Life and Health News
January 2016
We are celebrating over 25 years of providing selected items of current interest to our clients and friends. The items contained in this newsletter are derived from bulletins, regulations and legislative activity affecting the insurance industry. Please feel free to share this newsletter with others that may be interested. Contact our office for further details about any of the items contained in the newsletter.
ACCELERATED BENEFITS
Kansas amended its requirements for life insurance or annuity contracts providing for accelerated benefits to revise contract requirements and restrictions. Regulation 40-2-20
AGENT / PRODUCER COMPENSATION
Colorado published a bulletin prohibiting any commission structure that appears to discourage producers from actively marketing certain "metal tier" health benefit plans from certain carriers in the individual and small group benefit plan market. Bulletin No. B-4.87
AGENT / PRODUCER LICENSING AND APPOINTMENT
Illinois advised they will no longer mail new or renewal licenses. License alerts will be sent via email and the licensee can print the new license from a specified webpage. Company Bulletin 2015-12
New Jersey amended its insurance producer licensing act to ensure that the examination and registration materials for the examination shall be offered in English and Spanish. 17:22A-31
CREDIT INSURANCE
Indiana issued a bulletin to all insurers engaged in the business of selling credit insurance. The Commissioner reviewed and adjusted the discount rate based on the sales of the three-year Treasury Notes on the last day of the last three calendar years. The discount rates to be used are 1.15% for life and 0.75% for accident and health. The life discount rate includes 0.4% for mortality. The credit life prima facie rates for monthly outstanding balance basis have been increased as provided in the bulletin. The rate adjustment indicated for accident and health is a decrease of 10%. Bulletin 222
Compliance Training
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DATA CALLS / REGULATORY REPORTING
Illinois issued a bulletin to Chief Actuaries of life, accident and health insurance companies providing guidance for financial reporting, health insurance reporting and policy form filings. Company Bulletin 2015-11
Maine amended its requirements for filing its annual report of fraudulent insurance acts. Attachment A, the Maine Fraud and Abuse Annual Report is no longer required. The annual report by all insurers licensed to do business in Maine shall be submitted in a form and manner as prescribed by the Superintendent. Rule Ch. 920 s 5, Rule Ch. 920 Attachment A
Maryland issued a bulletin to all health carriers, HMO's and dental plan organizations that are required to file an Annual Statement. This Bulletin amends Bulletin 11-32 and reminds carriers that together with its annual statement, the Certificate of Compliance for Advertising must be filed. The requirement to file a Certificate of Compliance was added to the "Reports Due from Regulated Entities to the Maryland Insurance Administration" in 2010. Bulletin 15-30
FILING REQUIREMENTS / PROCEDURES
Maryland provided guidance to health insurers, health maintenance organizations and dental plan organizations regarding filing requirements for individual and small employer form and rate filings for plan or policy years beginning on or after January 1, 2017. Bulletin 15-33
Montana issued an advisory memorandum to provide prospective guidance as to new reporting, filing, and disclosure obligations applicable to health insurers. Advisory Memorandum of November 30, 2015
Texas issued a bulletin notifying individuals required to submit fingerprints to the Texas Department of Insurance in connection with licensing or submission of biographical information that the cost and locations for obtaining fingerprint services changed effective December 1, 2015. Commissioners Bulletin B-0030-15
FINANCIAL REGULATION
Connecticut published a bulletin reminding health insurers, fraternal benefit societies and health care centers authorized to do business in the state that 2015 annual statement filings are due by March 1, 2016. The bulletin also provides a schedule for quarterly statements. Bulletin Number FS-4-15
Connecticut published a bulletin to all accredited reinsurers regarding 2015 and 2016 financial reporting requirements. The bulletin provides deadlines and instructions. Bulletin Number FS-4AR-15
Connecticut published a bulletin to all captive insurers domiciled in the state, branch captives licensed to transact business in the state and risk retention groups formed as captives doing business in the state describing financial reporting requirements for 2016. Bulletin No. FS-4C-15
DOL Fiduciary Rule
The Department of Labor is likely to release its final rule in the first few months of 2016 which will expand the definition of “fiduciary” under ERISA. First Consulting will be ready to help explain the rule, how it affects your business, and how it will fit into the current insurance regulatory framework.
Click here to find out more.
