Life and Health News
May 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!
ADVERTISING / SALES & MARKETING
Maine published a bulletin notifying insurers of amendments to the Trade Practices and Fraud Chapter that prohibit the use of any advertising or marketing material that use the term "Medicare", "Medicaid" or "MaineCare" and mimics official notices or otherwise implies that it is an official document. The new sections also require additional disclosure to appear on any advertising or marketing material. Bulletin 471
AFFORDABLE CARE ACT
Colorado published a notice reminding carriers of three new regulations impacting ACA plans, including Regulation 4-2-81 establishing rules for required bronze, silver and gold standardized plans. Regulation 4-2-85 establishes rules for required premium reduction methodology. Regulation 4-2-60 is amended to provide necessary guidance on network adequacy filing procedures. Notice of Adoption 4-24-2024
ARTIFICIAL INTELLIGENCE
Illinois published a bulletin reminding companies that all existing laws and regulations, including unfair trade practices and unfair discrimination, apply to actions involving artificial intelligence systems. The bill explains new regulations requiring insurers to develop and maintain a written program for the use of artificial intelligence to avoid adverse consumer actions. Company Bulletin 2024-08
Nevada's Commissioner of Insurance issued a bulletin regarding the use of Artificial Intelligence Systems by Insurers. Bulletin 24-001
Pennsylvania issued a notice on the Use of Artificial Intelligence Systems by Insurers. Notice 2024-04
Utah created the Artificial Intelligence Policy Act under the Consumer Protection Law. Among other things, it requires a disclosure when an individual interacts with AI in an occupation that requires a state issued license. SB 149
Washington's Insurance Commissioner issued a Technical Assistance Advisory regarding the Use of Artificial Intelligence Systems in Insurance. Technical Assistance Advisory 2024-02
CAPTIVES
Iowa adopted a rule for the implementation and administration of captive companies. 191-113.1
CERTIFICATE OF AUTHORITY FILINGS
Delaware published a bulletin reminding insurers seeking to do business in the state of the department's "seasoning" requirements. No foreign company will be considered for admission until it has been transacting insurance business for three years and shown a net gain from operations at least one year prior to admission. The Department may waive these requirements. Bulletin Number 3 (Reissued)
CLAIMS / CLAIMS ISSUES
Louisiana published a directive to all health carriers. It reminds carriers of the provisions of the Network Adequacy Act and that delays caused by cybersecurity breaches may not disrupt payment for health care services. Insurers are directed to provide alternative processing options or waive certain requirements until operations are restored. Directive 223
CONFIDENTIALITY / PRIVACY
Kentucky enacted, effective 01/01/26, the Kentucky Consumer Data Protection Act. The act requires the appointment of a controller and establishes certain consumer rights relating to personal data. HB 15
CYBERSECURITY
Illinois published a bulletin notifying insurers of new requirements under the Insurance Data Security Law, which became effective 01/01/24. The bulletin explains the mandatory initial notification of a cybersecurity event and the continuing obligation to update. Beginning 04/15/25, there will be an annual certification of compliance required. Bulletin 2024-10
New Jersey, New Mexico, and Washington issued bulletins outlining its expectations for insurers in light of the Change Healthcare cyber-attack. Bulletin 24-04
Utah amended provisions in its law pertaining to cybersecurity, breach notification requirements, and authorized domain name extensions. SB 98
DEFERRAL OF CASH SURRENDER BENEFITS
Idaho issued a bulletin reminding companies that the minimum interest rate to pay on deferred payment of cash surrendered values is 10.250%. This rate will remain in effect until June 30, 2024. Bulletin 24-03
DENTAL INSURANCE
Virginia requires dental carriers that offer large employer coverage (average of at least 51 employees) to annually file an actual loss ratio report with the Insurance Department beginning in 2025. HB 1132, SB 257
DEPARTMENT OF INSURANCE
Idaho enacted legislation amending provisions relating to administrative rules. Changes include allowing the legislature to review and reject materials incorporated by reference. Amendments also require that incorporated materials must be easily accessible on the agency's website. HB 563
