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Around the PIA Western Alliance States

Posted By Administration, Tuesday, November 7, 2017

California — Cannabis Insurance: California Insurance Commissioner Dave Jones has announced that cannabis businesses licensed by the State of California may now purchase commercial insurance coverage from an admitted commercial insurance company. Jones has approved the filing of the first admitted commerical insurance company to file cannabis business insurance, so that the insurer can begin writing policies and offering coverage for cannabis business owners.

“This is the first of what I hope will be many commercial carriers filing insurance products to fill insurance coverage gaps for the cannabis industry. Consumers who visit cannabis businesses, workers who work there, businesses who sell products to or rent property to cannabis businesses, and the investors, owners and operators of cannabis businesses all should have insurance coverage available to help them recover when something goes wrong just as any other legalized business does,” Jones said.

Jones launched an initiative earlier this year to encourage commercial insurance companies to write insurance to fill coverage gaps for the cannabis industry. This first filing and approval of commercial insurance for the cannabis industry is a successful result of Commissioner Jones' initiative. Jones has convened meetings between commercial insurance company executives and cannabis business owners to educate the insurance industry about the sophistication, professionalism and risk management of the cannabis industry. Jones has also organized tours for insurance executives at cannabis businesses.

Last month Jones held a first in the nation public hearing to identify insurance gaps faced by the cannabis industry. Cannabis businesses and insurance industry representatives testified about the limited availability of insurance for cannabis businesses. The hearing revealed that while there is insurance available from surplus lines insurers, insurance coverage is limited in scope and, until the approval being announced today, commercial carriers were not yet writing insurance. Jones also announced that department staff would be allocated to cannabis insurance filings.

"Our mission remains insurance protection for all Californians, which includes insurance for California's legalized cannabis businesses and customers. We encourage more insurance companies to file cannabis business insurance products with the department to meet the needs of this emerging market," Jones added.

 

California — The Oroville Dam: The Oroville Dam repairs are done. As you recall, the nation’s highest dam nearly collapsed early this winter when heavy rains fell.

The repairs done may not be enough. California Department of Water Resources Deputy Director Joel Ledesma said a review will be done by the state, federal government officials and by experts from the private sector. The review will look at the repairs and the dam’s almost collapse cause.

That examination is expected to be done by September of 2019.

 

Source link: Insurance Journal

 

Idaho — The Department of Insurance Wants Public Comment: The Idaho Department of Insurance intends to apply to the Centers for Medicare and Medicaid Services (CMS) and to the United States Department of the Treasury for a Section 1332 State Innovation waiver on or about January 5, 2018. The purpose of the waiver is to extend eligibility for help in paying monthly health insurance premiums through Advance Premium Tax Credits (APTC) to working U.S. citizens who file federal income tax returns with income below 100% of the Federal Poverty Level (FPL). The proposed effective date for the waiver is January 1, 2019.

Currently, thousands of Idaho residents have incomes of under 100% FPL and are without health coverage. Due to the requirement to have income of at least 100% FPL in order to qualify for APTC, these Idahoans do not have access to affordable health insurance. While these working U.S. citizens are ineligible for APTC, lawfully-present non-citizens falling into the same income range are eligible for and receive APTC. This Section 1332 waiver application, if approved, would provide working Idahoans with income below 100% FPL who are U.S. citizens access to APTC similar to lawfully-present non-citizens.

The Department’s comprehensive public notice, tribal notice and the draft waiver application are available on our website at https://doi.idaho.gov/publicinformation/PublicComments. The Department is seeking public comment through public hearings, the interactive form available on the website, email or traditional mail as indicated below.

Interested parties may also request hard copies of the waiver packet or submit comments via email or traditional USPS mail to:

Attention: Weston Trexler

Product Review Bureau Chief

Department of Insurance

P.O. Box 83720; Boise, Idaho 83720-0043

E-mail to: DOI.Reform@doi.idaho.gov

Public comments will be accepted until December 15, 2017.

 

Oregon — The SAIF Controversy: Dan Harmon is a board member of Oregon Business & Industry. Harmon was also on Oregon’s Task Force on Workers' Compensation Reform. It looked at work comp issues in Oregon in 2001.

He’s concerned by the new effort afoot to take money from the state’s workers’ compensation agency the State Accident Insurance Fund (SAIF) to reduce the heavy cost of the state’s Public Employee Retirement System (PERS).

The Legislature set up a task force to study the PERS issue and one of the ideas being floated is to raid the SAIF reserves.

In an article for OregonLive.com Hartman said, “Oregon’s worker compensation system is one of the best in the nation. It offers affordable employer premiums, excellent worker benefits and a proven record of improving worker safety. The state-chartered nonprofit's strong financial position is the foundation that supports this exemplary system.”