FORM FILINGS
Puerto Rico published a circular letter providing general guidelines and requirements for certain forms submissions by life and disability insurers, health services organizations and fraternal benefit societies writing life, annuities, consumer credit, disability, accident and health insurance in Puerto Rico. Circular Letter CC-2015-1869-AV-AS
GROUP LIFE
Oregon published a bulletin to clarify the division’s position regarding approval of life discretionary groups under ORS 743.360. An insurer must obtain separate approval of the group as a discretionary group for health insurance. Bulletin Ins 2015-2
HEALTH INSURANCE - COMPREHENSIVE
Colorado issued a bulletin to provide carriers offering managed care and/or health benefit plans in the state guidance on what is expected when a consumer undergoing treatment is transitioning from one plan to another plan. Bulletin No. B-4.86
Colorado issued a bulletin to provide guidance regarding the requirements of a succeeding carrier when a consumer's employer replaces, within 31 days, one small group plan with another small group plan due to termination, cancellation or expiration of the current small group plan. Certain consumer protections for waiting periods met and deductibles already paid apply. Bulletin No. B-4.85
Colorado published a bulletin to provide carriers and consumers guidance regarding the methods of contraception that health benefit plans must cover, as well as clarify the federal position that carriers must cover all FDA-approved birth control methods. Bulletin No. B-4.84
New York enacted legislation listing types of insurance that are excluded from the definition of "student accident and health insurance." AB 7725
HEALTH INSURANCE / HEALTH RATES
Delaware issued a bulletin providing guidance to health insurers and HMO's regarding the new mini-COBRA law that provides continuation of coverage requirements for when a policy terminates. Domestic/Foreign Insurers Bulletin 51
Utah issued a bulletin to all insurers whose health benefit plans offer coverage for preventive services subject to the United States Preventive Services Task Force (USPSTF). It also provides guidance to insurers regarding the coverage requirements for tobacco cessation as required by the U.S. Department of Labor, Department of Health and Human Services, and the department of the Treasury (the agencies). Bulletin 2015-11
LONG-TERM CARE INSURANCE
Iowa amended its prompt payment of certain health claims rule and no longer exempts long-term care insurance from the requirements. Regulation 191-15.32
Michigan amended its long-term care insurance and partnership program policy requirements to provide updated producer education and training requirements. House Bill 4836
A Practical Approach to Advertising Compliance
The First Consulting Advertising Seminar provides a comprehensive overview of advertising compliance laws for all states. Both first time and prior attendees of this seminar will return with immediate benefits. Registration is open now!
Click here to find out more.
PATIENT PROTECTION AND AFFORDABLE CARE ACT
Massachusetts amended its reporting deadline to provide that each health carrier must provide to the Office of Patient Protection no later than April 1st of each year, certain information to assist the Office of Patient Protection in resolving enrollment waiver requests. 958 CMR 4.070
PREMIUM TAX
New Mexico issued a bulletin reminding insurers of health insurance premium surtax of one percent of the gross health insurance premiums and membership and policy fees on health insurance or contracts, excluding disability income insurance or contracts, covering health risks within New Mexico. Bulletin 2015-031
SERFF FILINGS
Missouri adopted the requirements of the System for Electronic Rate and Form Filing (SERFF) for submission of documents and reports to the Insurance Department. The adoption is effective January 30, 2016. 20 CSR 100-9.100
Puerto Rico issued a circular letter to life and health insurers writing life, annuities, consumer credit, disability and health insurance in the Commonwealth stating that, as of December 1, it would begin to provide more detailed information regarding the status of SERFF filings, using the State Status section of the filing. The letter provides further details of SERFF functions to be used in such submissions. Circular Letter CC-2015-1870-AV-AS
Texas published a bulletin announcing it will provide viewing access to rate and policy form filings via SERFF effective January 1, 2016 for filings received by the Department after April 14, 2014. Commissioner's Bulletin B-0028-15
SMALL EMPLOYER GROUPS
Indiana issued a bulletin to all insurers and HMO's issuing policies of accident and sickness insurance in the group market. The purpose of this Bulletin is to provide guidance on how Indiana will define a small group for purposes of providing employer health coverage. Bulletin 221
New Mexico issued a bulletin providing clarification of small group sales going forward. Bulletin 2015-029
South Carolina published a bulletin addressing the PACE Act and its definition of small employer for purposes of market reforms under the Affordable Care Act. Bulletin Number 2015-08
STOP LOSS
Maryland issued a bulletin to notify insurers of medical stop-loss insurance of new regulations that require carriers to provide a completed medical stop-loss disclosure form to small employers before entering into a policy or contract of medical stop-loss insurance. The regulations also set forth the standard disclosure form to be completed by carriers. Bulletin 15-28
Utah amended it rules for Stop-loss insurers marketing to small employers to no longer require the use of the Utah small employer stop-loss universal application and provides new stop-loss disclosure requirements. Rule R590-268-5
DOL FIDUCIARY RULE – FIRST CONSULTING CAN HELP
The Department of Labor is likely to release its final rule in the first few months of 2016 which will expand the definition of “fiduciary” under ERISA. Are you prepared for it? Once it is released, do you have a plan of action for implementation? What steps have you taken to ensure your company complies not only with the DOL rule, but also the already existing state regulatory framework?
Once the rule is released, First Consulting will be ready to help explain the rule, how it affects your business, and how it will fit into the current insurance regulatory framework. We can also help you:
- Create a customized compliance plan for implementing the rule’s changes
- Assist with memos or webinars to train your employees or your field force
- Answer one-off questions about the rule’s impact
Please contact me for more information.
Kevin W. Mechtley, J.D.
Consultant
Kevin.Mechtley@FirstConsulting.com
COMPLIANCE TRAINING FOR ALL LINES OF INSURANCE
Finally, Compliance Training developed specifically for the Insurance industry, by members of the Insurance industry! Four distinct topics: Anti-Fraud, Anti-Money Laundering (AML), Office of Foreign Assets Control (OFAC) and Privacy.
First Consulting training delivers:
- accessible online from desktop or laptop 24/7 or via webinar
- customizable with your logo and company policies
- life & health or property & casualty
- in compliance with state or federal training requirements
- Click here to learn more about the specific details of each course.
Visit our website or contact me to learn how we can assist you with Compliance Training or to enroll in a free demo!
Carol Stern, FLMI, AIRC, ACS
816.391.2746
Carol.Stern@FirstConsulting.com
