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Around the PIA Western Alliance States

Posted By Administration, Tuesday, April 5, 2016

Arizona — Transition Policies

Weekly Industry News received this from the Arizona Department of Insurance.


Final Extension of Transition Policies through December 31, 2017


Phoenix - The Arizona Department of Insurance (ADOI) announced that insurers in the individual and small group[1] (#_ftn1) major medical health insurance markets can choose to renew transitional policies through December 31, 2017.  Transitional plans are non-ACA compliant policies that have been continuously in effect since by or before December 31, 2013.


At least six health insurers have individual or small group transition policies still in effect in Arizona.  By extending the transition period, consistent with the February 29, 2016 Bulletin (https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/final-transition-bulletin-2-29-16.pdf) issued by the Center for Consumer Information and Insurance Oversight (CCIIO) (https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/final-transition-bulletin-2-29-16.pdf), insurers will have the option to continue the pre-2014 individual and small group policies covering more than 100,000 Arizonans through the end of 2017. Insurers that offer this short term extension of coverage are required to send each policyholder a Renewal Notice that explains the offer to continue the transition policy to the end of 2017 and includes information regarding any related price increase.


Each policyholder that chooses to renew his or her transition plan will receive a final notice, by or before October 1, 2017, explaining that the transitional plan is being discontinued effective December 31, 2017. However, extending transition plans to the end of 2017 allows affected policyholders to select a new plan during the annual open enrollment period along with other Arizonans.


The transition extension does not affect grandfathered policies issued prior to March 23, 2010.  These policies can remain in effect as long as they maintain grandfathered status.


This decision extends the Department’s prior determination on transitional plans as outlined on March 27, 2015 (https://insurance.az.gov/sites/default/files/documents/files/Transition%20Policies%20Determination%202016.pdf) (https://insurance.az.gov/determination-2016-transition-affordable-care-act-compliant-policies).


Idaho — Insurance Gap

The Idaho Legislature was unable to come up with an agreeable plan to insure those who cannot qualify for Medicaid or other Affordable Care Act subsidies.


The session ended on March 25th with an impasse on the subject.


Governor Butch Otter said he was disappointed in the outcome but disagrees with proponents who say people in Idaho without health insurance are dying. I see plenty of people that die every day in hospitals and they have insurance. And they’re in the hospital. But they still die.”


Or to put it more succinctly, Otter said those without insurance still have healthcare options.


House Speaker Scott Bedke said the House will eventually do something but it’s going to take time. I think we need to count it as great progress that, from an issue that we weren’t talking about and said that we were not going to take up, that we have in a very meaningful way. And I believe that on this foundation we can build a solution that will work.”


Whether that’s true or not will have to wait. The governor said he is not going to call a special session to fix the problem.


Source link: Insurance Business America


Nevada — Exchange Success

Silver State Health Insurance Exchange Executive Director Bruce Gilbert said the exchange saved Nevadans close to $1.2 million last year. He made that comment in an interview with the American Journal of Managed Care.


The main reason — he noted — is the state running the exchange and not opting to tie into the federal government’s exchange. He said Nevada was able to attract more enrollees than would have happened if the state didn’t do its exchange.


Being more state specific made it more attractive to Nevadans.


Source link: Insurance Business America


New Mexico — Fire Danger

Dry conditions are serious in New Mexico. A red flag warning has been issued for parts of southern, central and eastern New Mexico. Fires that happen in those areas will spread rapidly and could become quite dangerous.


Outdoor burning is not recommended.


Source link: Insurance Journal


New Mexico — Cannabis Mandate

Via legislative decisions and court decisions, those on workers’ compensation benefits are entitled to medical marijuana or medical cannabis.


As it stands now, a recipient can get up to 230 units — equal to 230 grams — per calendar year. At $12.02 per unit it’s expensive.


Two bills have been introduced in the Legislature on the subject. House Bill 195 wants to remove medical cannabis from workers’ compensation. It says, If this quick and decisive action by the legislature to undo the court’s decision passes, it will serve as a strong precedent for other states with medical cannabis laws that the workers’ compensation industry is not prepared for medical marijuana to be a part of the treatment guidelines.”


Another part of the bill adds, Nothing in this section shall be construed to require a workers’ compensation carrier or an employer providing workers’ compensation benefits to pay for costs associated with the purchase or use of medical cannabis.”


The Senate bill doesn’t want it removed but wants a study done.


