Life and Health News
April 2024
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
Arkansas issued a bulletin explaining state standards and requirements for qualified health plans and stand-alone dental plans for 2025. The bulletin explains the specific standards as well as policies and procedures for qualifying. Bulletin 3-2024
AGENT / PRODUCER LICENSING AND APPOINTMENT
Arkansas published a bulletin reminding companies of the requirement to file annual renewal appointments for insurance producers. The bulletin provides information about how to process renewals. Bulletin 2-2024
California published a notice reminding all licensees and applicants of the requirement to report any changes in background information within 30 days of the date the licensee or applicant learns of the change. Notice Dated March 5, 2024
ANNUITIES / ANNUITY CONTRACTS
California enacted legislation requiring that recommendations for annuity sales be in the best interest of the consumer. The bill addresses training requirements for producers, disclosure, and sales standards. SB 263
Indiana amended and updated its annuity suitability rule to require recommendations for annuity sales to be in the best interest of the consumer. The rule also addresses producer training, insurer supervision and consumer disclosure. 760 IAC 1-72 +
New Hampshire amended and readopted a Suitability in Annuity Transactions rule. Ins. 305.01 +
ARTIFICIAL INTELLIGENCE
Connecticut, New Hampshire, Rhode Island, and Vermont published bulletins reminding insurers that decisions based on analytical and computational technology (including AI Systems) must comply with all insurance laws and regulations. Specifically for CT, Domestic insurers must complete an AI Certification, due on September 1 of each year. The department states that the NAIC Principles of Artificial Intelligence is appropriate guidance. Connecticut Bulletin MC-25; New Hampshire Bulletin INS 24-011-AB; Rhode Island Bulletin 2024-03; Vermont Bulletin 229
CLAIMS / CLAIMS ISSUES
Wyoming passed a law establishing a two-year time limit to seek reimbursement of an overpayment of a health insurance claim. HB 15
CYBERSECURITY
Alaska, Arkansas, Colorado, Connecticut, Illinois, Michigan, Missouri, Maine, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington, Wisconsin, and the Federal Center for Medicare & Medicaid Services published bulletins outlining its expectations for insurers in light of the Change Healthcare cyber attack.
DRUG / PRESCRIPTION COVERAGE
Michigan issued a bulletin alerting companies to a shortage of ADHD drugs. The bulletin urges companies to exercise flexibility with coverage and cost-sharing for the duration of the shortage. Bulletin 2024-11-INS
New Mexico passed a law that modifies the guidelines related to step therapy for prescription drug coverage and eliminates step therapy requirements for certain conditions. SB 135
ELECTRONIC TRANSACTIONS
South Dakota passed a law that allows insurers to comply with policy delivery requirements by one of the following alternative delivery methods: 1) Via first-class mail using an intelligent mail barcode or another similar tracking method used or approved by the U.S. Postal Service; or 2) Via commercial delivery service using a tracking method approved by the Insurance Division. HB 1126
EXCEPTED BENEFITS
Internal Revenue Service, Department of Labor and the Department of Health and Human Services issued Final Rules for Short-Term, Limited-Duration Insurance and Independent, Non-coordinated Excepted Benefits Coverage. 29 CFR Part 2590
FRAUD / ANTI-FRAUD
Delaware reissued its bulletin to remind insurers of its mandatory fraud reporting requirement. The bulletin also makes certain updates to its fraud reporting form. Domestic/Foreign Insurers Bulletin 15 (Reissued)
GUARANTY ASSOCIATION
Vermont's Department of Financial Regulation approved a new Life and Health Guaranty Association Summary Document/Notice to Policyholders to be used on and after May 1, 2024. Bulletin 228
HEALTH INSURANCE - COMPREHENSIVE
Wyoming passed a law dealing with the payment of claims from an insurer or its intermediary to pharmacies. SF 100
Wyoming prohibits discrimination against organ transplant recipients by insurers. SF 5
HOLDING COMPANIES
Washington updated its Insurer Holding Company Act to adopt the NAIC revisions requiring group capital calculation. SB 6027
IIPRC / INTERSTATE COMPACT
South Dakota enacted the Interstate Insurance Product Regulation Compact law effective July 1, 2024. HB 1091
MEDICARE SUPPLEMENT INSURANCE
Maine issued a bulletin explaining certain amendments to its Trade Practices laws prohibiting the use of terms such as Medicare, Medicaid or MaineCare in advertising and sales material. Additional requirements include guidelines around format and required disclosures. Bulletin 471
OMNIBUS LEGISLATION
Indiana enacted legislation amending numerous insurance topics including producer licensing by creating the insurance producer education and continuing education commission. Other topics include insurance holding company systems and annual reporting. HB 1332
PHARMACY BENEFIT MANAGERS
New Mexico passed the Prescription Drug Price Transparency Act that requires Pharmacy Benefit Managers, manufacturers, Pharmacy Services Administrative Organizations, and health insurance companies to report certain information to the Insurance Department. HB 33
REINSURANCE
Delaware enacted a new law to establish standards for reserve financing arrangements involving certain term and universal life policies (including those with secondary guarantees). 18 Delaware Code s 311 and 915
REPORTS - DATA CALLS & OTHER REPORTS
Colorado adopted a regulation establishing the data reporting requirements for all health care sharing plans offering plans for residents of CO. The regulation addresses reporting requirements, reporting due date and confidentiality. 3 CCR 702-4, Regulation 4-10-01
Pennsylvania's Insurance Department notified all insurers writing group or individual Medicare Supplement business that certain data must be submitted to the Department by May 31, 2024. Medicare Supplement Data Call issued March 23, 2024
THIRD PARTY ADMINISTRATORS
New Jersey's Department of Insurance issued a list of items a Third Party Administrator (TPA) must provide to the Insurance Department in order to voluntarily surrender its TPA license. Notice dated March 21, 2024
UNCLAIMED PROPERTY
Idaho approved a bill revising its unclaimed property act. Changes are intended to clarify certain presumptions, provide definitions and guidelines for policies and procedures, including reporting and notice. HB 471