product filings under the Uniform Standards for Individual Disability Income Insurance Product Lines, effective November 19, 2018.     FIN 2018-1


MEDICARE SUPPLEMENT INSURANCE

Colorado amended regulation 4-3-1 to provide reasonable standardization of coverage and simplification of terms and benefits of Medicare supplement policies and to comply with the mandate of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This regulation also makes substantive amendments to several rules and changes the effective date to 12-01-2018.     3 CCR 702 Reg. 4-3-1

Idaho has extended the special enrollment period for Medicare beneficiaries under the age of 65 who are able to buy a Medicare supplement policy within 6 months of qualifying for coverage.     IDAPA 18.01.54 s26

Rhode Island amended its regulation regarding Medicare supplement insurance minimum standards, effective November 25, 2018.     230-RICR-20-30-7


MISCELLANEOUS

Illinois issued a bulletin concerning health insurance reporting requirements, the valuation manual and filings for life insurance policies that accelerate benefits for long-term care, credit life and Medicare supplement.     Bulletin 2018-11


SMALL EMPLOYER GROUPS

Rhode Island adopted a regulation regarding small employer annual filings to replace a repealed regulation.     230-RICR-20-30-10.12


THIRD PARTY ADMINISTRATORS

Nevada issued a bulletin regarding the due date for filing annual reports for third-party administrators.     Bulletin 18-006