Life and Health News
June 2026
Welcome to our latest newsletter! As a thought leader in the Insurance Industry for over 50 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
Colorado updates the premium reduction methodology applicable to Colorado Option standardized bronze, silver, and gold health benefit plans that must be offered by carriers participating in the individual and small group markets on or after January 1, 2027. 3 CCR 702-4, Amended Reg 4-2-85
Connecticut establishes filing requirements for forms and rates applicable to non-grandfathered individual and small employer group health insurance plans subject to the Affordable Care Act for the 2027 plan year. The bulletin applies to carriers offering coverage on or off the Connecticut Health Insurance Exchange and provides guidance for submitting products for regulatory review and approval. Bulletin HC-90-
South Carolina announces filing guidance for plan year 2027 for major medical and dental filings. Notice dated May 20, 2026
AGENT / PRODUCER LICENSING AND APPOINTMENT
Georgia passed a law allowing a person with a criminal history to request a preliminary determination from the Insurance Commissioner regarding whether the individual's record would prevent licensure. SB 207
ARTIFICIAL INTELLIGENCE
Vermont passed a bill that promotes the responsible and ethical use of artificial intelligence across health care and human services, including health insurance. The law impacts utilization review. HB 814
CAPTIVES
Florida passed legislation updating certain definitions, setting limits on insurable risks, revising minimum capital, unrestricted net assets, and unimpaired surplus standards, and specifying how the Florida Insurance Code applies to protected cell captive insurance companies. HB 883
Iowa revised its captive insurance laws. Among other changes, the bill also eliminates certain captive insurer registration fees, provides a temporary premium tax incentive for eligible non-life captive reinsurance companies that redomesticate to Iowa. HF 2766
CYBERSECURITY
Missouri issued a Bulletin seeking additional information from insurers and other regulated entities that used Conduent Business Services, LLC or its affiliates during the cybersecurity incident, to help assess potential effects on Missouri consumers. The bulletin reminds entities of their reporting and notification responsibilities under the Insurance Data Security Act. Bulletin 26-08
New York issued guidance highlighting the growing cybersecurity risks posed by advanced artificial intelligence systems and encourages regulated entities to evaluate whether their current security programs, risk assessments, and system controls remain adequate as cyber threats become more sophisticated. Industry Letter dated May 21, 2026 (A)
New York issued guidance to help regulated entities strengthen cybersecurity risk management during periods of elevated cyber threats. Advises organizations to evaluate whether additional safeguards are needed based on their technology environment, third-party dependencies, industry risks, and emerging threats such as geopolitical events and advances in artificial intelligence. Industry Letter dated May 21, 2026 (B)
DISASTER PREPAREDNESS
New York establishes updated disaster preparedness, business continuity, and emergency response requirements for life and health insurers, replacing prior guidance. Covered entities must file disaster response and business continuity planning materials with the Department of Financial Services, maintain board-approved plans, and conduct annual risk and business impact assessments. Insurance Circular Letter 2 (2026)
DISCRIMINATION
Iowa enacted legislation that prohibits life, disability, and long-term care insurers from denying, restricting, terminating, or conditioning coverage based solely on an individual's status as a living organ donor. The law also bars insurers from discriminating against living organ donors in policy issuance, benefits, premiums, coverage amounts, or any other terms and conditions of coverage. HF 2633
FRAUD / ANTI-FRAUD
Nevada announced its 2026 fraud assessment, which applies to all insurers holding a Certificate of Authority on January 1, 2026. Assessment invoices will be distributed electronically on June 1, 2026, companies were asked to verify or update their designated fraud assessment contact by May 22, 2026, and all payments are due by July 15, 2026. Notice dated May 13, 2026
Oklahoma Notice of 5/8/26 informed insurers of the Anti-fraud Assessment Annual Fee. The Annual Fee of $750.00 is due by 7/1/26. OPTins will be the website used to process electronic payments. Notice dated May 5, 2026
HEALTH CARE EXCHANGE / MARKETPLACE
Colorado amends network adequacy requirements for mental health, substance use disorder, and psychiatric nursing providers by requiring carriers, beginning January 1, 2027, to annually confirm network participation for providers who have neither submitted claims nor communicated their intent to remain in the network during the preceding 12 months. The law also adds new requirements for the timely credentialing of providers. HB 1002
