Regulatory Roundup: End of COVID-19 Emergency Order Shakes Up Health Care, WA and MS Reduce CE Requirements

State by state variations of laws, compliance protocols, industry transparency, and general regulatory culture can lend one the impression that keeping up with industry changes is a little bit like herding cats. So, what better way to wrangle some of the more localized insurance news than in a Regulatory Roundup?

On an ongoing basis, in no particular order or rank, we’re wrestling the various regulatory changes, compliance actions, and commissioner decisions into our roundup. As a disclaimer: There’s a lot going on at any given time in these here United States, so this isn’t a comprehensive picture of state-level action by any means. Think of it as, instead, a sampler platter of regulation. 

Also important to note: If we’re recapping interpretations of legal decisions, this is some armchair insurance speculation and not at all legal advice. If you need legal advice, get a lawyer. 

May 11, 2023, end of COVID-19 emergency status to change coverage for services

As the U.S. Department of Health and Human Services (HHS) plans to end the COVID-19 public health emergency (PHE) on May 11, 2023, many states anticipate changes to consumer health insurance.

The PHE went into effect Jan. 31, 2020, and the anticipated end marks a significant change for infrastructure that has relied on the PHE declaration for many emergency measures that have stuck around for more than three years. While coronavirus deaths continue to trend down, more than 1,000 people a week still die from the disease.

A bulletin from the Alabama Department of Insurance notes the primary concerns for health insurance consumers in the state:

COVID-19 testing

For people with private health insurance plans, COVID-19 testing coverage may no longer be free, and plans may require cost-sharing fees. Medicare enrollees will also be unable to procure over-the-counter COVID-19 tests for free unless their healthcare provider orders one. 

The state notes those who are underinsured or uninsured may be able to obtain free COVID-19 tests from USPS, community partners, pharmacies, and the federal Centers for Disease Control and Prevention (CDC).

COVID-19 vaccines

People with private health insurance can still receive COVID-19 vaccines at no cost if they are in-network. Medicare enrollees will still be able to get COVID-19 vaccines without cost-sharing. Medicaid or Children’s Health Insurance Program (CHIP) enrollees will continue to have access to COVID-19 vaccines without cost-sharing or co-pays through Sept. 30, 2024. After that, states will determine vaccination and treatment coverage for Medicaid and CHIP recipients.

COVID-19 treatment

According to the Alabama DOI, COVID-19 treatment coverage will not change. Those with health insurance will have the same cost-sharing and deductible requirements as they currently do. For Medicare recipients, the plan will continue covering oral antiviral medication and other in- or outpatient treatments the same as it currently does. 

Telehealth

Many states used the PHE conditions to order insurers to rely on telehealth in several situations, sometimes incentivizing or even requiring telehealth usage. So, insurance carriers will undoubtedly implement many changes as state statutes for standards of care revert to their pre-pandemic situation. In Alabama, Medicaid or CHIP enrollees will continue to have access to telehealth services, per federal recommendations. Medicare conditions for telehealth services will still apply until December 31, 2024.

Insurance education training changes for Washington, Mississippi

There’s a student loan joke in here somewhere, but getting an insurance license in Washington is about to lose a hurdle, while maintaining one for Mississippi licensees “of an age” is also a bit less arduous.

Gov. Jay Inslee in Washington signed a bill that repeals the state’s prelicensing requirements for insurance producers. The law goes into effect July 5, 2023, after which point people who want to be licensed as insurance producers will need to pass the licensing exam, but no more will the commissioner compel them to present a prelicensing course completion certificate as a prerequisite. 

For prelicensing course providers, the new rule will likely have a mixed effect: While more people might bypass prelicensing courses, the state will also cease many of its course content regulations. 

Meanwhile, Mississippi passed legislation that will allow a person 65 or older who has been continuously licensed as an insurance producer for 25 years or more to opt out of continuing education (CE) requirements. 

A producer who wants to take advantage of this new provision and bask in the advantages of wisdom and experience can submit this affidavit to the state to claim their exemption. 

Other state changes

Wyoming adopted the NAIC’s Model Regulation in Annuity Transactions, which will be effective July 5, 2023. The state expects producers who sell annuities to be compliant with new CE requirements by Jan. 5, 2024. Another bulletin in the state changes reporting requirements for insurers that write coverage for medical malpractice, giving them a three-month notice for any required reports. 

Colorado announced the results of the homeowners’ insurance market study the state required as part of last year’s legislation on disaster preparedness. The study examined insurance availability, affordability, and exposure in the wake of the Marshall Fire. Commissioner Michael Conway adopted the new regulations concerning premium rate setting and network adequacy standards for Colorado Option plans, effective May 30, 2023.

Montana Commissioner Troy Downing issued an advisory to insurers about changes to the 2024 form, rate, and network adequacy filing requirements for plans offered via the federal health exchange, HealthCare.gov. Because the rest of us are living in 2023, but health insurers are required to predict the future.

Louisiana Insurance Commissioner James Donelon revised and reissued an advisory letter to insurers and health maintenance organizations (HMOs) in every line of insurance. The advisory said every fee paid to an insurance producer as a percentage of premium or a direct compensation or reward that is a flat fee-for-service, either one is considered a commission. While the Louisiana Department of Insurance doesn’t require one over the other, the advisory is clear that the payment method should be accounted for in the quoted premium, period.

Michigan Department of Insurance and Financial Services issued a bulletin to adjust the amount of an insured’s unearned premium refund that the Michigan Property and Casualty Guaranty Association treats as a “covered claim” to $1,886 to account for changes in inflation. Another bulletin notes changes to the Michigan Selection of Personal Injury Protection Choice Form and the Bodily Injury Liability Coverage Limits Form. Beginning Jan. 1, 2024, the state will begin licensing and regulating pharmacy benefit managers (PBMs).

Arkansas reminded the industry of its upcoming carrier appointment renewal period. Invoices will be posted June 1 through June 30, 2023, via the National Insurance Producer Registry. 

West Virginia also announced the state is posting company appointment renewals through NIPR. Renewal invoices will be posted June 6 through Aug. 31, 2023. To see more carrier appointment renewal and termination dates, check out our running list.

New Jersey’s “Daniel’s Law” includes a provision that title search business entities must register with the state Department of Banking and Insurance. The Office of the Insurance Commissioner sent a bulletin giving the industry guidance on the new legislation and a link to help title search businesses register with the state.

Guam’s Department of Revenue and Taxation joined the North American Securities Administrators Association in April 2023. The move means Guam will likely eventually join its data to the Central Registration Depository, Investment Adviser Registration Depository, and Electronic Filing Depository systems, which will further streamline securities regulation both for securities professionals and those who regulate them. We love to see it. 

Washington Commissioner Mike Kreidler took the opportunity of Earth Day to kick off the 2023 Climate Summit Series, where his office brings in public attitude surveyors, insurance executives, Tribal communities, and elected officials to share perspectives on climate change and how it is shaping the state.

NAIC CEO Mike Cosedine announced his resignation March 15, 2023, effective April 30. 
While these points of interest aren’t comprehensive, our knowledge of producer license and compliance maintenance is. See how AgentSync can help make you look smarter today; head over to the Compliance Library and wrastle up some state-by-state regulation and more jurisdictional updates.