Life and Health News

January 2018

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!


ACTUARIAL

California issued a notice to the appointed actuaries of all life and disability insurance companies and fraternal benefit societies regarding the 2017 actuarial memorandum and regulatory asset adequacy issues summary.     Financial Notice dated 11-01-2017


AGENT / PRODUCER COMPENSATION

New York provided a circular letter to accident and health insurers to provide guidance and clarification regarding state and federal requirements for filing commissions, compensation, and other fees or allowances and paying compensation to insurance agents and brokers for comprehensive medical policies and contracts.     Circular Letter 2017-20


ANNUITIES / ANNUITY CONTRACTS

Florida amended its law regarding the mortality and investment increment factors used in computing the dollar amount of variable benefits or other contractual payments or values under a variable contract.     FAC Rule 69O-162.008, FAC Rule 69O-162.012


CLAIMS / CLAIMS ISSUES

Massachusetts issued a bulletin to address the coordination of benefits for accident-related medical claims between fully-insured health policies and the Personal Injury Protection ("PIP") and Medical Payments (“MedPay”) benefits of motor vehicle liability policies.     BULLETIN 2017-06


TIRED OF CHECKING STATE LEGISLATIVE UPDATES?
MAKE A NEW YEAR’S RESOLUTION!
Staying current with new regulatory rules and laws is often mentioned as one of the more difficult and time consuming responsibilities, and might be a resolution you are considering for your company.  Click here to learn more on how we can help you!


CONFIDENTIALITY / PRIVACY

Kansas issued a notice to set forth the views of the Kansas Insurance Department regarding recent amendments to the federal Gramm-Leach-Bliley Act (GLBA) and clarify when the annual privacy notice is not required to be provided.     Notice dated 09-22-17

Wisconsin extended the expiration date of an emergency rule regarding annual privacy notice requirements to January 26, 2018. The emergency rule adds circumstances under which the annual privacy notice is not required.     Ins 25.13


CREDIT FOR REINSURANCE

Wisconsin amended its law regarding reinsurance to allow a domestic insurer to take credit for ceded reinsurance as either an asset or a deduction from liability under certain circumstances.  The law also provides requirements an assuming insurer must meet to be eligible for certification.     Ins 52.02+


DISASTER / CATASTROPHIC EVENT

Puerto Rico issued a circular letter to clarify provisions of Ruling Letter Number CN-2017-221-D regarding access to health care during the emergency period caused by Hurricane Maria.     Circular Letter CC-2017-1918-D


DISCRIMINATION

Louisiana adopted new regulations regarding the procedure for receiving and investigating discrimination complaints within the business of insurance. The Division of Diversity and Opportunity is created within the Department of Insurance and it will review all complaints alleging a violation of discrimination provisions.     LAC 37:XIII.Chapter 15101 +


DRUG / PRESCRIPTION COVERAGE

New York issued a circular letter regarding pre-exposure prophylaxis (“PrEP”) for HIV Prevention. Insurers offering prescription drug coverage must cover PrEP.     Insurance Circular Letter No. 21 (2017)


HEALTH CARE EXCHANGE / MARKETPLACE

California readopted with amendments the emergency regulations pertaining to California Health Benefit Exchange policies and procedures for eligibility, enrollment and termination of coverage through the exchange.     T. 10 s 6410+, T. 10 s 6502+


HEALTH INSURANCE / HEALTH RATES

Colorado issued a bulletin applicable to sickness and accident insurance and all service or indemnity contracts issued by licensed carriers to provide clarification regarding newborn coverage requirements and the collection of required premium.     Bulletin B-4.6

Colorado withdrew Bulletin B-4.25 regarding non-network services provided at network facilities effective November 17, 2017.     Bulletin B-4.25 withdrawn 11-17-2017

Connecticut amended its law to provide that insurers cannot establish nonquantitative treatment limitations that place a greater burden on an insured for access to diagnosis or treatment of mental or nervous conditions than for diagnosis or treatment of medical, surgical or other physical health conditions.     House Bill 7127

Florida repealed its law regarding certificates of creditable coverage and the demonstration of creditable coverage.     Repealed FAC Rule 69O-154.110, 69O-154.111

Massachusetts amended its law to require that specified insurers provide coverage for contraceptive drugs, products, devices, procedures and services.     House Bill 4009

New York amend its insurance law, in relation to health insurance coverage for mammography, to clarify that mammogram screening may be done by breast tomosynthesis.     Assembly Bill 5677, Ins. Law s 3216, Ins. Law s 3221


