Life and Health News

October 2018

Welcome to our latest newsletter!  As a thought leader in the Insurance Industry for over 49 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!


ADVERTISING / SALES & MARKETING

Tennessee issued a bulletin to all licensed insurance producers regarding the use of the terms "Medicare", " Medicaid", "Social Security", or "TennCare" in advertising and business names.     Bulletin 18-01


AGENT / PRODUCER LICENSING AND APPOINTMENT

New Mexico issued a notice stating all active resident and non-resident individual licensees may renew their license 90 days prior to expiration.  All continuing education requirements for NM residents and those designating NM as their resident state must be completed at least 30 days prior to the license expiration date.     Individual License Renewal Notice

The Virgin Islands issued a bulletin notifying agents/brokers of the passage of the Virgin Island Producer and Adjuster Licensing Act.  This includes such items as the qualifications, procedures and requirements for licensing producers/brokers.  It also implements new licensing fees and creates a new licensing class of managing general agent.  Renewals must be filed by December 31 of each year.     Bulletin 2018-04


CYBERSECURITY

South Carolina issued a bulletin regarding cybersecurity.     Bulletin Number 2018-09


DISASTER / CATASTROPHIC EVENT

California has passed a bill requiring insurers to provide access to medically necessary health care when an insured has been displaced by a declared state of emergency. Insurers must, within 48 hours of declaration, file a notification describing any experienced disruption, or expectation of disruption to its operations, how it's communicating with the impacted, and summarizing the actions it has taken. This bill is effective 01/01/19.     AB 2941

Maryland issued a bulletin regarding the declaration of a state of emergency.  During the emergency, health insurers are required to waive the time restrictions on prescription medication, replacement of durable medical equipment or supplies, eyeglasses, and dentures.     Bulletin 18-17; 31.01.02.06A(3&4)

New Jersey terminated its Executive Order issued on August 14, 2018 declaring a State of Emergency due to severe weather events for Bergen, Essex, Monmouth, Ocean and Passaic counties.     Executive Order 2018-37

South Carolina issued an Executive Order regarding a moratorium on cancellation due to nonpayment of premiums and certain nonrenewals and extensions of insurance-related provisions affecting insureds impacted by Hurricane Florence.     Executive Order 2018-26, R 69-79


DISCLOSURE REQUIREMENTS

Nevada amended its regulation requiring certain information be included in certain agreements for consultation or advice relating to insurance, effective August 30, 2018.     NAC 686A s 1 (LCB File No. R001-18);  NAC 686A.320;  NAC 686A.330;  NAC 686A.340


FILING REQUIREMENTS / PROCEDURES

Nebraska issued a notice regarding short-term duration medical plan filing requirements.     Notice dated September 14, 2018


HEALTH INSURANCE / HEALTH RATES

Colorado adopted regulations to provide the necessary guidance to ensure that health insurance rates comply with Colorado's health benefit plan rating laws for insurers issuing non-grandfathered individual, small group, and/or large group health benefit plans. The regulation is effective 10/15/18 and replaces Emergency Regulation 18-E-01.     3 CCR 702 Reg. 4-2-39 s2 +

Colorado issued an emergency regulation, effective 09/07/18, to establish rules governing enrollment periods for individual and group health benefit plans. The Commissioner finds that the volatility and uncertainty within the individual insurance market, and the potential for consumer harm, constitute a triggering event requiring a special enrollment period. This regulation expires 01/02/19.     Emergency Regulation 18-E-04

Illinois made several amendments to its insurance code regarding the coverage of fertility preservation services. These amendments pertain to contraceptive coverage for male sterilization procedures, medically necessary expenses for fertility preservation, and potential discrimination when determining coverage. The amendments are effective 01/01/19.     HB 2617, Public Act 100-1102

Montana issued a message in SERFF stating that effective 10/02/18, insurers need to be licensed in the state and new forms must be approved that meet federal requirements and state laws in order to begin selling Short-term Limited Duration Health Insurance Plans. Also, previously approved forms cannot be used.     SERFF state message dated 8/31/18


INDUCEMENTS

Washington issued an advisory to all insurers in the state regarding "implementation credits".  An insurer paying, offering, promising, or agreeing to pay implementation credits violates WA insurance law regarding inducements or rebating.  Any filings that include implementation credits have been or will be rejected.     Advisory T-2018-01


LONG-TERM CARE INSURANCE

California has amended section 10235.50 of the Insurance Code, effective 01/01/19, to protect long term insurance policyholders from increased premiums. The bill provides requirements for insurers including offering inflation protection provisions and reducing or eliminating benefit adjustments provided by such provisions on policies issued after 01/01/20.     SB 1046, Section 10235.50


MISCELLANEOUS

Oklahoma distributed an email discussing its new Insurance Business Transfer (IBT) law.  The IBT law goes into effect in November and creates a way for insurers to transfer blocks of business to OK-based insurance companies.     Email dated 8/24/18


MISCELLANEOUS HEALTH / ACCIDENT

Alaska issued a bulletin stating that the DOI will resume oversight of the external review process on October 1, 2018. Health care insurers are encouraged to review Bulletin 18-05 and Bulletin 1810 for details.     Bulletin B 18-13

California has amended the Health and Safety Code regarding reporting of         unfair payment patterns and unfair billing patterns in Health Care Service Plans. The changes are effective 01/01/19 and require the department to review complaints on or prior to 07/01/19 and at least annually thereafter.     H & S s 1371.39

Colorado amended a rule that sets forth the minimum required information for health carriers to provide on an explanation of benefits form sent to covered persons. This rule applies to health and dental plans issued on or after the effective date of 10/01/2018.     3 CCR 702-4 Regulation 4-2-35

Colorado revised a bulletin regarding renewal and re-determination notices. The bulletin provides templates for notices to be sent by carriers to provide individual health benefit plan policyholders with information regarding their renewal status and re-determination information for Advanced Premium Tax Credits (APTC).     Revised Bulletin B-4.79

Delaware added glaucoma and chronic debilitating migraines to the list of debilitating medical conditions which may qualify a person, upon certification by a physician, to be eligible for the use of medical marijuana in accordance with the terms of the Delaware Medical Marijuana Act.     HB 374

Delaware has issued a bulletin to inform domestic and foreign insurers that the Governor has signed HB 303 into law which increases the annual assessment to domestic and foreign insurance companies admitted or authorized to transact business in the State of Delaware from $750 to $900. The revenue generated from the increased fees will be used to support the administration and operating costs within the Department of Insurance's Fraud Prevention Bureau.     Domestic/Foreign Insurers Bulletin 102

New Hampshire issued a bulletin in response to the U.S. Department of Labor's issuance of its final Association Health Plan rule.     INS 18-045-AB; Bulletin dated August 31, 2018

Oregon issued a bulletin regarding Regulation of Association Health Plans.     Bulletin No. 2018-07