Life and Health News
February 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!
AGENT / PRODUCER LICENSING AND APPOINTMENT
Ohio updated its agent pre-licensing education law to bring it to NAIC national standards. It covers agents, licensing, continuing education and distance learning courses, among other items. Rule 3901-5-07
Wyoming's Department of Insurance notified carriers it will email the Annual Appointment Renewal Invoice and Detailed Appointment List to each insurer on February 1, 2024. Other pertinent dates and guidelines are included in the notice. Notice dated December 13, 2023; Memorandum 12-2023
ANNUITIES / ANNUITY CONTRACTS
Oregon amended its regulation dealing with annuities to establish disclosure and care obligations for annuity sales. It closely aligns with the NAIC Suitability in Annuity Transactions Model Regulation. OAR-836-051-0905
Utah updated its Suitability in Annuity Transactions rule to provide that recommendations made by agents and insurers must be in the best interest of the consumer. Rule R590-230-1
CREDIT INFORMATION
District of Columbia approved a bill requiring credit reporting companies to accept a personal statement from a consumer indicating the consumer experienced financial hardship resulting from a public health emergency. Insurers, and other users of credit reports are prohibited from taking adverse action in these situations. B 118
DISASTER PREPAREDNESS
Maryland published a bulletin to notify all insurers, non-profit health plans and dental organizations that they are to provide information about disaster preparedness no later than 04/15/24. Companies are also encouraged to sign up for the department’s mailing list to receive future notifications. Bulletin 24-2
DISCRIMINATION
Illinois issued a bulletin to remind insurers that categorically excluding coverage for medically necessary services to treat gender dysphoria is discriminatory and a violation of 50 Ill. Adm. Code 2603.35. Bulletin 2024-01
EXCEPTED BENEFITS
New Mexico's Insurance Department announced a data call to all insurers offering Excepted Benefits under 13.10.34 NMAC due by February 15, 2024. Insurers should pursue approval of forms and rates for Excepted products via SERFF by March 1, 2024, to be effective with the new rule on January 1, 2025. Bulletin 2024-002
FILINGS: HEALTH
Delaware issued a bulletin to provide filing guidance as carriers look to develop paid family and medical leave plans to satisfy private plan coverage standards established under 19 Del.C. § 3716. Domestic-Foreign Bulletin 144
Nebraska's Department of Insurance published guidelines for Medicare Supplement new business rate filings. Notice dated January 2, 2024
New Mexico's Insurance Department announced it will not accept any new Blanket insurance products for review and approval although rate adjustments may be made. The Department expects to promulgate a rule for Blanket insurance in the coming year. Bulletin 2023-038
GUARANTY ASSOCIATION
The District of Columbia adopted a bill to amend the Life & Health Insurance Guaranty Association Act of 1992. Changes include adding health maintenance organizations as member insurers, making life insurance subject to long term care assessments and other administrative changes. B-126
HEALTH INSURANCE - COMPREHENSIVE
New Hampshire reminds insurers that mandated blood lead testing for one- and two-year-old children is considered a preventive service under the Affordable Care Act, and cost sharing is prohibited. Bulletin INS 24-001-AB
New Jersey enacted changes requiring carriers to remove any age and dollar limits on medically necessary hearing aids and cochlear implants under medical insurance. SB 2535
West Virginia reminds carriers that any prescription written for an inpatient at the time of discharge cannot be subject to a health insurer's prior authorization requirements and must be immediately approved for not less than three days, provided that the cost of the medication does not exceed $5,000 per day. Civil penalties will be issued for non-compliance. Bulletin 24-01
MARKET CONDUCT
Florida adopted a regulation establishing a methodology for scheduling and conducting market conduct examinations. Priorities include, first, statutorily required exams, then post-hurricane required exams, then identified market concerns. FAC Rule 69O-138.003
MISCELLANEOUS HEALTH / ACCIDENT
Massachusetts published a bulletin to all health carriers regarding Behavioral Health Wellness Examinations. Requirements include covering annual mental health wellness examinations with no patient cost-sharing. Bulletin 2024-02
MISCELLANEOUS LIFE / ANNUITY
New York amended its law to allow insurers writing life insurance to establish a wellness program that is not unfairly discriminatory and with no increase in premium. Rewards and incentives are subject to certain guidelines. SB 5890
PHARMACY BENEFIT MANAGERS
New Jersey revised its law so that pharmacy benefit managers cannot prohibit or discourage use of a discount from an on-line pharmacy discount program. SB 3604
RATEMAKING
Colorado adopted regulation amendments, effective 2-1-2024, establishing a methodology for setting rates for the Colorado Option premium rate reduction requirements on standardized health benefit plans. 3 CCR 702-4
REPORTS - ANNUAL / QUARTERLY STATEMENT
Florida adopted regulations incorporating the NAIC electronic transmission filing instructions by reference. Florida further established a risk-based selection methodology for scheduling examinations of insurers. FAC Rule 690-137.001
Rhode Island's Insurance Division published its Summary of Annual and Quarterly Filing Requirements for 2024 for Life, Accident and Health and Fraternal Insurance Companies. Letter dated January 16, 2024
Utah's Insurance Department notified Fraternal, Health and Life carriers who report accident and health on the Utah state page of the NAIC Annual Statement that they are required to file an additional Utah Survey. Notice dated December 12, 2023
REPORTS - DATA CALLS & OTHER REPORTS
Maine amended its regulation specifying procedures for filing health care claims data sets from third party payors, administrators, Medicare health plan sponsors and pharmacy benefit managers. Changes are made to terms and definitions. 90-590 s 243-1
Missouri issued a bulletin reminding insurers of the annual statistical reporting requirements. Details and deadlines are available on the department's website. Bulletin 24-01
UNCLAIMED PROPERTY
Florida enacted rule amendments relating to the procedures for filing claims with the state for unclaimed property. Rule amendments include specific procedures for different categories of property. FAC Rule 69G-20.0021