Life and Health News
June 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!
CAPTIVES
Iowa adopted new Chapter 113, titled Captive Companies. The rules establish the policies and procedures for the administration of captive companies, including financial, reporting and record-keeping requirements. 191-113.1+
Iowa approved a bill revising the calculation used to determine the amount of reinsurance tax due from captive companies. HF 2636
CLAIMS / CLAIMS ISSUES
Connecticut issued a bulletin to insurers regarding health insurance claim payment activity. The bulletin describes those factors that may be considered legitimate disputes for purposes of determining timely payment. Bulletin HC 132
Georgia enacted legislation addressing the requirement to furnish claims experience, upon request, to group policy holders. The new requirement becomes effective July 1, 2024. HB 63
CYBERSECURITY
Nebraska enacted the Data Privacy Act. This law impacts how companies collect, process, and protect personal information. LB 1074
DENTAL INSURANCE
Florida approved a bill amending its statutes on the payment of dental claims. SB 892
DISCRIMINATION
South Carolina passed a law prohibiting insurers writing individual and group life, disability income and long-term care policies from discriminating against living organ donors. HB 3255
DRUG / PRESCRIPTION COVERAGE
Maryland issued a bulletin reminding insurers of the requirements associated with prescription drug utilization review. Bulletin 24-13
ELECTRONIC TRANSACTIONS
Oklahoma passed a bill permitting a health benefit plan sponsor to consent to electronic communication on behalf of covered individuals enrolled in the plan if certain actions are taken. HB 3304
Tennessee passed a law requiring a hospital, physician, or other healthcare provider to accept an electronic insurance card as proof of an individual's health insurance plan or policy. The card must contain specific information. This act takes effect January 1, 2026. HB 1877
West Virginia's Insurance Commissioner issued a new bulletin explaining the changes between the 2019 and 2023 laws regarding electronic prior authorizations. Bulletin 24-03
FILINGS: HEALTH
Maine issued a bulletin notifying companies that it has created uniform deadlines for rate and form filings for non-grandfathered individual and small group Health Plans. The uniform rate and form filing deadline will be June 10, 2024. Bulletin 474
FRAUD / ANTI-FRAUD
Alabama adopted amendments to its insurance fraud law, including increasing the statute of limitations from two years to seven. It also gives insurance fraud investigators the powers vested in law enforcement officers including the power of arrest and service of process. HB 140
California's Special Investigative Unit issued a notification of changes to its SIU Annual Reporting Process. The new due date is September 15 with notification to be mailed during the last two weeks of June. SIU E-Blast 2024-11
GUARANTY ASSOCIATION
Kansas enacted legislation related to the Kansas Insurance Guaranty Association Act. The bill makes numerous changes to the existing act, including updating certain definitions and establishing continuity of guaranty fund coverage when a policy is transferred from one insurer to another. HB 2787
HEALTH CARE EXCHANGE / MARKETPLACE
Federal Centers for Medicare and Medicaid Services (CMS) issued a timeline for calendar year 2024 for Qualified Health Plan (QHP) data submission, rate review, form review and risk adjustment. CMS Notice dated May 8, 2024
North Carolina's Insurance Department issued important filing information for carriers who will submit 2025 Plan Year exchange certified stand-alone dental (SADP) forms and rates to the North Carolina Insurance Department for review and approval. Memo dated April 26, 2024
HOLDING COMPANIES
New Jersey's Insurance Holding Company System law was revised to mirror amendments to the NAIC model regulation. NJAC 11:1-35.13
LONG-TERM CARE INSURANCE
California published a bulletin to all companies writing long-term care in the state, notifying them of the annual assessment to offset the costs of principle-based reserving (PBR). Assessments are applied on the gross annual long-term care premium written the previous year and applied on a tiered basis. Bulletin 2024 - 2
MEDICARE SUPPLEMENT INSURANCE
South Dakota updated the Medicare Supplement rules for plans A through N and Appendix D to incorporate 2024 Medicare Supplement coverage amounts. Regulation 20:06:13
MISCELLANEOUS
Nebraska revised its Deposit of Securities law that covers definitions, depositories, registered securities, and withdrawal. Regulation 210 NAC Ch. 6 s 001
Oklahoma passed a bill which outlines the procedure for a mutual insurer to become a converted stock insurer and a mutual holding company or an intermediate stock holding company. HB 3090
MISCELLANEOUS HEALTH / ACCIDENT
Arizona approved a bill allowing a health insurer to establish a savings incentive program for insureds who utilize a health care provider at a price below the insurers usual reimbursement amount. SB 1402
Colorado enacted legislation addressing limitations on provider-administered drugs and setting standards for required coverage. HB 1010
The Federal Departments of Labor, Health and Human Services (HHS) and the Treasury along with the Office of Personnel Management (OPM) issued FAQs regarding the No Surprises Act. CMS Notice dated May 1, 2024
Iowa published a bulletin providing general information about Short Term Limited Duration Plans and announcing changes in the federal law limiting the maximum allowable coverage period. Bulletin 24-01
Maine published a bulletin summarizing legislative changes affecting health insurance. Bulletin 475
New Jersey's Department of Banking and Insurance issued a bulletin to all health insurance companies, health or dental service corporations and health maintenance or dental plan organizations informing them that consumers who lost Medicare or Children's Health Insurance Program (CHIP) coverage are eligible for a special enrollment period with these organizations. It also revised the guaranteed issue period for Medicare Supplement plans for individuals losing Medicaid coverage. Bulletin 24-05
North Carolina's Department of Insurance provided guidance to insurers regarding the submission of Student Health insurance plans for the 2024/2025 School Year. Memo dated April 26. 2024
Oklahoma amended its law dealing with credentialing and recredentialing of health care providers. If an application for credentialing or recredentialing is denied, the plan shall notify the applicant in writing the reason for the denial and what corrective actions the applicant may consider within ten (10) calendar days of the determination to deny the application. SB 1631
Vermont passed a law requiring insurers to provide coverage for diagnostic breast imaging services without cost-sharing except under a high deductible health plan. HB 621
MISCELLANEOUS LIFE / ANNUITY
California published a bulletin for all companies writing life insurance in the state, notifying them of the annual assessment to offset the costs of principle-based reserving (PBR). Assessments are applied on the gross annual life premium written the previous year and applied on a tiered basis. Bulletin 2024-3
OMNIBUS LEGISLATION
Kansas enacted legislation containing numerous provisions relating to insurance, including provisions for compensation to the insurance department when certain examinations are performed. The legislation sets and adjusts the maximum amounts that will be charged for consulting, data processing and other costs of the examination. SB 356
PHARMACY BENEFIT MANAGERS
Oklahoma amended its Pharmacy Audit Integrity Act to modify audit provisions. SB 1670
PREMIUM TAX
Kentucky published a bulletin outlining current policies and procedures relating to local government premium taxes. Bulletin 2024-03
REPORTS - DATA CALLS & OTHER REPORTS
Colorado published a bulletin providing additional guidance on the on the manner and format for the life insurance interim progress report on use of external consumer data and information sources (ECDIS). Bulletin B-10.003
Illinois adopted revised rules for supplier diversity reports. 50 ILL Adm Code 910.10+