Read the Academy’s latest overview of state legislative and regulatory activities.

News from the American Academy of Actuaries

Summer/Spring 2022


StateScan Roundup (formerly StateScan Quarterly) recaps developments in spring and summer state legislation and regulation of interest to actuaries. For a more comprehensive review of state legislation of interest to actuaries log in to our online portal, StateScan.

PROPERTY/CASUALTY

Auto Insurance

New York Gov. Kathy Hochul and Washington Gov. Jay Inslee both signed bills (N.Y., Wash.) into law regarding peer-to-peer car-sharing insurance. These laws govern how the cars in use are insured and how liability is determined in the case of an accident or damaged property. West Virginia Gov. Jim Justice signed a bill into law that permits fully autonomous vehicles to operate with or without a human driver. The law requires that autonomous vehicles have an automated driving system (ADS) and a dynamic driving system (DDS) to fall back on in case of an emergency. Prior to utilizing the autonomous vehicle, the owner must submit financial responsibility and proof of insurance to the Department of Motor Vehicles.

Flood Insurance and Climate Risk

West Virginia Gov. Jim Justice signed a bill into law that extends the State Office of the National Flood Insurance Program (NFIP). This bill also transfers the State Office of the NFIP from the insurance commissioner to the Division of Emergency Management where the program will be fully funded and provide proper guidance and information to the public on floodplain management.

Travel Insurance

Nebraska Gov. Pete Ricketts signed a bill into law that includes the Travel Insurance Act “creating a comprehensive legal framework within which travel insurance may be sold in [the] state.” Utah Gov. Spencer Cox signed a bill into law that establishes the scope of the Travel Insurance Act, implemented provisions regarding premium taxes, travel protection plans, and travel administrators, and established a classification for travel insurance. Indiana Gov. Eric Holcomb signed a bill into law that establishes requirements for offering and disseminating limited lines travel insurance policies. Alabama Gov. Kay Ivey and Mississippi Gov. Tate Reeves enacted very similar laws (Ala., Miss.) to create travel insurance acts. These laws pertain to licensing and registration, sale of travel insurance, and the establishment of sale practices standards.

Workers’ Compensation

West Virginia Gov. Jim Justice signed a bill into law modernizing and updating the workers’ compensation statutes pertaining to electronic invoicing and transfers, requiring the insurance commissioner to issue a written notice to employees if an employer does not have workers’ compensation insurance. Idaho Gov. Brad Little signed a bill into law that streamlines the state’s workers’ compensation settlement process for employers and injured workers who choose to settle the claims without going to trial. Colorado Gov. Jared Polis signed a bill into law that requires that on-the-job injuries be reported in writing to the employer within 10 days of the incident. Indiana Gov. Eric Holcomb signed a bill into law that provides compensation for two years after a workplace accident and after two years the injured can apply for an adjustment claim. It also increased benefits for injuries and disablements for four years and established clean claim payment requirements for workers’ compensation claims. The law defines clean claims as claims that are submitted directly by a medical service provider for payment, including claims from ambulatory outpatient surgical centers.

Medical Cannabis

Mississippi Gov. Tate Reeves signed a bill into law pertaining to medical cannabis. This law defines what a medical cannabis establishment is, states that government medical assistance programs or private insurers are not required to reimburse individuals who utilize cannabis for medical reasons and lays out the disciplinary actions for the use of medical cannabis while working. South Dakota Gov. Kristi Noem signed a bill into law that revises provisions in law regarding cost reimbursement associated with medical cannabis. This bill states that it is not required for health insurance or workers’ compensation insurance to reimburse an individual for medical cannabis costs, for any person or establishment to allow a guest, client, customer, or other visitor to smoke cannabis on their property, or for a landlord to allow cannabis cultivation on a rental property.

Other Property/Casualty Issues

New York Gov. Kathy Hochul signed a bill into law allowing for property/casualty insurance documents and notices to be electronically delivered rather than mailed. The law requires that prior to sending the documents electronically, the insurer must obtain consent to deliver the document by this method.

Indiana Gov. Eric Holcomb signed a bill into law that allows property and casualty insurance companies to offer insurance on a group basis to 10 or more commercial, business, or not-for-profit entities with a pre-existing relationship to each other.

 


HEALTH

Long-Term Care

Washington Gov. Jay Inslee signed an amended bill into law which expands the state’s Life and Disability Insurance Guaranty Association membership to include health care service contractor businesses and health maintenance organization businesses. It also added health benefit plans and long-term care policies into the disability insurance account definition.

