Life and Health News
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
New Hampshire issued a bulletin to detail the process issuers must follow to have their non-grandfathered individual and small group health plans certified as Qualified Health Plans. Bulletin INS No. 18-016-AB
New Jersey issued a bulletin regarding minimum standards for health benefit plans to facilitate plan designs consistent with federal requirements. Bulletin 18-09
North Dakota issued a memorandum regarding 2019 ACA Product Filing Requirements. Memorandum 4-30-2018
Wisconsin issued a bulletin regarding the extension of transitional health insurance plans through December 31, 2019. Bulletin dated May 29, 2018
INSURTECH & COMPLIANCE – SOMETIMES YOU JUST NEED AN EXTRA SET OF HANDS!
InsurTechs and Innovative Products are still subject to the same cumbersome compliance challenges as traditional products. Click here to learn how we help.
AGENT / PRODUCER COMPENSATION
New York issued a circular letter regarding insurance producer compensation for accident and health insurance policies and contracts. Circular Letter 2017-20 Supplement 1
AGENT / PRODUCER CONTINUING EDUCATION
Texas has reduced the number of required continuing education hours for certain licensees from 30 hours per reporting period to 24 hours per reporting period. This change does not affect licensees subject to the 10 hour continuing education requirement. 28 TAC s 19.1003+
CONFIDENTIALITY / PRIVACY
Mississippi issued a bulletin to provide guidance regarding the annual privacy notices required by the Gramm-Leach-Bliley Act. Bulletin 2018-5
Oklahoma issued a bulletin to clarify that a licensee of the Oklahoma Insurance Department, subject to the privacy notice requirements under the Gramm-Leach-Bliley Act (GLBA), does not need to provide the annual privacy notice under GLBA under certain conditions. Bulletin No. EX 2018-01
Oklahoma enacted the Insurance Business Transfer Act (IBTA). This act establishes the requirements for notice, disclosure, standards and procedures for the approval of the transfer and novation by the Oklahoma Insurance Commissioner and the District Court of Oklahoma County pursuant to an Insurance Business Transfer Plan. SB 1101/36 s 1681-1688
DISASTER / CATASTROPHIC EVENT
Maryland's governor declared a State of Emergency due to severe storm and flooding. Maryland Insurance Administration encourages insurers to provide reasonable accommodations, including a grace period for premium payment, to policyholders that reside in and the businesses located in several zip codes to prevent and avoid cancellation of insurance. Bulletin 18-09 and Bulletin 18-07
New Jersey released a bulletin to provide guidance to insurers regarding pre- and post-disaster regulatory activity. Bulletin 18-05
New York released a circular letter setting the standards expected of many authorized insurers in planning, preparing for, and responding to disasters occurring anywhere in the world that could affect the ability to continue doing business and servicing the people of New York. Circular Letter 3 (2018)
DRUG / PRESCRIPTION COVERAGE
Wisconsin amended its code relating to prescription eye drops, effective August 1, 2018. 632.895 (16t)
LICENSING ASSISTANCE FROM FIRST CONSULTING
In addition to our insurer and TPA licensing services, First Consulting’s licensing services are also available to other industry entities. Click here to learn more.
FRAUD / ANTI-FRAUD
Oklahoma sent out a special notice about the Anti-Fraud Assessment Annual Fee that must be paid electronically through OPTins. Special Notice Regarding 2018 Anti-Fraud Assessment Fee
HEALTH CARE EXCHANGE / MARKETPLACE
The Center for Consumer Information and Insurance Oversight and the Centers of Medicare and Medicaid Services issued a notice titled "2019 Letter to issuers in the Federally-facilitated Exchanges". The Letter provides updates on operational and technical guidance for the 2019 plan year for issuers seeking to offer qualified health plans. CMS Notice dated April 9, 2018b
The Centers for Medicare and Medicaid Services issued a notice providing guidance concerning hardship exemptions from the individual shared responsibility provision for persons experiencing limited issuer options. CMS Notice dated April 9, 2018c
The Centers of Medicare and Medicaid Services issued a notice regarding extension of transition of non-grandfathered coverage in the small group and individual health insurance market. All policies renewed under the transitional policy must end by December 31, 2019. CMS Notice dated April 9, 2018d
The Department of Health and Human Services amended a regulation regarding the Affordable Care Act and HHS notice of benefit and payment parameters for 2019, effective June 18, 2018. This includes, among other things, payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs; cost-sharing parameters; and user fees for Federally-Facilitated Exchanges and State Exchanges on the Federal platform. 45 CFR Parts 147, 153, 154, 155, 156, 157, and 158
HEALTH INSURANCE / HEALTH RATES
Alabama issued a bulletin regarding the age curve for individual and small group health insurance markets for the 2019 plan year. Bulletin No. 2018-02
Colorado has adopted an emergency regulation regarding premium rate setting for non-grandfathered individual small and large group health benefit plans. 3 CCR 702-4, Emergency Regulation 18-E-01
New York issued a circular letter to advise insurers and fraternal benefit societies of their statutory obligations regarding underwriting in life insurance, disability income insurance, and long term care insurance for the use of PrEP (antiretroviral pre-exposure prophylaxis) to reduce the risk of contracting HIV infection. Insurance Circular Letter No. 8 (2018)
Pennsylvania amended its code adding an exception to the restrictions to inducements that an insurance producer may offer. An insurance producer may not make receipt of anything of value contingent on the purchase of insurance. 40-25-1245; 40-25-1246
ADVERTISING COMPLIANCE EVENT and SOCIAL MEDIA MINI-BOOTCAMP
Don’t be left out. This seminar will share advertising and social media compliance expertise and insight to help you maintain regulatory and ethical compliance. Click here to learn more!
LONG-TERM CARE INSURANCE
Texas issued a bulletin regarding rate increases for long term care coverage. B-0010-18
Maine issued a bulletin regarding the tax credit available for employer-offered disability insurance. Bulletin 429
Wisconsin amended its code relating to unclaimed life insurance and annuities. 632.63
InsurTechs and Innovative Products are still subject to the same cumbersome compliance challenges as traditional products.
Whether it’s determining how a new product fits within state regulation or simply a backlog of new products waiting to be filed with the states. First Consulting has experience working with both InsurTech startups as well as innovation areas of traditional insurance carriers, to help efficiently navigate this process.
Let First Consulting be your extra set of hands to help expedite getting these products to market faster!
Contact me today to discuss how our services can help you with the latest innovations impacting your compliance department.
In addition to our insurer and TPA licensing services, First Consulting’s licensing services are also available to other industry entities such as:
• Discount Medical Plan Organizations
• Limited Health Service Organizations
• Pharmacy Benefit Managers
• Warranty Service Providers
Our team of dedicated professionals have years of experience navigating the license process and are able to assist you from start to finish.
Contact me today, or click here to learn more about our TPA and specialty licensing services.