Life and Health News
April 2023
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!
AGENT / PRODUCER CONTINUING EDUCATION
California's Licensing Division published notice of required producer education for anti-fraud training. Beginning March 1, 2023, both the pre-licensing training as well as continuing education must include the anti-fraud content. Notice Dated March 10, 2023
ANNUITIES / ANNUITY CONTRACTS
South Dakota amended provisions regarding producer recommendations and responsibilities for annuities. HB 1091
CLAIMS / CLAIMS ISSUES
Michigan's Insurance Director informed carriers of filing requirements in connection with the mandated standardized electronic prior authorization process for health benefit claims. All insurers who issue or administer a health benefit plan must demonstrate compliance in a SERFF filing by May 1, 2023. ACA insurers must include the information in their ACA filing. Bulletin 2023-05-INS
DISCRIMINATION
Michigan's Insurance Department published this bulletin to inform insurers of amendments to the Elliot-Larsen Civil Rights act (ELCRA). Amendments to the bill prohibit discrimination in the insurance and financial services industry on the basis of sex, sexual orientation, gender identity or gender expression. Bulletin 2023-07-BT/CF/CU/INS
ELECTRONIC TRANSACTIONS
South Dakota passed a bill that amends provisions regarding electronic delivery of group health insurance documents. SB 62
ESSENTIAL HEALTH BENEFITS
Connecticut's Insurance Department informs carriers in the individual and small group health insurance markets of required revisions to non-grandfathered policies in order to meet revisions to essential health benefits. The bulletin also covers rate filings, maximum copayment amounts and formulary and network adequacy filings. Bulletin HC-90-23
Maryland published a bulletin for carriers who offer non-grandfathered health benefit plans in the individual or small group market of required revisions to certain essential health benefits. Bulletin 23-5
EXCEPTED BENEFITS
New Mexico's Superintendent of Insurance declared a moratorium on review and approval of excepted benefits filings until the final excepted benefits regulation goes into effect. A regulation was promulgated at 13.10.34 NMAC with an effective date of July 1, 2023. There is a pending rule promulgation to extend that effective date. Bulletin 2023-005
FILINGS: HEALTH
Alabama's Department issued a bulletin advising health insurers of filing deadlines for plan Year 2024. Bulletin 2023-01
Connecticut's Insurance Department published a bulletin concerning health insurance rate filing submission guidelines. Bulletin HC-81-23
Massachusetts published filing guidance notifying insurers of the timing and content of upcoming merged market (individual and small group) filings. Filing Guidance Notice 2023-B
Mississippi's Insurance Department issued filing guidance to all issuers of single risk pool and small group health insurance products and stand-alone dental plans issued inside and outside of the federally facilitated marketplace. The filing deadline is May 18 for form filings and June 30, 2023, for rate filings. Bulletin 2023-1
Washington's Insurance Department reminds disability income insurers they must file rates prior to use. All insurers must comply with separate requirements pertaining to experience rated groups. Advisory T-2023-03
FINANCIAL REGULATION
Arkansas' Insurance Department published notification for domestic companies that, effective March 2023, it has adopted the NAIC Accounting Practices and Procedures Manual as of March 2022. Bulletin 1-2023
HEALTH CARE EXCHANGE / MARKETPLACE
The Federal Department of Health & Human Services published its 2024 Qualified Health Plan (GHP) Data Submission and Certification Timeline. This applies to health plans and stand-alone dental plans. CMS Bulletin dated March 10, 2023
HEALTH INSURANCE - COMPREHENSIVE
Louisiana's Department of Insurance created amendments to the Basic Health Insurance Plan Pilot Program including modifications to accident and health insurance. LAC 37:XIII.Chapter 31
Maryland's Insurance Department published a bulletin notifying insurers in the individual and small group market of certain updates to the Maryland Benchmark Plan. Based on updated guidance, requirements for certain essential health benefits (EHB) are revised. BULLETIN 23-5
West Virginia passed a law to reduce cost sharing on insulin to $35 per month and $100 for covered devices. The law permits testing equipment to be purchased without a prescription. SB 577
West Virginia updated its law regarding prior authorizations. Prior authorizations must be submitted via an electronic portal, and the time frames for requests and the appeal process have been reduced. Other updates have been made to the process. SB 267
MARKET CONDUCT EXAMINATIONS
Kentucky's Insurance Department announced adjustments to a number of error tolerance rates used in Market Conduct Examinations. The bulletin includes the new rates. Bulletin 2023-01
PHARMACY BENEFIT MANAGERS
Wyoming passed the Prescription Drug Transparency Act which prohibits certain actions by pharmacy benefit managers, allows individuals to choose in-network retail pharmacies, changes the process for maximum allowable cost appeals, and allows pharmacies to file appeals in electronic batch formats, among other provisions. SF 151
PRE-NEED CONTRACTS
California's Department has implemented a rule setting out requirements for funeral providers to make reasonable efforts to return the benefits of an unclaimed preneed funeral account. T. 16 Sec 1267
Michigan's Insurance Department issued a bulletin advising of the updated maximum amount of benefits that can be assigned pre-death. The maximum assignment value for June 1, 2023, through May 31, 2024, is $12,720. Bulletin 2023-04-INS
REINSURANCE
Arizona's Department amended its reinsurance rule to update definitions. R20-6-307
REPORTS - DATA CALLS & OTHER REPORTS
Delaware's Department published a bulletin with information about completing the 2023 Affordability Standards Data Submission (ASDS) for health insurance, due 6-15-23 for individual and small group and 9-1-2023 for large group. Bulletin 138
Delaware's Insurance Commissioner requested that all carriers marketing health insurance complete a survey by September 25, 2023. In addition, the commissioner requests carriers to update the survey every three years so the information remains up to date. Bulletin 52 (Reissued)
RESERVE VALUATION
Indiana adopted a new rule setting uniform standards for reserve financing arrangements for certain term and universal life products. 760:1-82-1
SUITABILITY
Georgia has amended its Suitability in Annuity Transactions regulation, incorporating the most recent NAIC updates, requiring that annuity recommendations be in the best interest of the customer. 120-2-94
Illinois published a bulletin allowing insurers a grace period to implement certain changes to Part 3120 (Suitability in Annuity Transactions Model). Companies must now comply by August 1, 2023. Bulletin 2023-04