SAMPLE ARTICLE: Insurance Regulations, Bulletins, and Legislation
(Alphabetically by line of business/topic and then by state.)
Accident and Health
Arkansas Insurance Department issued Bulletin No. 13-2023 on August 28, 2023. The Bulletin lifts the administrative stay that was in place pending the review of Act 1103 of 2021 Drug Pricing Nondiscrimination Act, by the Eighth Circuit Court of Appeals in Pharmaceutical Research & Manufacturers of America v. McClain. The stay was lifted due to the “immediate need of hospitals to have enforcement of the Act.” Enforcement of Act 1103 will begin with current and prospective complaints.
Arkansas Insurance Department issued Bulletin No. 14-2023 on September 1, 2023. The Bulletin is in response to questions received regarding Act 494 of 2023, which requires reimbursement for behavioral health services provided in hospital outpatient clinics or a physician clinic. The coverage must not be subject to any policy deductibles or copayment requirements, and it may not diminish or limit other benefits under the health benefit plan.
Delaware Department of Insurance issued Bulletin No 139 on August 28, 2023, regarding the correction of a technical error in Senate Bill 227 relating to reimbursement for chronic care management to eliminate an inadvertent difference in the requirements between types of plans. The change clarifies that the law applies to group and blanket plans.
North Carolina Department of Insurance issued State of Emergency Bulletin 23-B-06 on August 29, 2023, regarding compliance requirements for health benefit plans to allow extra prescriptions during a state of emergency or disaster. Extra prescriptions are allowed under the Bulletin when the request is made within 29 days of the date of the Bulletin.
Texas Department of Insurance issued Commissioner’s Bulletin B-0012-23 on August 31, 2023, listing the insurance legislation passed and signed during the recent legislative session.
HB 3359 – Network adequacy and access plan requirements - Adds network adequacy framework, data requirements, and requirements for travel time, distance, and appointment wait times. HB 3359 requires a public hearing before approving a waiver to determine whether there is good cause for a waiver. The new law also expands annual report requirements to include data on waivers, deviation from network adequacy standards, and corrective actions, sanctions, or penalties related to deficiencies. See the legislation for various effective dates. TDI will adopt rules.
HB 1592 – Self-funded ERISA opt-in to Texas balance billing dispute resolution - Allows ERISA health employers to opt into the Texas balance billing and independent dispute resolution system. Effective September 1, 2023. TDI will adopt rules.
SB 2476 – Ground ambulance balance billing - Expands current balance billing prohibitions to include ground ambulance services. SB 2476 directs TDI to create an emergency service provider balance billing rate database. Health plans must reimburse ground ambulance services at a rate set, controlled, or regulated by a political subdivision if the entity has submitted the rate to the TDI database (with an annual increase per Medicare Inflation Index, not to exceed 10%), or the lesser of the billed charge or 325% of Medicare. Effective September 1, 2023. The changes apply on or after January 1, 2024. TDI will adopt rules.
HB 999 – Copay accumulators - Requires a health benefit plan issuer or pharmacy benefit manager to apply any third-party payment for prescription drugs to the enrollee's deductible, copayment, cost sharing responsibility, or out-of-pocket maximum applicable to prescription drug benefits under the enrollee's plan. Effective September 1, 2023. The changes apply on or after January 1, 2024.
SB 1286 – Clarify prompt pay waivers during a catastrophe - SB 1286 authorizes TDI to limit the duration of relief from claim-handling deadlines. TDI may approve or disapprove requests for extensions and will update rules to clarify the process for requesting an extension. Effective September 1, 2023.
SB 1003 – Expanding provider directory - requires provider directories to include non-physician providers who may bill separately from a facility. Non-physician providers include nurse anesthetists, anesthesiologist assistants, nurse midwives, surgical assistants, physical therapists, occupational therapists, and speech–language pathologists. Effective September 1, 2023. Websites must be updated by January 1, 2024. TDI will adopt rules.
HB 711 – Network contracting
Prohibits the following provisions in network provider contracts:
Anti-steering
Anti-tiering
Gag clause
Most favored nation clause
See legislation for full information on effective dates. TDI will adopt rules.
HB 290 – Multiple Employer Welfare Arrangements (MEWAs) - Allows MEWAs based on the employers' geographical association, allows for "working owners" to get MEWA coverage, waives the two-year requirement, and requires demonstration of federal compliance. MEWAs are authorized to provide comprehensive health benefit plans and structure them like a PPO/EPO, provided the MEWA complies with additional Insurance Code provisions. Effective September 1, 2023 (for MEWAs issued an initial certificate of authority on or after January 1, 2024, or to MEWAs that elect to opt in). TDI will adopt rules.
HB 1996 – Group family leave insurance - Creates minimum standards for group family leave insurance products as a type of disability income insurance. Includes an exception for foreign groups from filing for review and approval. Effective September 1, 2023. The changes apply on or after January 1, 2024.
