Automobile Insurance
    New Jersey Bulletin 09-20 reminds personal auto carriers they have not had to offer insurance to all comers since Jan. 1. As a result, the state says nonrenewal notices should not say that an insurer may only deny coverage to individuals who are not eligible persons and which reference appeals to the Insurance Department for denials of coverage. Instead, cancellation and nonrenewal notices should conform to the existing rules at NJAC 11:3-8.5(b).
 
    New Jersey Bulletin 09-23 reminds insurers they must calculate and add state sales tax to the salvage retention deductions in the written total loss cash settlement valuations given to their insureds and third-party claimants.
 
 
Data Calls
    Maine Bulletin 359 gives a blanket extension, until Aug. 14, for certain health carriers to submit specified information under Chapter 765, Health Insurance Emergency Planning and Procedures. Insurers with less than 500 covered lives in Maine may file a statement with the Insurance Bureau indicating the number of covered lives in Maine instead of filing the specified information.
 
 
Health Insurance
    Florida Informational Memorandum OIR-09-04M tells of changes to state law in HB 185 that create two new provider contract prohibitions for prepaid limited health service organizations (PLHSOs). Contracts between those entities and a provider of limited health services may not prohibit or restrict the provider from contracting with other PLHSOs. The entities are also prohibited from requiring providers to accept the terms of other health care practitioner contracts with the PLHSO, or any insurer or other PLHSO under common management or control with the PLHSO. These prohibitions apply to all contracts entered into or renewed on or after July 1, 2009.
 
    New Hampshire Bulletin INS 09-038-AB reminds health insurers and HMOs that they cannot apply a preexisting condition limitation period to a person who had a lapse of health coverage greater than 63 days, when the basis for the lapse of health coverage was due to unemployment and the person has remain unemployed during the entire period of time that coverage has lapsed. But the provision doesn’t apply to a person who obtained employment, but wasn’t offered health coverage. A carrier can ask for tax forms or other information to confirm that the member has remained unemployed during the entire period of time that health coverage has lapsed.
 
    Oregon has amended OAR 836-052-0900 to bring state standards for physician credentialing in line with national and federal standards. The changes were adopted July 16 and are effective Oct. 1.
 
    South Carolina Bulletin 2009-10 serves as a supplement to Bulletin 2007-02 with regard to fees for COBRA administrative services. Included in the guidance is a note that no one engaged in the business of insurers is permitted offer COBRA administrative services for no fee or a reduced fee. That includes a prohibition against providing the service for no fee if a client purchases insurance coverage.
 
 
Insurance Fraud
    A proposed rule in Texas, 43 TAC 25.977, would eliminate the phone numbers of crash victims from police accident reports. The Coalition Against Insurance Fraud thinks that will help prevent fraud rings from badgering accident victims to seek bogus injury treatment at crooked clinics. “We applaud the department’s proposed rule in eliminating phone numbers, which are a major source by fraud rings to solicit accident victims for fraudulent purposes,” the coalition wrote to Texas officials. The Insurance Department will hold an Aug. 4 public and accept written comments through August 7.
 
 
Life Insurance & Annuities
    Massachusetts Bulletin 2009-10 discusses the state’s policy about exclusions for war in life insurance policies issued in Massachusetts. It doesn’t apply to the sale of life insurance policies to an individual known to be a service member at the time of sale; that issue is addressed in rule 211 CMR 27.04. For others, a policy, endorsement, exclusion, or rider may contain provisions excluding or restricting coverage as specified therein in the event of death under the following condition:
    Death as a result of war or an act of war, if the cause of death occurs while the insured is serving in the military, or within six months after termination of service in the military forces.
    Insurers must change any policy forms on file to make them consistent with the requirements in the Bulletin. The current guidance replaces Bulletin 2006-04, which has been withdrawn. 
 
    Oregon Bulletin 2009-7 withdraws Bulletin 2009-6, dealing with filing procedures for life insurance and annuity advertisements. The earlier notice, in turn, had withdrawn Bulletin 2000-2 and Bulletin 2009-3. The end result is that all four bulletins have now been withdrawn. The Insurance Division told ICI that it doesn’t think there is a need for a bulletin about filing instructions. Instead, it is putting all filing instructions in the Transmittal & Standards Form. You will need to include a certificate of compliance with all filings.
 
 
Medicare Supplement Insurance
    Arizona joins a growing list of states with its Bulletin 2009-02 that addresses how it will conform Arizona’s Medicare supplement insurance rules to the 2008 revisions adopted by the National Association of Insurance Commissioners (“NAIC”) to the NAIC Model Regulation to Implement the NAIC Medicare Supplement Insurance Minimum Standards Model Act. The bulletin confirms and clarifies that insurers can sell Medigap policies after June 2, with an effective date of June 1, 2010.
 
 
Producers
    Hawai’i has revised its Form ARDR, which is used to add or delete a designated representative from the business entity’s license. The July 28 version replaces an earlier modification issued July 9.
 
    New Hampshire Bulletin INS 09-048-AB warns producers about the terms contained in a certificate of insurance. Of particular interest is the apparent practice of issuers of insurance certificates being asked to include a 30-day cancellation notice, when the carrier’s standard is 10 days and it hasn’t authorized a deviation. In at least some of the cases where a 30-day notice wasn’t provided, the insured is not being allowed to work on certain contracts, projects or job sites. State law insurers to provide at least a 10-day notice of cancellation to the insured in the event of non-payment of premium or of a substantial increase in hazard. Insurers may increase this notice period at their discretion, but are not required to do so. The bulletin reminds producers they may also be subjecting their agency to an E&O exposure if they improperly issue a certificate of insurance or other evidence of insurance coverage that provides for a notice period longer than the insurer provides.
 
    Utah Bulletin 2009-5 says the state will begin to accept documents and notices submitted for insurance producers through the Attachments Warehouse run by the NAIC and the National Insurance Producer Registry. That should allow for the electronic filing of documents for producer licensing, the state says. 
 
 
State Regulation of Insurance
    Maryland COMAR 31.01.02.01 to .09 amends rules to provide guidelines and procedures to the insurance industry in the event of an emergency. The rules went into effect July 16.
 
 
(RR&B is produced with the assistance of The CLEAR Report and the Coalition Against Insurance Fraud.)
 
 
Copyright 2009 ProBusiness Publishing LLC

Publish date Aug 03 2009
Prior Issues

Reprinted with permission from Insurance Compliance Insight.
Copyright © 2009 ProBusiness Publishing LLC
Licensed from ProBusiness Publishing LLC. All rights reserved.