Automobile Insurance
    New Hampshire Bulletin Ins. 09-064-AB reminds automobile insurers they are not to pay health care providers directly from a claims presented under medical payments coverage. The proper procedure is to have the insured submit the claim to the carrier, and for the insurer to pay that claim directly to the insured.
 
    New Jersey requires personal and commercial auto carriers to file an phone number where law enforcement agencies can make inquiries about the insurance status of a driver. More that 80 insurance verification numbers on file are out of date, according to an Insurance Department audit. Bulletin 09-33 tells how you can update your records.
 
    New York has issued a data call, telling selected commercial auto insurers that “your company is required to complete the Voluntary Public Auto Classifications Survey (emphasis added).” The survey requests detailed information about the number of policies and direct premiums written, by category, under all public auto classifications of public commercial auto from Jan. 1, 2008 through Sept. 30, 2009. The announcement has a link to instructions and the online survey form.
 
 
Health Insurance
    In an Oct. 23 letter, Louisiana is asking insurers to cover the cost of administering the H1N1 flu vaccine.
 
    New York is saying that a plan to provide discount dental services through licensed dentists by establishing a prepaid membership plan is probably OK under state insurance law. According to Legal Opinion 09-09-05, so long as the fees charged for services cover the cost of services, including reasonable overhead, such a proposed discount dental service plan won’t be viewed as conducting insurance.
 
    Ohio Executive Order 2009-21S adopts an emergency rule and appendix that require health insurers to provide information about the state’s new open enrollment program. It will remain in effect for 90 days, while the Insurance Department’s proposed Rule 3901-8-12 and appendix, is submitted through the usual rulemaking process.
 
    Oregon is proposing to change OAR 836-052-1000 and update the list of prosthetic and orthotic devices that must be covered by group and individual health insurance policies. Comments about the proposal are being accepted though Dec. 15.
 
 
Medicare Supplement Insurance
    Texas Bulletin B-0047-09 reminds companies, agents and others that the marketing of Medicare Advantage, prescription drug plans and 1876 cost plans is subject to strict marketing standards established by the Centers for Medicare and Medicaid Services. It wants all parties to review the guidelines in Chapters 3 and 2 of the Medicare Managed Care Manual and the Prescription Drug Benefit Manual.
 
 
Producers
    Florida is doing a better job of issuing licenses for new insurance producers. The waiting period used to be 20 business days. Now a notice on the state’s producer Web site says applications sent in after Sept. 21 will be acted on within 15 working days.
 
    New Jersey and North Dakota are joining other states in addressing the use of the NAIC/NIPR Attachments Warehouse for the electronic filing of insurance producer licensing documents. The Attachment Warehouse aims to streamline the filing of license documents and make it easier for producers to acquire multistate licenses. Details are in New Jersey Bulletin 09-32 and North Dakota Bulletin 2009-03. Alaska (Bulletin B 09-08), Arkansas (Bulletin 13-2009) and Idaho (Sept. 22 press release) are among other states that have recently issued similar guidance. We have also seen an email message from the Oklahoma Insurance Department that purports to be text of a bulletin about the topic, but that document hasn’t been posted to the department Web site and we haven’t been able to verify it.
 
    New Jersey is proposing changes to NJAC 11:17-6.3, which relate to insurers who act as a managing general agent for unaffiliated insurers. The change would exempt them from having to be licensed as insurance producers, maintaining surety bonds or obtaining errors and omissions coverages. The Insurance Department says the requirement isn’t feasible, nor was it contemplated when the governing law was written 15 years ago. It will accept written comments on the proposed rule change through Dec. 18.
 
 
Property/Casualty Insurance
    Delaware proposed Regulation 901 would establish procedures for arbitrating certain claims for benefits available under automobile or homeowner policies or agreements. If adopted, the rule would go into effect Jan. 11, 2010. Written comments are being accepted through Dec. 7, according to the public notice.
 
    Recommendations to a commercial insurance policy holder are just that – recommendations. New York Legal Opinion 09-09-02 states that an insurance company cannot cancel a commercial policy simply because a policyholder doesn’t follow its recommendations. That’s because the insurer has already inspected, and knows the condition of, the risk when it makes its recommendations prior to the renewal date. That guidance doesn’t apply, of course, when there is a substantial and material increase in the risk after the policy has been issued.
 
 
Rates, Forms & Filings
    The Colorado Division of Insurance has issued two updates – to Regulation B-4.18, Requirements for the Filing of Rates and Forms for Life, Accident and Health Carriers, and to Regulation B-5.18, Requirements for the Filing of Rates, Rules, Loss Costs and Forms for Property & Casualty Carriers.
 
    Delaware is proposing to adopt changes to Regulation 1305 that would create procedures and time lines for all rate filings made by insurers.
 
    A Minnesota notice says the state will accept multiple company filings for life and health lines of coverage starting Nov. 1. The filer will have to be requesting approval for an identical filing (no exceptions for any company represented in the filing). Forms may either be submitted with the name of each company appearing at the top of the form with a means of designating the appropriate company, such as check boxes, or as a separate form for each company represented in the filing. A separate filing fee will still have to be paid for each company represented in the filing.
 
    Minnesota also has new filing requirements for property/casualty filings.  Some took effect Aug. 1, while others go into effect Jan. 1, 2010.
 
    Oregon is proposing changes to OAR 836-053-0471 and -0475, which pertains to the review of proposed schedule or table of premium rates filed for health benefit plans for small employers, individual health benefit plans and portability health benefit plans. The rules clarify the public process that is established for individual and small-employer group plans, specify the materials that must be submitted in a schedule or table of premium rate filing, and makes all materials available to the public for review. The proposal comes with Exhibit 1, Exhibit 2 and Exhibit 3 to OAR 836-053-0471, and with Exhibit 1 and Exhibit 2 to OAR 836-053-0780. Comments will be accepted through Jan. 8, 2010.
 
 
State Regulation of Insurance
    Alabama Bulletin 2009-08 tells of new audit and financial examination fees that will go into effect Dec. 31.
 
    An online notice tells how the Hawai’i Department of Commerce and Consumer Affairs, and its Insurance Division, will operate during upcoming furlough days.
 
    Minnesota has posted a summary of legislation of interest to insurance companies.
 
  
(RR&B is produced with the assistance of The CLEAR Report and the Coalition Against Insurance Fraud.)
 
Copyright 2009 ProBusiness Publishing LLC

Publish date Oct 26 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.