Regulatory Roundup: HCSM, Delaware P&C Insurance Market Regulations, and Changes in Colorado Post-Marshall Fire

Regulatory Roundup: HCSM, Delaware P&C Insurance Market Regulations, and Changes in Colorado Post-Marshall Fire

This post is part of a series sponsored by AgentSync.

State-by-state variations in laws, compliance protocols, industry transparency, and general regulatory cultures can make keeping up with industry changes feel like keeping cats. So what better way to wrangle with some of the most localized insurance news than in a regulatory roundup?

On an ongoing basis, in no particular order or rank, we battle the various regulatory changes, compliance actions and Commissioner’s rulings in our roundup. As a warning: there’s a lot going on at any given time in this United States, so this is by no means a complete picture of the action at the state level. Instead, think of it as an example of a regulatory plateau.

Ministries of health care sharing are under scrutiny

Health Care Sharing Ministries (HCSM) is not insurance. But, if someone was trying to untangle how to regulate them, the closest business model would be, well, insurance.

The recent waves of shared ministry bankruptcies, as well as consumer misunderstanding of what is and is not covered by shared health ministries, or even consumer misunderstandings about whether an HCSM is insurance ( still no) have led to increased regulatory scrutiny in recent years. .

Following the significant collapse of Sharity HCSM in 2021, both Washington and Colorado have worked to help consumers understand what HCSMs are and are not.

The governor of Colorado signed legislation this year that will require departments, plans, or shared healthcare arrangements to collect and report relevant data such as administrative costs, payments and reimbursements, and number of state-registered residents. Addenda to the rule include provisions for HCSMs to protect some of their data from public disclosure requirements to maintain some level of privacy.

In August 2022, Washington State passed regulations for HCSMs that would better define them, put parameters around data reporting and transparency, require certain protections for members in the event of acquisitions, mergers or bankruptcies. , and would also very clearly distinguish them from real insurance. The Washington Insurance Commissioner has been keen to put something on the books regarding HCSMs for some time.

While thoroughness may not fascinate everyone, if you’re one of those absolute insurance nerds, you might want to scroll down the rule and read the public comment and who submitted it. Notably, while some of the HCSMs alleged it was targeted harassment, others said they welcomed the opportunity to demonstrate their commitment to transparency and ethics.

This will no doubt not be the last time we write about HCSM as the saga of American health insurance (and its alternatives) continues.

Colorado addresses unrenewed policies after Marshall fire

HCSMs aren’t Colorado’s only area of ​​concern when it comes to insurance regulation. State advisories in recent weeks have also addressed the phenomenon of non-renewing home insurance policies.

The Colorado Division of Insurance issued a consumer alert on August 31, 2022, noting that after the Marshall fire, more consumers saw their coverage not renewed. While carriers must provide a specific reason for non-renewal and 30 days’ notice before the renewal date, there is nothing illegal about carriers abandoning policyholders for whom the risk has become too great for be assured.

The Colorado DOI has also encouraged consumers whose policies have been discontinued to purchase coverage, because one company exiting a market or changing its approach does not mean all companies have done so.

The state also issued an emergency regulation instituting tolls on claims that take a long time, as the state tries to push insurers to process claims in a timely manner. The state’s press release says this settlement is another result of the Marshall Fire.

Another recent proposed emergency regulation from Colorado will require carriers to waive cost-sharing agreements for consumers to have access to COVID-19 vaccines.

Delaware updates P&C guidelines for credit spreads, benefit allocation

Delaware has issued guidance to property and casualty insurers as the state enters peak storm season.

Bulletin notifies P&C insurers of new law regarding deviations from organizational rate filings. Previously, an insurer that filed and obtained commissioner approval for a deviation from the rating agency’s filing had one year before the deviation expired. From now on, provided that the insurer does not modify its deviation, the insurance department considers that this deviation remains in force permanently, without renewal.

The state also released a bulletin guiding property and casualty insurers on how to help consumers navigate the process of awarding benefits to contractors and helping consumers distinguish between adjusters and contractors.

Given some states’ difficulties with contractors, insurance benefit awarding, and public adjusters, it seems remarkable that Delaware places the responsibility for public education on insurance producers and adjusters. claims.

Other State Departments of Insurance Regulatory and Legislative Changes

Florida has released new, updated personal and commercial policy forms for property and casualty insurers.

The Office of the Washington State Insurance Commissioner has released proposed language for a new rule on the e-filing process for small pharmacy appeals regarding reporting requirements for Pharmacy Benefits Manager claims settlements. They will host a public meeting on the topic at 10 a.m. Washington time on October 18, 2022, or you can send comments to by October 24, 2022.

Connecticut kept health insurers’ rate increases low in 2023, reducing insurers’ rate increase requests by about 47%, “keeping insurers at historically low profit margins.” A press release from commissioner Andrew Mais notes: “Per my order, profits are capped at 0.5%”.

Oregon has issued a bulletin giving P&C insurers guidelines on how to word policies with language that excludes intentional acts coverage, to ensure policy language is not too vague.

Maryland updated its annuity education requirements for life insurance producers who want to sell annuity contracts; either a full four-hour training or, for those who have already taken the Annuities Course, a one-hour training covering updates to the Annuities Laws.

FINRA (the Financial Industry Regulatory Authority) has reminded that effective September 6, 2022, FINRA members and registered agents will again be required to submit their fingerprints within the usual time limits. During COVID, FINRA suspended fingerprinting requirements, but they are baaaaaaaack.

While these points of interest are not exhaustive, our knowledge of producer licensing and maintaining compliance is. Find out how AgentSync can help you look smarter today.

Colorado Property Damage Legislation

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