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- Insurance Regulatory Insights
When we started this newsletter in April 2024, our mission was to provide timely updates on legislation and state department of insurance communication impacting product design, rating, underwriting, and marketing for the senior supplemental health market. We want to free up your schedule by doing your regulatory compliance research for you!
We are excited to share that Insurance Regulatory Insights now has over 800 subscribers!
To celebrate, this week we are recapping the key legislation that has passed since April 2024.
Thank you for reading each week and sharing with others! Reach out if you would like to see a topic highlighted or have ideas for future content.
Medicare Advantage / Part D
State | Bill/Notice Number | Effective Date | Summary |
|---|---|---|---|
MD | 10/01/2024 | Extends state prescription assistance program until Dec. 1, 2030 for those with Part D. | |
MS | 07/01/2024 | Prohibits telephone solicitation to any person in the state regarding Medicare Advantage plans, unless the person has first initiated the call. Also prohibits issuers, and agents acting on behalf of an issuer, from a telephone solicitation to any person in the state for the purpose of advertising the sale or soliciting purchase of a Medicare Supplement plan. |
Med Supp
State | Bill/Notice Number | Effective Date | Summary |
|---|---|---|---|
IN | 07/01/2024 | After December 31, 2024, all plans offered by a Medicare Supplement carrier must also be made available to an individual eligible for Medicare by reasons of both disability and end-stage renal disease. Medicare Supplement carriers may not charge a higher premium rate for individuals under age 65 compared to an individual who is 65 years of age for Plans A, B, and D. For all other plans, carriers cannot exceed 200% of the premium rate for an individual who is 65 years of age. In addition, carriers cannot impose waiting periods or pre-existing condition limitations for the under 65 eligibles. | |
NE | 01/01/2025 | Makes at least one plan available to U65 with disability and premium not to exceed 150% of >65. Also defines requirements for medical supplies and reimbursement | |
IL | 01/01/2026 | Amends annual OE period- birthday rule to include the individual may also purchase a plan from any affiliate authorized in the state offering equal or lesser benefits | |
MN | 08/01/2025 | Amends Minnesota Statutes 2022, sections 62A.3099 through 62A.44 by prohibiting pre-existing condition limitations, adds a guaranteed issue situation for individuals losing state public program coverage due to Medicaid unwinding, and adds an open enrollment period. | |
MN | 08/01/2026 | Changes effective date of SB2744 to 8/1/2026. |
Dental
State | Bill/Notice Number | Effective Date | Summary |
|---|---|---|---|
CO | 06/30/2024 | Provides loss ratio guidance and requires filing report annually before July 31, starting in 2024. | |
LA | 01/01/2025 | Establishes Dental Loss ratio standards and requires carriers to submit a report March 1, 2025, and annually thereafter, no later than June thirtieth of each calendar year. | |
VA | 01/01/2025 | Loss Ratio Requirements and require carriers to file report annually before April 30, starting in 2025 | |
RI | 03/01/2025 | Requires dental health insurance carriers to file an actuarial memorandum disclosing incurred claims/earned premiums by March 1, 2025 (reporting years 2023 & 2024) and March 1, 2026 (reporting year 2025), to assist with a study report/recommendations regarding a dental insurance loss ratio. |
STLDI/Fixed Indemnity
State | Bill/Notice Number | Effective Date | Summary |
|---|---|---|---|
All | 06/17/2024 | Defines and provides limits for STLDI and disclosure requirements for STLDI and Hospital Indemnity and other Fixed Indemnity Products. | |
IL | 01/01/2025 | Provides that, on and after January 1, 2025, no company shall issue, deliver, amend, or renew short-term, limited-duration insurance to any natural or legal person that is a resident or domiciled in the State. Defines short-term, limited duration insurance as having an expiration date fewer than 365 days after the effective date. |
Telos Actuarial’s team of experienced regulatory compliance professionals are ready to help YOU stay informed of legislative and regulatory changes. Reach out to us for more information!