Annual Statements & Financial Reporting
    Connecticut amended rules in Sec. 38a-54-6 address qualifications of independent certified public accountants used for insurer annual audited financial reports.
 
 
Automobile Insurance
    Massachusetts Bulletin 2009-13 has standards the commonwealth will use to review personal auto rate filings on and after April 1, 2010.
 
    Auto insurers in New York are required to pay a surcharge to the Public Goods Pool on payments made for services rendered in general hospitals, diagnostic and treatment centers, and freestanding clinical laboratories. Circular Letter 21 (2009) says insurers and self-insurers cannot offset an applicant's aggregate no-fault benefit limit for the payment of the surcharge when it is paid directly to the Health Department’s Office of Pool Administration.
 
 
Health Insurance
    California AB 2 would require health insurers to show that a patient knowingly misrepresented a known health condition when applying for coverage before rescinding an individual health insurance policy. Plans would also have to complete medical underwriting prior to issuing a contract. Additionally, proposed regulations would require insurers to take certain steps before rescinding a policy. Gov. Arnold Schwarzenegger has not yet acted on the bill, but he vetoed a similar bill during the last legislative session.
 
    Florida Informational Memorandum OIR-09-06M discusses legislation that requires insurers to make payments directly to any provider not under contract with the insurer if the insured makes a written assignment of benefits. Previously, direct payments by an insurer were only required for emergency services and care. The guidance refers to HB 1122, but the bill is actually SB 1122.
 
    Idaho Bulletin 09-09 defines prior creditable coverage and also reminds insurers that coverage exclusions for pre-existing conditions, including pregnancy, may not be applied to HIPAA-eligible individuals.  
 
    Rules in Maine Chapter 765 have requirements and procedures designed to help carriers prepare for public health emergencies.
 
    New York has posted new information to its Web site about extending health insurance eligibility to a policyholder’s children, up to age 29. The law also provides for extending coverage through a “make-available” requirement, and guidance will provided for that soon. 
 
    Rhode Island is proposing to repeal four health insurance and Medicare supplement rules – Regulation 46, Regulation 47, Regulation 57 and Regulation 82 – because regulatory authority has been transferred to the Office of the Health Insurance Commissioner.
 
    Texas has adopted two health insurance rules: 28 TAC 26.409, which governs health group cooperatives, and various sections of 28 TAC 21 and 28, which deal with Consumer Choice health benefit plans.
 
 
Life Insurance
    A bill passed by the California legislature, SB 98, would, for the first time, regulate life settlements in the state. The bill would ban life settlements for two years after a policy was purchased. It would also require licensing for professionals who transact life settlement contracts. Consumer disclosures would also be required. Schwarzenegger has not yet acted on the bill.
 
    Texas is proposing amendments to 28 TAC 3.6101-.6102, and 3.7001-.7003 and .7006. The rules govern the minimum reserve requirements for credit life and credit accident and health insurance.
 
 
Medicare Supplement Insurance
    Maine Chapter 275 has new Medicare Supplement rules.
 
 
Producers
    Hawai'i has posted a new form producers can use to request a duplicate copy of their producer license.
 
    Oregon Proposed Rule 836-080-0160 sets standards for producers’ use of senior designations and other certifications or designations that falsely indicate or imply that the person has special certification or training.
 
    Rhode Island Bulletin 2009-7 says the state is now using the NAIC/NIPR Attachments Warehouse to accept electronic documents and notices submitted for producers.
 
 
Property/Casualty Insurance
    Alabama Bulletin 2009-07 tells insurers how to implement Act 2009-500. The law requires companies to provide a premium discount or a rate reduction to those who build, rebuild or retrofit their property to resist hurricanes and other windstorm events. The discounts apply to policies written or renewed on or after May 1, 2010.
 
    Maine Bulletin 364 discusses a state law that went into effect Sept. 12 that deals with insurance policies of homeowners who operate a child care business. The law:  
    • prohibits an insurer from refusing to issue or renew, or canceling a homeowner policy unless the insurer bases that action solely on factors other than the presence of the family child care business when the homeowner meets four stated requirements;
    • limits an insurer’s discretion to decline to issue coverage and to cancel coverage at will within the first 90 days of a policy; and
    • prohibits an insurer from treating the presence of a family child care business as a factor related to the property’s insurability once the policy has been in place for 90 days and the policyholder is protected by the law.
    The bulletin warns that an insurer taking an adverse underwriting action against a family child care provider will be expected to have objective evidence in its file that identifies the reasons for its underwriting decision.
 
    New Jersey Bulletin 09-28 instructs insurers to tell personal lines policyholders about protections in state law that deal with the use of credit scores and extraordinary life events, including, but not limited to, a catastrophic illness or injury; the death of spouse, child, or parent; temporary loss of employment; divorce; identity theft; or a military overseas deployment. In such cases, the insurer may consider only credit information not affected by the event or shall assign a neutral credit score. The Department of Banking and Insurance wants insurers to show they have told insureds and potential insureds about the protection.
 
    Ohio has posted a notice withdrawing Amended Rule 3901-7-01 "Annual review of title insurance agent escrow accounts." The action was effective Sept. 14. The pre-existing rule, Rule 3901-7-01, remains in effect.
 
 
(RR&B is produced with the assistance of The CLEAR Report and the Coalition Against Insurance Fraud.)
 
Copyright 2009 ProBusiness Publishing LLC

Publish date Sep 21 2009
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Reprinted with permission from Insurance Compliance Insight.
Copyright © 2009 ProBusiness Publishing LLC
Licensed from ProBusiness Publishing LLC. All rights reserved.