

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, instead, as 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.
Medicare Advantage open enrollment period
It’s true, consumers who have enrolled in Medicare Advantage have from early January to the end of March to make changes to their coverage, swap plans, etc. State departments of insurance are issuing guidelines to keep consumers safe and reminding us all that fraudsters are alive and well.
But, perhaps more germane to the insurance carriers and agencies working in this space, it’s also not the time you want to have to worry about keeping your distribution force appropriately licensed and appointed. Now is not the time to make mistakes. Now is not the time to call your state regulator and ask them * very politely * to fast-track an appointment or cut you slack on a license date.
So, if you want to make next open enrollment season less of a strain, consider how AgentSync can help you button up your process for a less chaotic (and more profitable) year.
SILA formalizes 2025 board members
The Securities and Licensing Administration (SILA) may not be a regulatory body, but regulatory interest and the praxis of insurance compliance surely intersect there. So it seems only fitting to congratulate and note the year’s board of directors:
Executive Board:
- President Tim Owen
- President Elect Barb Gavitt
- Secretary Nikki Brown
- Treasurer Paula Sisneros
- Governance Lesli Leakey
- Legal Adviser Fred Karlinsky
- Executive Director Sherri Coleman (SILA)
Board of Directors:
- Sponsor & Fundraising Chair Codi Henry
- Communications Chair Allister Yu
- Membership Chair Amy Ward
- Nominations Chair Tracy Sloan
- Securities Chair April Gaskins
- Education Chair Brandi Brown
- Vendor Relations Chair Ryan Fitzgerald 🥳
- Regulatory Advisor Rachel Chester (Rhode Island)
- Regulatory Advisor Richard Tozer (Virginia)
- Regulatory FINRA Advisor Bill Swanstrom (FINRA)
- Regulatory Securities Advisor (Wisconsin)
- Congratulations to these board members, and good luck in 2025!
SILA also congratulated the members that achieved a SILA Designation in December 2024:
- Kaitlyn Brown
- Melinda Doane 🎉 🎉 🎉
- Kiersten Krout
It wouldn’t be right to look to the upcoming year without a word of remembrance for last year’s president, John “Paul” Willis, a sweet man and dedicated professional whose death mid-December closed 2024 with profound sadness for all whose lives he touched.
Washington discusses carceral health care and liability insurance
Washington’s Legislature has been puzzling over how to support transitional health services for incarcerated Washingtonians. Using community healthcare providers for transitional services as people leave incarceration and enter regular civilian life can make a significant difference in recidivism rates and overdoses. Yet, providers report struggling to get professional liability coverage for these services because liability insurers report numerous backend issues that complicate coverage.
Commissioner Mike Kreidler’s office offered the Legislature several policy options to remove barriers to this coverage:
- Option 1: Expand data collected for the Office of the Insurance Commissioner’s confidential Annual Medical Professional Liability Study. Additional data could allow insurance companies to more accurately assess risk and provide coverage. This could also bolster future, broader carceral medical liability studies.
- Option 2: Create a new risk pool (or other insurance mechanism) to provide medical liability insurance for transitional services. The state could subsidize the cost if the risk pool charges less than actuarially justified premiums for the coverage.
- Option 3: Establish a joint underwriting association or similar mechanism to provide medical liability insurance for CHPs.
- Option 4: Extend the state tort claims act to CHPs that meet certain criteria established by the state. The CHPs would be designated as employees of the state only when providing transitional services.
- Option 5: Implement different negligence standards for transitional services provided by CHPs to reduce costs, so they can only be held liable if they display gross negligence or bad faith.
- Option 6: Combine different policy options.
It remains to be seen which options may appeal to legislators in the 2025 session, but the intersection of healthcare and liability insurances, prisoner advocates, and taxpayer interests is sure to bring many stakeholders to the table.
Other state regulatory changes
Alaska announced the new law, “Pharmacies/Pharmacists/Benefits Managers,” is effective as of Jan. 1, 2025. The law formalizes a specific process for pharmacy benefits managers (PBMs) to register with the state. For some PBMs that have previously been registered as third-party administrators (TPAs), the state issued Bulletin B 24-12 clarifying how they should handle registration moving forward.
Colorado Division of Insurance officials are working through data for health insurance costs in the state after 2024’s expenses were higher than expected. Bulletin B-4.145 advises health insurers that this may affect the rate they pay for the state’s reinsurance program.
Georgia Commissioner John King issued Directive 24-Ex-12 to advise that insurers can waive a “de minimus” premium for marketplace plans (e.g., insurers can issue health care plans for $0.00 instead of arbitrarily charging something like $0.22 on subsidized plans). King said the state won’t consider these plans to be violations of Title 33, Chapter 6 (the unfair trade practices piece of Georgia law).
Kansas Commissioner Vicki Schmidt gave a preview of the insurance department’s legislative agenda. The Commissioner’s office seeks to reduce fees and move to perpetual producer appointments, among other changes, and announced producers and agencies kept more than $1 million in their pockets last year thanks to the department’s lowered fees.
New Jersey Bulletin No. 24-18 reminded PBMs and other pharmacy service administrative organizations that new regulations requiring their licensure have gone into effect as of Jan. 1, 2025. If you need to remember what PBMs are, we got you.
New York surplus lines insurers can take note, the Excess Line Association of New York (ELANY) added Richmond National Insurance Company to its list of E&S insurers approved in the state. For a brush-up on your E&S basics, check out Surplus 101. The state has also updated its renewal period for business entities, which now starts 120 days before an agency license expires instead of 180 days.
Oklahoma Insurance Commissioner Glen Mulready announced, since census data revealed “the Hispanic-Latino population has become the second-largest ethnic group in Oklahoma over the last decade,” the Oklahoma Insurance Department will now offer all producer and adjuster licensing exams and study manuals in Spanish as well as English. The change began Jan. 1, 2025. The administration also amended Bulletin No. 2024-07 summarizing the rule changes of 2024.
South Carolina Bulletin Number 2025-01 reminded PBMs and pharmacy services administrative organizations (PSAs) the state’s law, as of Jan. 1, 2025, allows the Insurance Director to examine and audit these businesses to determine compliance. PBMs and PSAs should expect these inspections at least every five years, and are on the hook for any expenses incurred by the Department of Insurance during the exam or audit process.
Washington State Office of the Insurance Commissioner adopted a new rule regarding prior authorization late in December 2024, updating timeframes in which health care insurers must respond to enrollees’ prior authorization requests for health care services and prescriptions.
FINRA published final statements for broker-dealer and investment adviser firm renewals Jan. 2, 2025. The deadline for renewal payments is Jan. 24, 2025.
NASAA has issued a change to its model rules regarding exam requirements for broker-dealer agents and investment adviser representatives. The changes extend the timeframe for an exam’s validity based on rules many states have already implemented.
Stay on top of regulatory changes with AgentSync
While these points of interest aren’t comprehensive, our knowledge of insurance producer and variable lines broker 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. If you’re looking for a solution that builds regulations like these into your distribution channel management workflows automatically, AgentSync can help. See us in action or talk to one of our experts today.