Annual Statements and Data Calls
Delaware says in Captive Insurance Bulletin 1 that it now requires captive insurance companies domiciled in the state to file quarterly and annual statements if they reinsure life insurance policies as part of a securitization transaction.

    A new Illinois rule, 50 IAC 4203.10 to.230, puts new requirements in place for medical malpractice insurers to provide data to the insurance division. The procedures apply to all direct property and liability business written in the state. Illinois does not want reinsurance premium data, including premiums ceded to, or for losses recovered from, other insurers because of the reinsurance ceded. Content, form and data reporting requirements are in the rule. Separately, Illinois has a March 1 deadline for insurance companies to submit information about policies in force for various lines of insurance. The data call contains the reporting requirements for each line.

    New York has three data calls due soon – the annual Section 3425 Compliance Report by April 30, Regulation 41 excess line information by March 15 and medical malpractice net premiums data by March 1. It is also requiring, in Circular Letter 2 (2007), that an additional copy of the annual Special Investigations Unit fraud report be submitted electronically, using an electronic form, on the insurance department’s Web site.

Health Insurance
Massachusetts Bulletin 2007-01 restates requirements in a new state law that health benefit plans providing dependent coverage must make that coverage available, for persons having “a qualified event,” through their 26th birthday or the day two years following the loss of their dependent status, whichever is earlier. The requirement applies to all insured health plans and HMOs, but not to stand-alone dental plans or Medicare supplement plans. Plans that provide services through a defined network of providers can restrict coverage to persons, including dependents, who live in the plan service area. Except for limitations of family relationships and other limits permitted by law, insurers cannot impose any limits on eligibility for dependent coverage.

    Massachusetts Bulletin 2007-02 contains an addendum, Massachusetts Bulletin for People with Medicare, that must be provided with the state’s 2007 Guide to Health Insurance for People with Medicare.

    New York has amended its cosmetic surgery rules. The 35th Amendment to Regulation 62 makes denials of coverage for cosmetic surgery subject to the utilization review and external appeal requirements of state law. The insurance department says that insurers and HMOs have been making cosmetic surgery determinations inconsistently and have denied policyholders the right to appeal the decision.

Life Insurance
Kansas, in KAR 40-2-20, has requirements for accelerated benefits in life insurance policies, including five categories of qualifying conditions – life expectancy of less than two years, and conditions that require extraordinary medical intervention or continuous confinement in a medical facility.

Medicare Supplements
Delaware has revised Title 18 Sec 1501, Subsection 17.4.4 to make it clear that insurers must make Medicare supplement plans A, B, C and F available to consumers. Details about the plans’ benefits are in the rule.

Policy Requirements
Texas has amended 28 TAC 1.601 to change the wording of a notice that insurers and HMOs must give to consumers about the insurance department’s toll-free telephone number for getting information and filing complaints. The notice must appear on a full, separate page with each insurance policy, certificate, annuity contract, health care plan or evidence of coverage issued or renewed in the state. The changes add e-mail and Internet contact information and make several stylistic changes that must be followed in the notices.

Producers
Idaho has become the latest state to require its producers to complete a one-time, three-hour continuing education course before selling federal flood insurance. The insurance department’s Web site provides details in Bulletin 07-1 and a list of approved courses.

    Iowa’s licensing Web site is back in business after being down for several weeks for an overhaul. The new site is tied to the National Association of Insurance Commissioners national online renewal system.

    The Massachusetts appointment renewal site is now operational, according to a recent notice. The processing of appointments to be renewed or nonrenewed must be completed before April 8.

    South Dakota SB 23 places new limits on unsolicited sales calls based on a prior or existing business relationship. Such a relationship must be formed by either a purchase or transaction within the previous 18 months or an inquiry or application within the previous three months, and cannot have been terminated by either party.
(Produced with the assistance of The CLEAR Report)

Publish date Mar 05 2007
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Reprinted with permission from Insurance Compliance Insight.
Copyright © 2007 Praxsys Publishing Inc.
Licensed from Praxsys Publishing Inc. All rights reserved.