HB 2002 – Credit for direct provider payment - Requires an insurance company to credit toward the plan deductible and out-of-pocket maximum an amount that the policyholder pays directly to any provider for a medically necessary covered service/supply if
a claim for that service/supply isn't submitted to the insurance company, and
the amount paid by the policyholder is less than the average discounted rate paid to an equivalently licensed in-network provider.
Effective September 1, 2023. The changes apply on or after January 1, 2024. TDI will adopt rules
SB 622 – Disclosure of prescription drug coverage information - Starting in 2025, SB 622 requires health plans to provide information about an enrollee's prescription drug coverage upon request through a standard application programming interface. Issuers with less than 10,000 enrollees may register with TDI for a temporary extension. TDI will issue a bulletin to advise issuers on how to request an extension. Effective September 1, 2023. The changes apply on or after January 1, 2025.
HB 1696 – Optometrist contracting - Prohibits managed care plans from discriminating against an optometrist or therapeutic optometrist based on their licensure. Plans are prohibited from changing a contract with an optometrist or a therapeutic optometrist without advance written notice, prohibits the inclusion of certain provisions in a contract, prohibits chargebacks, and prohibits differential reimbursement based on certain characteristics of an optometrist's or therapeutic optometrist's practice. Effective September 1, 2023. The changes apply on or after January 1, 2024. TDI will adopt rules.
Life Insurance/Annuities
Texas Department of Insurance issued Commissioner’s Bulletin B-0012-23 on August 31, 2023, to provide a list of the insurance legislation that was passed and signed during the recent legislative session.
HB 2839 – Liquidity stress testing - Adds requirements and confidentiality standards for an annual liquidity stress test for large life insurance companies. Liquidity stress testing (LST) is a National Association of Insurance Commissioners accreditation standard in states designated as a lead state for companies triggering the LST requirement. Effective September 1, 2023. TDI will adopt rules.
HB 1587 – Life and annuity oversight - Exempts certain life and annuity products from the form filing and approval process. The new law also limits the requirement to obtain the commissioner's approval to use a separate account in conjunction with certain life and annuity products to domestic insurance companies. Effective June 9, 2023.
Property and Casualty
Alaska Insurance Division issued Bulletin B 23-05 on August 29, 2023, providing the list of eligible surplus lines insurers. This Bulletin supersedes Bulletin B 23-02.
Florida Office of Insurance Regulation issued a Data Call Notice on Hurricane Idalia Catastrophe Reporting. Daily reporting is required beginning on September 1, 2023, and running through Wednesday September 6, 2023.
Hawaii Insurance Division issued Memorandum 2023-HE, a data call related to the August 2023 wildfire and wind damage claims, on September 1, 2023. The data must be provided semi-monthly, with the first report due on or before September 15, 2023. In addition to claims, there are two non-claims schedules to be completed; one related to reinsurance and the second is a total insurance value schedule by zip code and line of business.
Louisiana Department of Insurance launched a second round of applications for insurers who want to participate in the Insure Louisiana Incentive Program. Applications are due by September 30, 2023. To participate, insurers must meet solvency standards that are consistent with those required by the federally backed mortgage companies. The insurers will also be subject to enhanced solvency monitoring including, but not limited to, newly increased capital and surplus requirements, monthly reporting and in-depth reinsurance program reviews.
Louisiana Department of Insurance issued Bulletin 2022-09 (Revised and Reissued) on August 31, 2023. The Bulletin remined property and casualty carriers who issue homeowner policies that the Commissioner’s catastrophe claims process guide must be provided to policyholders whenever a state of emergency is declared by the Governor and the policyholder is asserting a claim. The Guide is available here. The required Certificate of Hand-Delivery is available here.
Maryland Insurance Administration issued Bulletin 23-12 on September 1, 2023. The Bulletin provides information for property and casualty carriers and producers regarding a new law (HB 0128), which addresses Private Passenger Motor Vehicle Liability Insurance – Enhanced Underinsured Motorist Coverage. The new law becomes effective on October 1, 2024, and applies to all new private passenger auto quotes, binders, and policies issued, sold, or delivered on or after July 1, 2024. In addition, the MIA encourages carriers to make the necessary filings by March 1, 2024, as standalone form filings and standalone rate/rule filings in order to expedite the review.
Michigan Department of Insurance and Financial Services issued Bulletin 2023-20-INS on August 25, 2023. The Bulletin provides updates to the hospitals entitled to enhanced reimbursement from auto insurers based on indigent patient volume.
Michigan Department of Insurance and Financial Services issued Bulletin 2023-21-INS on September 1, 2023. The Bulletin provides payment and billing guidance for no-fault auto insurers and health care providers.
