Life and Health News
September 2022
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
Illinois issued a bulletin sharing tips with prospective license applicants when completing background questions in an effort to reduce problems and delays in processing license applications. Bulletin 2022-14
North Carolina eliminated the requirement for a broker license for both resident and non-resident individuals. The requirement for a resident broker to maintain a bond is also eliminated. A producer may now procure insurance for parties other than themselves through a duly authorized agent of an insurer without holding a broker license. All existing broker licenses will be cancelled. This cancellation is not an administrative action and need not be reported to other states. Notice dated July 14, 2022
ANNUITIES / ANNUITY CONTRACTS
Colorado amended its regulation concerning Best Interest Obligations and Supervision in annuity transactions to require an insurance producer to act in the best interest of a consumer when making a recommendation of an annuity. New sections were added to provide disclosure and election forms. Regulation 4-1-11
CAPTIVES
Delaware issued a bulletin to all captive managers, auditors, and actuaries accredited in Delaware and members of the Delaware Captive Insurance Association. The purpose of the bulletin is to inform all captive insurers that Delaware adopted NAIC Actuarial Guideline XLVIII (AG 48). Captive Bulletin 11
DEPARTMENT OF INSURANCE
Colorado Department of Insurance requires all domestic and foreign insurance carriers to designate a registered agent other than the insurance department. Bulletin B-1.37
Maryland issued a bulletin to all insurers indicating that Maryland accepts payment of corporate amendment and expansion application filing fees electronically through OPTins. Bulletin 22-10
DRUG / PRESCRIPTION COVERAGE
West Virginia issued guidance regarding cost sharing for prescription insulin drugs. Cost sharing is limited to $100 for a 30-day supply regardless of quantity or type of insulin. Bulletin 2022-09
ELECTRONIC TRANSACTIONS
Mississippi enacted the Insurance E-Commerce Model Act to regulate the electronic delivery of insurance documents and notices. HB 1187
EXCEPTED BENEFITS
New Mexico amended standards for accident-only, specified disease, hospital indemnity, disability income, supplemental, and non-subject worker excepted benefits. 13.10.34.1 + NMAC
HEALTH INSURANCE - COMPREHENSIVE
Federal Departments of Labor, Health, and Human Services (HHS) and the Treasury issued FAQs with guidance on implementing the requirements of The No Surprises Act, including those related to surprise billing protections, open negotiation, and the federal IDR (Independent Dispute Resolution) process. FAQs Part 55
Illinois issued a bulletin to all companies writing Accident and Health Insurance and Managed Care Plans. This bulletin gives direction as to how the federal No Surprises Act fills gaps in protecting against balance billing and prior authorization under Illinois law. The scope of service, providers and facilities has expanded. Company Bulletin 2022-13
Illinois issued a bulletin to health insurers giving guidance related to coverage of reproductive health care services, including abortion and contraceptives. Company Bulletin 2022-15
Oregon issued a bulletin to all entities offering health benefit plans regarding coverage of Human Monkey Pox Virus vaccine. The guidance involves network restrictions, cost sharing, prior authorization, and utilization review. Bulletin dated 8/10/22 concerning hMPXV vaccination
HOLDING COMPANIES
Louisiana amended its Holding Company Regulation by adding provisions for exemptions to the filing of reviewed financial statements for both Form A and Form B. Regulation 31
MENTAL HEALTH PARITY
Arizona adopted a new regulation to implement the Arizona Mental Health Parity Act (also known as "Jake's Law) dealing with reporting and benefits. Regulation R20-6-1301
MISCELLANEOUS HEALTH / ACCIDENT
Colorado adopted a regulation setting forth the minimum requirements for occupational accident insurance coverage for independent contractors of common and contract carriers. Benefits must include medical, temporary, and permanent disability, death and dismemberment and survivor benefits. Regulation 22-E-13
The District of Columbia amended the Universal Paid Leave Amendment Act of 2016 to prohibit insurers from reducing short-term disability benefits based on actual or estimated paid leave benefits, regardless of the jurisdiction in which the policy was issued or written. B 915
NONFORFEITURE
Indiana revised the minimum nonforfeiture interest rate for deferred annuities from 1% to 0.15%. HB 1238; 27-1-12.5-3
PHARMACY BENEFIT MANAGERS
Arkansas issued a bulletin to all licensed pharmacy benefit managers reminding them of the prohibition on charging a fee to pharmacies related to claims processing or participating in a pharmacy benefits manager network. Bulletin 10-2022
REINSURANCE
West Virginia amended its rule concerning Term and Universal Life Insurance Reserve Financing to adopt the NAIC model regulation. It applies to reinsurance treaties that cede liabilities pertaining to covered policies issued by a domiciled company. Rule 114-102-1
RESERVE VALUATION
Maine updated its Minimum Reserve Standards for individual and group health insurance contracts. Rule Chapter 130
Mississippi adopted the NAIC Valuation of Life Insurance Policies regulation, including the introduction and use of New Select Mortality Factors, Model Regulation. Rule 19.01 +
TRADE PRACTICES
Delaware updated its rule prohibiting unfair claim settlement practices. It is considered prima facie evidence of a general business practice of committing an unfair claim settlement practice if the Department of Insurance finds, given a sample of claims during an investigation or examination of an insurer, that the total number of unfair claims settlement practices exceeds 4% or more of claims within a single category of prohibited practices and in a single 12-month period. Rule 902
Louisiana increased the maximum penalty for a violation of the Unfair Trade Practices Law from $250,000 to $500,000 in a 6-month period. SB 209
Texas issued a bulletin reminding all insurers of their duty to act in good faith and to promptly pay settled claims. Bulletin B-0006-22