Medicaid

Mississippi Gov. Tate Reeves signed a bill into law pertaining to Medicaid rate changes and reimbursements. It requires the Division of Medicaid to give 30 days’ notice prior to implementing a rate change or changes to state plan amendments. Within this time period, the chairpersons of the House or Senate Medicaid Committees may object and make written recommendations to the Division of Medicaid within seven days of receiving the notice. The Division of Medicaid can take the recommendations into consideration but can proceed without modifying the rate change or amendments. Florida Gov. Ron DeSantis signed a bill into law on the statewide Medicaid managed care program that requires the reimbursement method for provider service networks be on a prepaid basis. Utah Gov. Spencer Cox signed a bill into law that allows for Medicaid reimbursement for diabetes prevention services. The enrollee must meet the National Diabetes Prevention Program’s eligibility criteria requirements and not have participated in this program after July 1, 2022, while enrolled in the Medicaid program. The Medicaid program can set the rate of reimbursement for the enrollees. Gov. Cox also signed a bill into law that amends the Medicaid delivery system by adding a behavioral health delivery working group. The working group will establish measurable metrics regarding the federal Medicaid managed care requirements, the timeliness and accuracy of authorization and claims processing, and the availability of care management services. Kentucky Gov. Andy Beshear signed a similar bill into law pertaining to behavioral health. It establishes a pilot behavioral health conditional dismissal program that allows for the dismissal of charges against an individual with a behavioral health disorder who has been charged with a qualifying offense upon completion of the program. Virginia Gov. Glenn Youngkin signed a bill into law that directs the Board of Health to amend the state plan for medical assistance services to include the payment of the originating site fee to emergency medical services agencies that offer telehealth visits for Medicaid patients.

Prescription Drugs

New York Gov. Kathy Hochul signed a bill into law relating to prescription drug formulary changes during a plan year. It prohibits health care plans from making changes during the contract year and expands the timeframe for notifying policyholders of changes to their plan from 30 days to 90 days before the start of the plan year. Hochul also signed a similar bill, which conforms other sections of state law with language prohibiting prescription drug formulary changes.

Washington Gov. Jay Inslee signed a bill into law that establishes a prescription drug affordability board. It allows for the board to review up to 24 prescription drug prices a year in three categories: i) brand name drugs, ii) biosimilar products with an initial wholesale cost that is not at least 15% lower than the reference biological product, and iii) generic drugs with a wholesale cost of $100 or more for a 30-day supply that has increased by 200% or more in the last 12 months. Once the board analyzes the selected drugs, they may choose 12 prescription drugs on which to set an upper payment limit. This law also requires that any savings generated for a health plan that is attributable to the upper payment limit that the board established must be used to reduce costs and out-of-pocket fees to consumers.

Illinois Gov. J.B. Pritzker signed a bill into law that requires health benefit plans to issue a physical or electronic card that displays any deductible applicable and the out-of-pocket maximum limitation to the plan.

Pharmacy Benefit Managers (PBMs)

Oklahoma Gov. Kevin Stitt signed a bill into law that prohibits PBMs from engaging in spread pricing and requires PBMs to provide the insurance commissioner with certain information pertaining to pharmaceutical manufacturers and provider contracts, plan utilization and pricing data, and pharmacy utilization and pricing data on a quarterly basis.

Cost Sharing/Pricing

Washington Gov. Jay Inslee signed a bill into law requiring cost sharing for prescription drugs to be counted against an enrollee’s obligation when determining the enrollee’s contribution.

Virginia Gov. Glenn Youngkin signed a bill into law relating to group health benefit plans. This law requires health benefit plans issued by a self-funded multiple employer welfare arrangement (MEWA) to provide essential health benefits and cost-sharing requirements, offer a minimum level of coverage that provides benefits that are actuarially equivalent to 60 percent of the full actuarial value, not limit coverage for an individual by imposing a pre-existing condition exclusion on the individual, prohibits them from establishing discriminatory rules based on health status, meets the health insurance issuer’s renewability standards, establishes actuarially sound base rates that considers the pooling of all participant claims, and utilizes the employer member’s specific risk profile to determine actuarially adjusted premium rates.

 


LIFE

Life Issues

Washington Gov. Jay Inslee signed a bill into law that contains provisions for rules pertaining to the Insurance Guaranty Fund. The requirements state that benefits provided by a long-term insurance care rider to a life insurance policy must be considered to be the same type of benefits as the base life insurance policy to which it relates and define the breakdown of the class B assessment for long-term care insurance.

Alabama Gov. Kay Ivey signed a bill into law relating to insurance and annuities, which requires the insurance commissioner to adopt rules regarding nonforfeiture benefits for contingent deferred annuities.