HIV

New Hampshire amended the language in the HIV Antibody Testing Consent Form.     Ins 1103.01, Ins 1103 Appendix A


HOLDING COMPANIES

Illinois added a rule providing that enterprise risk reports are to be filed on or before May 1 of each year.     50 Ill. Adm. Code 652.50


IIPRC / INTERSTATE COMPACT

The Interstate Compact amended its filing fee rules to pro-rate the annual registration fee to fifty-percent of the annual registration fee listed in the schedule of fees on October 1 of each year instead of on July 1.     Operating Procedure 8 s 104


INDUCEMENTS

New Jersey revised its law to provide that the prohibitions against rebates and inducements do not prohibit insurance producers from providing persons with services or other offerings for free or at a discounted price in a fair and non-discriminatory manner. Also, the definition of "inducement" is amended to apply to money or other specified items with a value greater than $100, rather than $25.     NJAC 11:17A-1.2, NJAC 11:17A-2.3


LIFE INSURANCE / LIFE CONTRACTS

Virginia adopted rules and procedural requirements to establish uniform standards governing reserve financing arrangements pertaining to certain life insurance policies.     14 VAC 5-318-10+


2017 CSO FILING ASSISTANCE
The new 2017 CSO Mortality Table is here. We can help draft new or revised forms for filing with the Interstate Compact or with each state and we can make the filings on your Company's SERFF instance or on ours.  Click here to learn more!


PREMIUM ISSUES

Oregon issued a bulletin providing operational guidance to insurers providing health benefit plans subject to health insurance premium assessment.     Bulletin 2017-6 (Updated)


PREMIUM TAX

Connecticut lowered the tax rate on all net direct premiums received from foreign and alien insurers on or after January 1, 2018, to be one and one-half per cent.     12-210


REPORTS - ANNUAL / QUARTERLY STATEMENT

Connecticut issued a bulletin reminding insurers to annually submit to the commissioner and the NAIC, before the first day of March, a report, prepared in accordance with the NAIC Annual Statement Instructions Handbook and to follow those accounting procedures and practices prescribed by the NAIC Accounting Practices and Procedures Manual.  Insurers must also report their financial condition on a quarterly basis during 2018.     Bulletin FS-4-17


RESERVE VALUATION

New Jersey amended its law regarding the minimum reserve standards for individual and group health insurance contracts.     NJAC 11:4-6.1, NJAC 11:4-6.2

New York published a letter that applies to life insurers, fraternal benefit societies and insurers accredited for reinsurance of life and annuities to remind them of considerations that focus on actuarial opinions, memorandums and other solvency issues.  It provides instructions on filing, describes additional tests and standards, and provides guidance to appointed actuaries on the analysis they should consider in rendering opinions.     Letter titled Special Considerations relating to December 31, 2017 Reserves & Other Solvency Issues


STANDARD VALUATION LAW

Alabama adopted the 2017 version of the NAIC Valuation Manual effective January 1, 2018.     482-1-161-.04


HAPPY NEW YEAR – CREATE A NEW YEAR’S RESOLUTION

I am sure you, like many others, have made a personal New Year’s resolution. Have you made a business New Year’s resolution? It’s not only a good idea to have a business New Year’s resolution but it’s not too late to get started.

Staying current with new regulatory rules and laws is often mentioned as one of the more difficult and time consuming responsibilities, and might be a resolution you are considering for your company.

First Consulting can help with our Compliance Monitoring service. There are two different levels so you can you choose the one that is right for your company.

    •   Level One –

  •  Review and summarize legislation that apply to your business; and
  •  Advise which products and business area(s) are impacted.

    •   Level Two –

  • All of Level One; and
  • Provide a list of action items required to maintain compliance. (For example, you may need to draft and file an endorsement, send endorsement to insureds and update procedures, etc….)

    •   Each level will provide summaries on a weekly, bi-monthly or monthly basis.

Contact me today to learn more on how we can help.

Vickie Goodman
816.391.2735
Vickie.Goodman@FirstConsulting.com


2017 CSO FILING ASSISTANCE

The new 2017 CSO Mortality Table is here. That may mean new life insurance policy forms or the changes may be limited to the actuarial support with or without new schedule pages.

Either way First Consulting can help!

We can help draft new or revised forms for filing with the Interstate Compact or with each state and we can make the filings on your Company's SERFF instance or on ours.

Find out how First Consulting can help with the compliance issues you face – developing or filing new/revised products, research, admissions, and much more….

Contact me or any First Consulting Associate for a proposal and estimate of fees.

John Palmer
816.391.2744
John.Palmer@FirstConsulting.com