Montana Commissioner of Securities and Insurance issued a new Advisory Memorandum on August 14, 2023, reminding insurers of the rules regarding insurance refusals and wildfire risks. The Memorandum indicates that previously Insurance Commissioners have relied on a 2000 Advisory Memorandum, but the office has recently received consumer complaints due to refusals to write new or increased coverage to “the alleged risks of wildfires in Montana.” The Memorandum includes the statutory reference prohibiting that practice. The Commissioner states, “Any refusal to issue or renew, or any cancellation or limitation on the amount of property or casualty insurance based on the threat of wildfires and which involves property that does not have a substantially increased risk of loss due to wildfires will be investigated for violation of the Montana Insurance Code. This office will aggressively pursue any such violation of this statute.”
Texas Department of Insurance issued Commissioner’s Bulletin # B-0011-23 on August 28, 2023, to all insurance companies licensed to write property and casualty insurance in Texas advising of the Calendar Year 2022 disallowed expenses data call. Data is due on September 29, 2023. The forms are included as links within the Bulletin.
Texas Department of Insurance issued Commissioner’s Bulletin B-0012-23 on August 31, 2023, to provide a list of the insurance legislation passed and signed during the recent legislative session.
HB 1900 – Earlier notice of nonrenewal or cancellation - Requires insurance companies to give a 60 day notice (rather than 30 days) for nonrenewal or cancellation of a policy. The Bill applies to personal auto policies, residential property policies, and policies issued to governmental entities. Effective September 1, 2023, the changes apply only to policies delivered, issued for delivery, or renewed on or after January 1, 2024. TDI will adopt rules.
HB 1706 – Right to a public adjuster - Establishes the right of a policyholder to hire a licensed public insurance adjuster. An insurance policy may not include a provision that prohibits a policyholder from contracting with a public insurance adjuster. Effective September 1, 2023.
HB 1074 – Rebating and loss control - Clarifies that loss control and mitigation services are not deceptive trade practices, nor are they prohibited by the anti-rebating and anti-inducement statutes. Costs to the insurance company must be reasonable in comparison to premiums or coverage. Effective September 1, 2023.
SB 224 – Catalytic converter theft - Increases the Motor Vehicle Crime Prevention Authority fee from $4 to $5 per motor vehicle each year. SB 224 also increases criminal penalties for catalytic converter theft. Effective May 29, 2023. TDI will adopt rules.
HB 2190 – Accident/collision terminology - Changes the terminology used to describe transportation-related accidents from "accident" to "collision" including in the Insurance Code. The legislation doesn't change statutory definitions. Effective September 1, 2023. TDI will adopt rules.
HB 998 – FAIR Plan expansion - Expands eligibility for FAIR Plan coverage. A property owners' association no more than 10 miles beyond the designated catastrophe area (Texas Windstorm Insurance Association service area) may be insured through FAIR Plan if the commissioner determines that coverage isn't reasonably available. Effective September 1, 2023. Coverage will be available on or after September 1, 2024. TDI will adopt rules.
SB 2008 – Farm Mutual service expansion - Increases population limits for what is considered "rural" property for farm mutual insurance companies from 2,500 or less to 6,500 or less. Effective September 1, 2023.
State Regulation of Insurance
Delaware Department of Insurance issued Domestic and Foreign Insurers Bulletin No. 140 on August 28, 2023. The Bulletin sets forth the increases to the minimum amount of capital stock or unimpaired basic surplus and free surplus an insurer must possess and maintain during the year.
New Mexico Office of Superintendent of Insurance issued a Notice on August 29, 2023, providing an extension of time to pay the New Mexico Fraud Assessment until October 2, 2023. After that date, there is a penalty of $1,000/month or partial month in which the assessment is unpaid.
Texas Department of Insurance issued Commissioner’s Bulletin B-0012-23 on August 31, 2023, to provide a list of the insurance legislation that was passed and signed during the recent legislative session.
HB 1040 – Electronic communication - Allows regulated entities to conduct business electronically to the same extent as in-person transactions, provided all parties agree or receive notice and don't request otherwise. A notice of the cancellation or termination of a policy must be in paper or another nonelectronic form. Effective September 1, 2023. TDI will adopt rules.
HB 1903 – Capital stock requirements - Removes the requirement for insurance companies to have at least 50% of their authorized stock issued and outstanding. Effective September 1, 2023.
States of Emergency
Georgia Governor declared a State of Emergency on August 29, 2023, due to the potential impact of Hurricane Idalia. The Office of Commissioner of Insurance and Safety Fire issued this statement on the same date with this reminder, “From allowing Georgians to receive an early refill of important medications to a ban on public adjusters from soliciting new business, these measures are designed to protect Georgians at their most vulnerable during a national disaster.”
North Carolina Governor declared a State of Emergency on August 29, 2023.