Iowa has adopted new regulations defining the re-organization of the insurance department. The new regulation also addresses the requirements for using the commissioner as the agent for service of process. 191-1.1
DISCLOSURE REQUIREMENTS
Virginia passed a Genetic Data Privacy law that applies to direct-to-consumer genetic testing companies. Genetic data cannot be collected, used, transferred, disclosed, or shared without certain disclosures to the consumer and the consumer's written consent. SB 1087
ELECTRONIC TRANSACTIONS
Oklahoma amended its insurance code to allow an insurer to post a policy or endorsement on its website if it does not contain personally identifiable information and meets certain requirements. HB 1505
Virginia passed a law allowing a plan sponsor of a health, dental, or vision benefit plan to agree to conduct insurance business electronically on behalf of a party enrolled in the plan. HB 595
FILING REQUIREMENTS / PROCEDURES
Alabama published a bulletin notifying carriers of the filing deadlines for Plan Year 2025 Qualified Health Plans, including the deadline for submission of individual and small group form filings, 06/12/24 and the rate filing deadline, 07/17/24. Bulletin 2024-01
Michigan published a bulletin providing updated information about the form and rate filing requirements for medical plans. Bulletin 2024-14-INS
FRAUD / ANTI-FRAUD
Delaware published a reissued bulletin regarding the Insurance Fraud Reporting Form. Insurers are reminded of the state's mandatory reporting requirements. Domestic-Foreign Bulletin 15 (Reissued)
GUARANTY ASSOCIATION
The District of Columbia updated its summary disclosure regarding the life and health insurance guaranty association. The department has removed addresses from the notice to avoid the need to update the notice when any address changes. Bulletin 04-IB-003-6/1 (Revised 03/04/24)
HEALTH INSURANCE - COMPREHENSIVE
Delaware enacted legislation requiring certain individual and group carriers to cover annual ovarian cancer screening tests for women at risk for ovarian cancer. HB 15
Delaware published a bulletin reminding health carriers that HB 60 requires service for diagnostic breast examinations and supplemental screenings be covered at least as favorably as mammogram screenings. Domestic and Foreign Insurers Bulletin 145
Mississippi enacted a law requiring health carriers, when administering a policy issued in another state covering an insured in the state of Mississippi, to offer reimbursement based on the state of issuance, under certain conditions. HB 1410
Nebraska passed a law requiring self-funded and insured health plans to not impose deductible, coinsurance, or any other cost-sharing requirements for colorectal cancer screening. LB 829
INSURER INVESTMENTS / SECURITIES
Iowa enacted HF 2405, making a number of changes in the statute governing investments made and held by life insurance companies and adding a new definition for "credit instrument". HF 2405
MEDICARE SUPPLEMENT INSURANCE
Arizona updated its regulations to adopt by reference the most recent changes to the Model Regulation to Implement the NAIC Medicare Supplement Insurance Minimum Standards. R20-6-1101
Nevada issued a notice regarding the Medicare Supplement "Birthday Rule" which contains details for carriers implementing this rule. Notice dated March 29, 2024, AB 250
Oklahoma's Insurance Commissioner advised Medicare Supplement carriers of a regulation change that requires carriers to provide new supplement policies with the same or lesser benefits to current Medicare supplement policyholders who have had no gap in coverage greater than 90 days. Notice dated February 27, 2024
Vermont's Insurance Commissioner reminds companies and producers who sell Medicare Supplement coverages that the producer must make reasonable efforts to determine the appropriateness of a recommended purchase or replacement and comply with insurance laws. Bulletin 151 (Revised)
OMNIBUS LEGISLATION
Indiana enacted numerous measures, including changes to the oversight of continuing education courses. It also removes the requirement for an alien or foreign insurer to annually file with the department a statement of its assets and liabilities. HB 1332
PHARMACY BENEFIT MANAGERS
Oregon revised its Pharmacy Benefit Manager law to require manuals and contracts to be filed with the Department of Consumer & Business Service. A PBM must also be licensed instead of just registered with the DCBS, among other items. HB 4149
Tennessee amended several rules including definition changes, appeal requirements, reporting and fees. Rule 0780-1-95-.02
TRADE PRACTICES
Maine enacted legislation requiring telephone solicitors, prior to commencing a sales call, to use the reassigned numbers database to verify that a consumer's telephone number has not been reassigned. HP 1433