Illinois provides instructions to Issuers seeking certification or recertification of individual and small group plans and Stand-alone Dental Plans offered on the Individual and Small Business Health Options Program Marketplace. This Bulletin also applies to those plans offered off the ACA Marketplace (Off-Exchange) in the individual and small group markets for Plan Year 2027. Bulletin 2026-6
HEALTH INSURANCE - COMPREHENSIVE
Delaware amended provisions that prohibit disability insurance, health and accident insurance, sickness insurance, and other health benefit plans from imposing annual or lifetime numerical limits on physical therapy visits for the treatment of the spine and other neuromusculoskeletal structures, including the extremities. The legislation previously referred to "treatment of back pain". SB 238
Kentucky issued a bulletin clarifying that that health benefit plans issued or renewed on or after January 1, 2024, must provide coverage for biomarker testing when ordered by a qualified health care provider and supported by recognized medical and scientific evidence. Bulletin 2026-03
Mississippi published a bulletin to clarify existing law that prohibits step therapy or fail-first protocols for the treatment of stage four advanced, metastatic cancer under health benefit plans. Bulletin 2026-7
Tennessee adds a new group health continuation coverage requirement to policies providing hospital, surgical or major medical expense insurance. HB 705
HOLDING COMPANIES
Rhode Island updates its holding company regulation to adopt changes to NAIC Model #450 which establishes uniform, national standards governing reserve financing arrangements pertaining to holding company systems. 230-RICR-20-45-1.4
MISCELLANEOUS HEALTH / ACCIDENT
South Carolia establishes a regulatory framework for wellness reimbursement programs, including licensing requirements, operational standards, and consumer disclosures. HB 4305
NONFORFEITURE
South Carolina updates its standard nonforfeiture law for individual deferred annuities by introducing a definition for contingent deferred annuities. The legislation exempts contingent deferred annuities from certain existing nonforfeiture requirements that apply to other deferred annuity products. SB 857
PHARMACY BENEFIT MANAGERS
Colorado issued a bulletin providing guidance to Pharmacy Benefit Managers on identifying and verifying rural independent pharmacies. The bulletin explains the criteria PBMs must use to determine whether a pharmacy qualifies as a rural independent pharmacy. Bulletin B-4.158
PRE-NEED CONTRACTS
Iowa passed a bill that enhances regulatory oversight by the Iowa Insurance Division. HF 2634
Missouri updates its regulation to clarify pre-need reporting requirements. 20 CSR 2120-3.105
REGULATORY REPORTING REQUIREMENTS
California announces that the SIU Compliance Unit has completed transition to the new SIU Annual Report portal for insurer reporting purposes. The state advises that, for SIU Annual Reports covering multiple companies, only the primary reporting insurer should register because subsidiary companies will automatically appear under the primary insurer. SIU E-Blast 2026-10
California established an annual assessment for long-term care insurers to fund principle-based reserving (PBR). The Department will invoice companies based on tiers of premium. Bulletin 2026-4
California issued a Bulletin specifying the annual assessment for life insurers to fund principle-based reserving (PBR) activities in the state. The assessment is based on life insurance premium with tiered assessment amounts. Bulletin 2026-3
REPORTS - DATA CALLS & OTHER REPORTS
Georgia revised its annual Mental Health Parity and Addiction Equity Act (MHPAEA) data call requirements, including reporting related to Autism Spectrum Disorder, for health insurers issuing health benefits in the state. The bulletin provides submission instructions. Directive 26-EX-4
THIRD PARTY ADMINISTRATORS
Louisiana issued guidance reminding licensed third-party administrators of their responsibility to conduct due diligence when contracting with entities that market or provide insurance-related products or services in the state. TPAs are expected to verify that such entities are properly authorized to transact insurance in Louisiana and that their agreements comply with state law. Bulletin 2026-07
North Carolina updated its regulations for the examination and oversight of third-party administrators by revising the requirements insurers must satisfy when providing certifications. 11 NCAC 12.0332
Puerto Rico requires all licensed third-party administrators to file their 2025 annual reporting materials by June 30, 2026. The Ruling Letter provides additional reporting requirements. Ruling Letter CN-2026-380-SR
UTILIZATION REVIEW - HEALTH CARE
Georgia amends its insurance laws governing private review agents and utilization review entities to regulate the use of artificial intelligence in health insurance coverage determinations. The law permits AI and other software tools to assist with utilization review activities and reduce administrative burdens but prohibits AI from independently issuing adverse determinations without review by a qualified human reviewer. SB 444
Iowa establishes new conduct standards for health carriers and revises rules governing utilization review organizations, including the use of artificial intelligence in coverage review activities. The legislation also updates audit and prior authorization requirements. HF 2635