Life and Health News
August 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
Maryland updated its Health Benefit Exchange regulations to address changes to the re-enrollment process, to ensure carrier awareness and to define the key term "provider network." COMAR 14.35.01.02+
AGENT / PRODUCER LICENSING AND APPOINTMENT
Maryland published a bulletin notifying companies and producer license applicants of HB 0265/SB 0336 which removes the education and experience requirements for producers required to pass a licensing examination. Beginning 10/01/24, applicants are no longer required to complete an approved program of study before taking the examination. Bulletin 24-19
ARTIFICIAL INTELLIGENCE
New York published expectations of all insurers using Artificial Intelligence Systems and External Consumer Data and Information Sources in insurance underwriting and pricing. Insurance Circular Letter 2024-7
Virginia's Burau of Insurance issued expectations as to how insurers will govern and manage the risks of Artificial Intelligence Systems. Administrative Letter 2024-01
CAPITAL AND SURPLUS REQUIREMENTS
Maryland issued a bulletin notifying companies of the annual group capital calculation reporting requirement. Bulletin 24-17
CONFIDENTIALITY / PRIVACY
Rhode Island created the Data Transparency and Privacy Protection Act to protect personal data of customers and allow customers to opt out of the collection of personally identifiable information. HB 7787 / SB 2500
CYBERSECURITY
Rhode Island passed a law requiring carriers to establish an information security program. HB 7281 / SB 2802
DISASTER / CATASTROPHIC EVENT
Iowa published a bulletin providing a summary of its expectations when a disaster has been declared. General expectations are outlined including, among other items, a grace period for cancellation, and claim reporting and resolution. Bulletin 24-03
DISCLOSURE REQUIREMENTS
California adopted a bill requiring any solicitation for a consumer financial product or service to include a certain disclosure, on the front of the envelope, in no less than 16 point bold type. SB 1096
ELECTRONIC TRANSACTIONS
Pennsylvania passed a law allowing an insurer to electronically deliver insurance notices or documents to a covered person under a health benefit plan, vision or dental plan. Certain disclosures are required to be given to the covered person. In addition, a health insurer cannot restrict the method of payment to a participating health care provider so that the exclusive payment method is a credit card payment. HB 1664
FILING REQUIREMENTS / PROCEDURES
Alabama has published a bulletin concerning filing requirements for federal disclosures for insurers that issue short-term, limited duration insurance and hospital indemnity and fixed indemnity policies. Bulletin 2024-02
New York's Insurance Department issued Filing Guidance for submitting wellness programs in connection with life insurance. Filing Guidance of July 16, 2024
Texas issued guidance to insurers that issue short-term limited duration policies and hospital indemnity and other fixed indemnity policies regarding filing requirements for new consumer disclosures. Bulletin B-0013-24
Utah's Insurance Commissioner issued a bulletin providing guidance regarding amended federal rules issued on March 28, 2024, revising the requirements for short-term limited duration insurance and fixed indemnity excepted benefits coverage. Bulletin 2024-8
FRAUD / ANTI-FRAUD
Florida adopted regulations updating its Anti-fraud Award Program. Changes are intended to align with statutory penalties. FAC 69D-1.001-004
HEALTH CARE EXCHANGE / MARKETPLACE
New Mexico's Insurance Superintendent informs all health care insurers, HMOs, and cooperatives providing individual and group health insurance in the individual and small group markets to submit their policies for compliance review with the Delivery of Necessary Diabetic Resources law pursuant to HB 53. Bulletin 2024-14
HEALTH INSURANCE - COMPREHENSIVE
Colorado published a bulletin providing guidance to insurers issuing health benefit plans in the individual and small group market. The department clarifies that its position is that companies are required to provide coverage for abortion services. B-4.139
Illinois has enacted a bill that gives additional authority to the insurance director in regulating large group health plans. The insurance department will now have the authority to accept or reject large group health insurance rate filings and apply state provider network adequacy rules to those large groups. HB 5395
