Insurance Compliance Services... Your Outsourcing Resource

News & Events

Important 2016 Updates to the NAIC Product Coding Matrix

Life, Accident & Health and Credit

The Operational Efficiencies (EX) Working Group of the Speed to Market (EX) Task Force for Life, Accident & Health and Credit met on July 7, 2015. As a result of that meeting changes are being made to the 2016 Uniform Transmittal Documents and the Uniform Product Coding Matrix for Life, Accident & Health, Annuity and Credit. Please click here to view the link for the Life, Accident & Health, Annuity and Credit product coding matrix.

Property & Casualty

The Operational Efficiencies (EX) Working Group of the Speed to Market (EX) Task Force for Property & Casualty met on July 9, 2015. As a result of that meeting changes are being made to the Property and Casualty Uniform Product Coding Matrix for 2016. Please click here to view the link for the Property and Casualty product coding matrix.

District of Columbia Issues Guidance on Association Health Coverage

Bulletin 14-IB-01-10/23 issued on October 23, 2014 provides guidance regarding health insurance coverage sold to associations and small employers, including coverage sold to small employers located in the District by captive insurers domiciled outside of the District. The Bulletin addresses:

- Size of the individual employer and how the size determines whether the employer's coverage is subject to the small group market or the large group market rules.

- Mixed associations and how to treat members of the association.

- MEWAs and ERISA applicability and state insurance law applicability.

- Requirement for a captive insurer, association, or MEWA to obtain a certificate of authority and a person or entity that engages in the solicitation or sale of insurance to obtain a producer license. It reminds associations and MEWAs of form filing requirements.

Bulletin 14-IB-01-10/23 can be found by clicking here.

PACE Act Capping Small Employer Definition at 50

The Affordable Care Act changed the definition of “small group” for the purpose of health insurance from an employer with 1 to 50 employees to one with 1 to 100 employees. This change would subject mid-sized employers (those with 51-100 employees) to new rating restrictions and benefit requirements.

On October 7, 2015 President Obama signed House Resolution 1624, also known as the Protecting Affordable Coverage For Employees Act (PACE Act). The PACE Act revised the definition of small employer for purposes of the Patient Protection and Affordable Care Act (PPACA), changing the number of employees that equate to a small employer back to 1 to 50 employees, rather than 1 to 100 employees. The PACE Act retains the smaller group size indefinitely, but does give states the option to extend the definition of small employer to 1 to 100.

Read more ...

District of Columbia Clarifies Summary and Disclosure Notice Requirements for Supplemental Health Policies

DC Bulletin 06-IB-004-8/29 dated October 23, 2014 is being reissued with revisions. The purpose of this bulletin is to clarify that limited benefit health plans, hospital indemnity, or other supplemental health policies shall not be marketed or represented as substitutes for health benefit plans, and that such plans do not provide sufficient coverage to qualify as minimum essential coverage, within the meaning of section 5000A(f) of the Internal Revenue Code, as mandated by the Patient Protection and Affordable Care Act. The revision of Bulletin 06-IB-004-8/29 can be found by clicking here.

States to Choose New Benchmark Plans for 2017

The current state benchmark plans will continue to be used through 2016. Currently the benchmark plans are based on 2012 plans which have been amended to include all ten of the Essential Health Benefits. A proposed rule will permit states to select a new benchmark plan for 2017. HHS will begin collecting data such as administrative data, covered benefits, limitations and exclusions on the 2014 plans in order to assist in identifying benchmark plans. It appears that HHS will continue to rely on this benchmark approach rather than committing to its own detailed essential health benefit requirements.

Virginia Provides Updates Regarding Guaranty Association Notice

Virginia issued Administrative letter 2014-05 dated October 6, 2014. The purpose of this Administrative Letter is to inform life, accident and sickness companies (insurers) of the updated disclaimer required to be attached to policies in order to comply with provisions of §38.2-1715 of the Code of Virginia. It explains that the revisions include a new address for the Guaranty Association and a new Bureau web address. It requires insurers to attach the Notice to policies or contracts delivered to Virginia policy or contract owners starting January 1, 2015. For details, please click here.

newsneventsheader

Conferences and Events

No events
P.O. Box 905 Doylestown, PA 18901 phone: 215.230.7960 fax: 215.230.7961