Source link: Risk and Insurance


Oregon — Notice of Public Hearing

Acquisition of Advantage Dental Plan, Inc. by Dentaquest Care Group Management, LLC:


Notice of Public Hearing

Before the Insurance Commissioner

of the State of Oregon

Department of Consumer and Business Services


In the matter of the Acquisition of Control of or Merger with a Domestic Insurer

Advantage Dental Plan, Inc. by Dental Service of Massachusetts, Inc.; DentaQuest Group, Inc.; DentaQuest Management, Inc.; DentaQuest Massachusetts Business Trust; DentaQuest, LLC; and DentaQuest Care Group Management, LLC by means of a transaction in conjunction with Advantage Consolidated, LLC


April 20, 2016 at 6:00 p.m.


Department of Consumer and Business Services

Division of Financial Regulation

Labor & Industry Building

Room 260

350 Winter Street NE

Salem, OR 97301

Conference Call 1-888-808-6929, Code: 3255610


Dental Service of Massachusetts, Inc. ("DSM") is a Massachusetts not-for-profit dental service corporation and, through its various subsidiaries, is one of the largest dental benefits administrators in the United States. DSM operates in Massachusetts under the Delta Dental brand name. Through DSM's direct subsidiaries, it also does business under the "DentaQuest" brand name serving customers nationally. Advantage Dental Plan, Inc. is a health care service contractor organized and licensed under the laws of Oregon that operates a dental plan in Oregon, with its headquarters in Redmond, Oregon. Advantage Consolidated, LLC owns and operates dental clinics in throughout Oregon through its ownership of Advantage Community Holding Company, LLC. DSM's subsidiary, DentaQuest, LLC has entered into a Unit Purchase Agreement with Advantage Consolidated, LLC whereby DentaQuest LLC or its designee will acquire an 80% controlling interest in Advantage Community Holding Company, LLC. Advantage Dental Plan, Inc. is a direct subsidiary of Advantage Community Holding Company, LLC. The purpose of the hearing is to permit public comment on the proposed transaction.


A copy of the Form A filed by DSM and its affiliates identified herein describing the transaction is available on the Insurance Division's website at the following link:

Acquisition of Advantage Dental Plan, Inc. by Dentaquest Care Group Management, LLC


The hearing record will remain open until 5:00 p.m., May 4, 2016. Written comments must be RECEIVED by the Division of Financial Regulation by the deadline. Written comments may be submitted via e-mail to FormAAdvantage.INS@oregon.gov or by mail to Advantage Dental Form A, Oregon Division of Financial Regulation, P.O. Box 14480, Salem, OR 97309-0405.


Notice of Rulemaking for Oregon SB 715 Regarding Travel Retailers


The Division of Financial Regulation (DFR) of the Department of Consumer and Business Services (DCBS) is currently forming an advisory committee for the rules to implement the provisions of a new law relating to travel insurance that becomes operative July 1,2016.


Senate Bill 715 was passed in the 2015 Legislative Session. We are seeking interested parties to serve on the external committee to provide input to the Division of Financial Regulation in making the rules that will help define the requirements outlined in the law.


The DFR anticipates that we will need only one meeting with the advisory committee on these rules. We welcome participation in this rulemaking process to consider the issues and determine the guidelines for travel retailers. Please contact Karen Winkel at ins.rules@oregon.gov. In order be considered to serve as a committee member your notice of interest in the group would need to be received by the close of business April 4, 2016. Public comment is invited throughout the process.


These rules must be completed and filed prior to the July 1, 2016 operative date. The external advisory committee meeting is tentatively scheduled for April 7, 2016 from 9:30 to 11:30 in Conference Room E of the Labor & Industries Building at 350 Winter St., Salem, Oregon 97301. For interested parties outside Oregon or for those who are some distance away from Salem, participation by teleconference can be arranged.


Washington — Commissioner Actions

The Office of the Insurance Commissioner has just filed the CR-103 form which finalizes the renumbering and movement of the health care networks and provider contracts and payment sections of WAC Chapter 284-43 into WAC Chapter 284-170.  Our office again wishes to emphasize that no rule language changes were made during this process.  The "new" WAC Chapter 284-170 should become available on the code revisers' website sometime in late April. 


You can find this completed rulemaking on the OIC website here.


The next and final step in this renumbering process will be to fix the cross references in these and other parts of WAC 284 that are affected by this section movement and renumbering process using a rule filing planned for late spring (after this filing officially takes effect). OIC's goal is to have all affected cross references fixed in time to show up in the code revisers' summer update of the WACs. The website which is linked above has a link to the crosswalk of these proposed reference fixes.

Tags:  Around the PIA Western Alliance States  Insurance Content  Insurance Industry  Insurance News  Weekly Industry News 

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