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New Requirements for Individual Term Life in Louisiana

The Louisiana Department of Insurance issued Advisory Letter No. 14-03 on August 8, 2014, which advises of amendments to R.S. 22:931 that apply to individual life policy issuers whose term life insurance policies allow their insureds the option to convert to a whole life policy. The advisory letter states that all currently approved policies issued on and after, August 1, 2014, must be revised to reflect the new Conversion Notice requirement. The revisions must be filed for review and approval, the Department will allow these revisions to be added via a rider or endorsement form. The revised filings are due by March 1, 2015. No filing fee will be incurred if revisions are filed prior to that date, however, full filing fees will apply after March 1, 2015. (Advisory Letter No. 14-03)

Health Care Reform Necessitates an Increase in Sharing of Personally Identifiable Information (PII)

A CMS data center in Baltimore, will host a variety of Health Care Exchange (HEX) Program locations, and contractor sites.

In addition to PII about program applicants, the HEX system will include PII about navigators, agents and brokers; exchange employees and contractors; CMS employees and contractors; insurers that sell coverage through the exchanges; and employers that have workers sign up for health coverage through the new Small Business Health Options Program (SHOP) exchanges.

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IIPRC Amends Standards for Individual Life Products

As part of their 5-Year Review of adopted standards, the IIPRC recently amended their Uniform Standards for individual life products. The amended Uniform Standards will become effective on December 4, 2014. The amendments will apply to filings submitted after that date. Previously approved forms do not need to comply with the changes.

Many of the revisions were made in order to provide clarification to the existing Standards and make them easier to use. There were several changes to two of the more frequently used standards: Individual Life Insurance Application Standards and the Additional Standards for Accelerated Benefits.

A summary of all the changes can be found on the IIPRC website under the Standards History section. Please click here to learn more.

Requirements for Accreditation for Participation in the Arkansas FFE-P

On January 8, 2013, the Arkansas Department of Insurance issued Arkansas Bulletin 1-2013. This Bulletin addresses the timeline and other requirements for a Qualified Health Plan (QHP) to gain accreditation as required to participate in the Arkansas Federally-Facilitated Exchange Partnership (FFE-P).

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Fixed Indemnity Insurance - FAQ 11

Fixed indemnity insurance is not considered to be traditional medical insurance. It started as income replacement insurance for people who were not able to work due to health issues. Over the years it has, however, morphed into a more complex product.

In 2013, in an effort to limit the use of fixed indemnity policies as a loophole out of the Affordable Care Act’s (ACA) provisions, HHS issued what came to be known in the industry as ‘FAQ 7’. The rule required that fixed indemnity insurance must pay benefits on a fixed amount basis, without regard to the cost of the actual service and on a pay per-period basis, not a per-service basis. A policy that did not pay this way would not be a ‘excepted benefit’ product and would be subject to the requirements of the ACA.

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Adoption of Essential Health Benchmarks as of December 2012

Each state is required to choose from a range of existing and popular (number of enrollees) health plans and use that plan as an Essential Health Benefit (EHB) benchmark. It is proposed that states without a benchmark plan selected by 12/26/12, will default to the small group plan with the largest enrollment in the state. Insurers will have to offer plans with substantially equal benefits to those found in a state's benchmark plan. The EHB benchmark only defines what benefits must be covered, not the cost sharing. The ACA (Affordable Care Act) explains the different levels of plans (bronze, silver, gold and platinum) and insurers will develop pricing and cost sharing features based on the actuarial values of each of the plan levels.

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