Life and Health News
July 2022
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 LICENSING AND APPOINTMENT
New Mexico advised applicants for an Insurance Producers License of the residency requirements for obtaining a resident license in New Mexico. Bulletin 2022-009
ANNUITY DISCLOSURES
Minnesota has amended its annuity law to add "best interest" requirements as set forth in the NAIC model law. These include standards of care, disclosure, conflict of interest, and documentation when recommending an annuity. SF 4108
CREDIT FOR REINSURANCE
Montana amended a Rule pertaining to Credit for Reinsurance. Rule 6.6.3843
DEPARTMENT OF INSURANCE
Mississippi issued a bulletin providing guidance regarding changing to a perpetual insurance company license and future fee payment procedures. Bulletin 2022-3
New Hampshire reminds all entities subject to the state's insurance law of their obligation to respond to Department investigations within 10 working days. Bulletin INS-22-028-AB
DISASTER PREPAREDNESS
Louisiana amended its law dealing with the items required to be in a catastrophe response plan for an insurer and third-party administrator, and the filing of the plan with the commissioner. HB 521; R.S. 22:572
DISCRIMINATION
Louisiana enacted a new law that states a carrier writing disability income, life or long term care insurance cannot deny, cancel or refuse to issue coverage, determine the price or premium for, or vary any term or condition of the policy based solely on the individual's status as a living organ donor without any unique and material actuarial risks in accordance with sound actuarial principles or actual and reasonably anticipated and expected experience of the individual. HB 307
Minnesota prohibits a carrier writing life insurance, long term care insurance or disability insurance from declining or limiting coverage of an insured or otherwise discriminating in premium rating, offering, cancelling or any other condition based solely on an insured being a living organ or bone marrow donor and without additional actuarial risks. HF 1829
FILINGS: LIFE
New York issued Supplemental Guidance on Equity Index Products which supplements the guidance dated October 31, 2007, regarding the permissible range of variability for certain features of fixed equity index annuities. Life Bureau Filing Guidance Note dated June 1, 2022
GROUP LIFE
Louisiana enacted legislation that authorizes discretionary group life insurance as an eligible group if it meets certain requirements. HB 198
HEALTH INSURANCE - COMPREHENSIVE
CMS published a Fact Sheet which summarizes HIPAA Requirements for Electronic Health Care Transactions. HIPAA Administrative Simplification Regulations Overview dated May 2022
Delaware's Insurance Department clarifies new Regulation 1322, Requirements for Mandatory Minimum Payment Innovations in Health Insurance. Domestic and Foreign Insurers Bulletin 130
Washington's Insurance Commissioner extended two emergency orders. The Orders requiring health insurers to waive copays and deductibles for COVID-19 testing and preventing surprise billing from labs performing tests are extended to July 27, 2022. Insurers must also allow a one-time early refill for prescription drugs and suspend any prior authorization requirement for treatment or testing of COVID-19. Press Release dated June 22, 2022
Wisconsin alerts insurers to recent changes to colorectal cancer screening guidelines and their effect on the application of cost-sharing provisions to insureds between the ages of 45 and 75. This change is based on the updated United States Preventive Services Task Force (USPSTF) recommendations. Bulletin dated June 9, 2022
MISCELLANEOUS HEALTH / ACCIDENT
Federal Centers for Medicare and Medicaid Services (CMS) released Transparency in Coverage Final Rules in 2020. Effective July 1, 2022, group health plans and issuers of group or individual health insurance must post on a public website certain plan pricing information in machine-readable files. Additional requirements go into effect starting January 1, 2023, and January 1, 2024. Federal Register 85 FR 72158
IRS released new limits for Health Saving Accounts (HSAs) and High Deductible Health Plans (HDHPs) for 2023. HSA contribution limit is $3,850 for self only coverage and $7,750 for family coverage. HDHP minimum deductible increases to $1,500 for self-only coverage and $3,000 f0r family coverage. Maximum out- of-pocket is $7,500 for self only coverage and $15,000 for family coverage. Revenue Procedure 2022-24
MISCELLANEOUS LIFE / ANNUITY
South Carolina allows an insurer to rescind a life insurance policy by mutual agreement within the two year contestability period based on false statements in the application or upon proving fraud or material misrepresentation by the insured. Certain notices must be given and processes followed. HB 4220
PHARMACY BENEFIT MANAGERS
Oklahoma SB 737 requires disclosure and reporting requirements by a Pharmacy Benefit Manager (PBM). PBMs must disclose to insurers, self-funded employers the existence of aggregate prescription drug discounts, rebates and audit recoupments and other items. PBMs must provide the insurance commissioner with quarterly reports of certain data pertaining to pharmaceutical manufacturer and provider contracts, plan utilization data, pricing data, pharmacy utilization data and pharmacy pricing data. Bulletin 5-2022
PRENEED CONTRACTS
Colorado continued its preneed funeral contract law scheduled for repeal to September 1, 2029. It also added a section dealing with the disposition of unclaimed preneed funeral contracts and the unclaimed property trust fund. Another change makes proof of net worth or surety bond requirements subject to a rule established by the Insurance Commissioner. HB 1228
REGULATORY REPORTING REQUIREMENTS
Arkansas requires health insurers and health maintenance organizations in the fully insured market to file a written report on or before January 1 of each year. The report must describe the savings derived from the receipt of pharmaceutical manufacturer rebates by health benefit plans and explain how the rebates are applied to reduce cost sharing requirements for consumers with prescription drug benefits. Bulletin 9-2022
REPORTS - DATA CALLS & OTHER REPORTS
New Mexico has issued a data call to major medical fully insured health insurance carriers to report information regarding prior authorizations. This call also applies to Medicaid managed care organizations and heath care purchasing act plan administrators. The information is due by August 15, 2022. Bulletin 2022-11
RESERVE VALUATION
Idaho's Insurance Commissioner issued a bulletin clarifying the reporting of reserve financing transactions, specific to reinsurance involving term life or universal life with secondary guarantees business, and the applicability of certain actuarial guidelines set forth in the NAIC Accounting Practices and Procedures Manual and Evaluation Manual. Bulletin 22-06
TRADE PRACTICES
Oklahoma issued a bulletin providing information to issuers of health benefit plans regarding HB 3495. It is an unfair trade practice to request a refund from claimants more than 12 months (previous law was 24 months) after the claim was paid and from a health care provider more than 18 months after the claim is paid. Bulletin 6-2-2022