New Hampshire amended its Terminal Patients Right to Try Act to by revising eligibility criteria and definitions, replacing the term biological products with biologics, and changing the name to Right to Try Act. HB 1300
New Hampshire passed a law that has the same requirements and prohibitions that exist under the Federal No Surprises Act. SB 173
New Hampshire passed the Lead Poisoning Prevention and Treatment Act of 2024 which requires the cost of blood lead testing to not be subject to a co-payment, deductible or coinsurance. Benefits provided shall include any follow-up blood lead testing that is necessary to complete the preventive screening when the initial blood lead testing indicates an elevated blood lead level or is inconclusive. SB 399
New Mexico's Insurance Superintendent advised all health care insurers and pharmacy benefit managers to submit health insurance policies for compliance review of SB 273, Parity for Coverage of Mental Health and Substance Use Disorder. Bulletin 2024-13
Pennsylvania passed a law requiring health insurers to include biomarker testing as a covered benefit under health insurance for the diagnosis, treatment, and management of a covered person's disease or condition. HB 1754
HOLDING COMPANIES
Delaware published a revised bulletin clarifying the Department's interpretation of the term "admitted assets" for purposes of triggering reporting requirements within a holding company system. The department is clarifying "admitted assets" include only those admitted assets in the insurer's general account. Bulletin No. 6 Rev. 7-9-2024
LONG-TERM CARE INSURANCE
Alabama enacted the Long-Term Care Insurance Policy Minimum Standards Act, which sets standards for long term care policies, administration and disclosures. Ch 482-1-091
MANAGED CARE PLANS / HMOS
Mississippi adopted amendments to its Managed Care Plan Network Adequacy Regulation, designed to ensure adequate access to managed care. Changes include authorizing the commissioner to request information and data from carriers and to maintain confidentiality of data as gathered. 19-3-14.01
MISCELLANEOUS
New Mexico's Superintendent of Insurance announced its Fraud Fee collection has been delayed due to automating the fee payment system. The fee will not be collected until September 1, 2024. Insurers are instructed to check the Department's website on that day for further instructions. Notice dated July 24, 2024
MISCELLANEOUS HEALTH / ACCIDENT
Arkansas issued a bulletin clarifying that the state's Medicaid plan, ARHOME, is supplemental to and not a replacement for payments from other sources. 10-2024
Colorado published an announcement that the state has extended the deadline to enroll for health insurance through Connect for Health Colorado. Individuals who are no longer eligible for Health First Colorado (Colorado Medicaid) due to the end of the Covid 19 Public Health Emergency now have until November 30 to complete enrollment. News Release 7-24-2024
Illinois enacted amendments to its Insurance Code including updates to required billing practices, notifications and utilization review. HB 2472
OMNIBUS LEGISLATION
North Carolina passed an omnibus bill that amends laws pertaining to insurance producers, electronic communications under a health benefit plan, and captive insurance. SB 319
PHARMACY BENEFIT MANAGERS
Oklahoma adopted a rule dealing with Pharmacy Benefit Management procedures, contract requirements, Maximum Allowable Cost lists, network access standards, and appeals, among other items. Rule 75:45-3-1+
REPORTS - DATA CALLS & OTHER REPORTS
New Jersey, in connection with 29 other states and territories, requested eligible insurers to file the Climate Risk Survey Disclosure Survey for 2023. California will collect the information from insurers and coordinate for the participating states. Insurers with direct written premium of more than $100M nationwide in 2023 must respond. Bulletin 24-09
Rhode Island added the Dental Insurance Loss Ratio Reporting and Study Act requiring dental insurers to file an actuarial memorandum disclosing its incurred claims and earned premiums with the Insurance Commissioner. The reporting deadline is March 1, 2025, for reporting years 2023 and 2024. SB 2873 / HB 7944
SUITABILITY
Missouri adopted the updated NAIC Suitability in Annuity Transactions Model. The updated rule requires producers to act in the best interest of the consumer when recommending an annuity. 20 CSR-400-5.900
TRADE PRACTICES
Pennsylvania passed a law allowing the offering of certain gifts valued at $125 or less by an insurer or producer to be in compliance with the trade practices law. SB 1092