South Dakota Gov. Kristi Noem signed a bill into law that revises the annuity sales standards to require all insurance producers to complete an annuity training course prior to engaging in the sales of annuities. In addition, the producer must provide a statement on the company website disclosing its license and authorization to sell life insurance.

Virginia Gov. Glenn Youngkin signed a bill into law related to pre-need funeral contracts. This law ensures that life insurance or annuity contracts in force to fund the pre-need funeral contract cannot be decreased over the span of the life insurance policy except for policies that have lapsed due to nonpayment of premiums.

 


PENSION

Pension Liability

West Virginia Gov. Jim Justice signed a bill into law that authorizes the creation of the public pension funding programs, specifically the Municipal Pensions Security Fund, to help reduce the unfunded liability of certain pensions such as policemen’s and firemen’s. It also requires all policemen’s and firemen’s pensions to be evaluated annually by an actuary who will provide a valuation report.

Wyoming Gov. Mark Gordon signed a bill into law relating to the state’s firemen pensions and the creation of the Fire A reserve account. The law creates a backup fund to be used only if funds in the firemen’s pension account are insufficient to provide benefits.

State IRA Plans

Hawaii Gov. David Ige signed a bill into law that establishes the Hawaii Retirement Savings Program and provides a state-facilitated payroll deduction individual retirement savings plan to the private-sector employees who do not have access to employer-sponsored plans.

Florida Gov. Ron DeSantis signed a bill into law relating to individual retirement accounts. This bill specifies that certain interests received by a transferee after a divorce are exempt from claims of creditors after being received by the transferee.

Illinois Gov J.B. Pritzker signed a bill into law that extends the pension buyout window for eligible state employees an extra two years, pushing it back until 2026.

Other Pension Issues

West Virginia Gov. Jim Justice signed a bill into law requiring the oversight board to contract an actuary once every five years to provide a report to the Legislature’s Joint Committee on Pensions and Retirement on the status of each active Deferred Retirement Option Plan (DROP).

Gov. Justice also signed a bill into law to update all retirement plans to comply with the federal Setting Every Community Up for Retirement Enhancement Act of 2019. It updates the required beginning date from age 70.5 to age 72 and clarifies the Minimum Distribution Incidental Benefit (MDIB) regulations.

Arizona Gov. Doug Ducey signed a bill into law that authorizes the creation of a study committee to investigate public-private partnerships’ retirement savings programs. The committee is to study the mechanisms that could assist Arizona citizens to be prepared to retire in a financially secure manner.

 


CROSS-PRACTICE

Reinsurance

Virginia Gov. Glenn Younkin signed a bill into law eliminating the requirement that the State Corporation Commission had to consider transfers made under the federal risk adjustment program or factor in transfers received for an enrolled individual. This would remove double reimbursement as a factor when establishing payment parameters for the benefit year under the Commonwealth Health Reinsurance Program.

New Mexico Gov. Michelle Lujan Grisham signed a bill into law that implemented provisions to the credit for reinsurance act to apply to life insurance policies with guaranteed nonlevel gross premiums and universal life insurance policies with provisions resulting in the ability of a policyholder to keep a policy in force over a secondary guarantee period, as well as providing variable annuities with guaranteed death or living benefits among others. Hawaii Gov. David Ige signed a similar bill into law implementing the National Association of Insurance Commissioners’ (NAIC’s) Model Credit for Reinsurance Act at the end of May.

Insurance Data Security

Kentucky Gov. Andy Beshear signed a bill into law that requires licensees to develop, implement, and maintain a comprehensive written information security and response program, implement information safeguards to manage identified threats, and submit a written statement certifying that the insurer is in compliance to the commissioner by Feb. 15 of every year.

The Rhode Island House of Representatives passed a bill that would adopt the NAIC model act regarding data security to establish standards for data security and standards for cybersecurity events. This bill would implement an information security program to assess risk and the likelihood of potential threats. It would also establish security measures to protect the confidentiality of nonpublic information and periodically test the reliability of the measures.

Unfair Trade Practices

Governors in Alabama, Georgia, Kansas, Kentucky and Virginia have signed similar bills into law requiring certain insurers to file a group capital calculation in accordance with the NAIC group capital calculation instructions and the NAIC Liquidity Stress Test Framework when evaluating life and annuity policies. These bills allow for domestic companies to qualify for an exemption from NAIC valuation manual standards. Kentucky specifies that in order to qualify for the exemption, the total adjusted capital must be at least 450% of the authorized control level risk-based capital.

 

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