So why — he says — do we want to make changes to such a well-oiled machine?

The reason — Hartman said — is to bail out a system that is structurally deficient. “Oregon's pension system has a $25 billion deficit. Payments to the pension system will consume more than one-third of the payroll at schools and other public employers by 2021 unless the state does something to improve the pension's financial foundation. Faced with mounting pension debt and crowded classrooms, a governor-appointed task force was instructed to compile a list of ideas for buying down the unfunded pension liability.”

Those ideas are — at best — ill-advised. None of the ideas will generate enough money to solve the problem. What the task force came up with is ways to shift cost to the taxpayer. And the worst idea of all is diverting money from SAIF to build up PERS. That poses some serious risks to the state’s work comp system.

  The low rates of SAIF is a cost advantage Oregon businesses have when competing with out of state companies

  SAIF uses investment earnings to offset work comp costs and diverting cash makes workers’ compensation costs higher for Oregon businesses

 

“The nonprofit is funded entirely through employer premium payments and investment income. No state revenue is used to fund it. Yet the proposals under consideration by the task force suggest that SAIF resources should be arbitrarily appropriated to help cover the state's unfunded pension liability,” he wrote.

 

Source link: OregonLive.com

 

Oregon — Medicaid Scandal: Oregon’s Health Authority has been a disaster. Its new chief financial officer is Laura Robison. She recently admitted what has long been suspected. OHA paid out $74 million to people that shouldn’t have been compensated.

Oregon could end up having to pay that Medicaid money back to the federal government.

A lot of people knew of the overpayments including Lynne Saxton who was just asked to step down by Governor Kate Brown. Some knew about it as much as a year ago. The person who didn’t know about the snafu is the governor.

She just learned about it from Saxton’s replacement Pat Allen. Chris Pair is a spokesman for Allen. He said, “The previous OHA administration did not inform the Governor's Office of this issue prior to October 17, which Governor Brown finds unacceptable.”

Robison said payments were made to give healthcare to people on Medicare who had already been deemed ineligible. “These issues landed on my desk essentially on my arrival and I've made it a priority to get these fully scoped and resolved as soon as possible. We don't understand all the reasons this was happening.”

 

Source link: OregonLive.com

 

Oregon — From the Oregon Insurance Division: The Oregon Division of Financial Regulation recently announced the following Proposed Rulemaking hearing:

Clarification of provisions related to registration and regulation of Pharmacy Benefit Managers

Amend: OAR 836-200-0401

Is amended to make technical changes, and to clarify the department’s authority to regulate and enforce PBM provisions under the Insurance Code.

In a budget note to Senate Bill 5701 (2016), the Oregon Legislative Assembly directed the department to convene a public workgroup to develop recommendations to improve the PBM regulatory framework. The department convened such a workgroup and developed statutory and rulemaking recommendations. The rulemaking recommendations reported to the legislature included (1) removing the current registration and renewal fee caps, to allow recoupment of administration and enforcement costs, and (2) clarifying registration and appeals processes and terminology associated with maximum allowable cost pricing.

House Bill 2388 (2017) modified and supplemented the PBM statutory framework to grant the department authority to suspend, revoke or deny the registration of applicants or registrants, to set registration and renewal fees based upon the department’s reasonable costs and to prescribe a procedure by which a pharmacy or an entity acting on behalf of a pharmacy may file a complaint against a PBM.

This rulemaking is necessary to implement the Senate Bill 5701 budget note recommendations and the provisions of House Bill 2388, and as an aid to the effectuation of the Insurance Code.

Filed: October 23, 2017

Public hearing: November 28, 2017, 10:00 a.m.

Last day for public comment: December 5, 2017, 5:00 p.m.

The agency requests public comment on whether other options should be considered for achieving the rule's substantive goals while reducing the negative economic impact of the rule on business.

For more information on this proposed rule, please visit the Division's website:

dfr.oregon.gov/laws-rules/Pages/proposed-rules.aspx

 

The Oregon Division of Financial Regulation recently announced the following Proposed Rulemaking:

Health benefit plan coverage of health services necessary to combat disease outbreak or epidemic

Adopt: OAR 836-053-0418

Clarifies the definition of “insurer” found within 2017 Or Laws, ch. 719, § 2 (Enrolled House Bill

3276) to confirm this law’s applicability to health care service contractors and multiple employer welfare arrangements

authorized to transact insurance or offer health benefits in the state of Oregon.

2017 Or Laws, ch 719 prohibits insurers from restricting coverage in the following manner when the Public Health

Director has determined there is a disease outbreak, epidemic or other condition of public health importance:

  Requiring services be administered by an in-network provider;

  Imposing cost-sharing requirements that are greater than cost-sharing requirements for similar covered services;

  Requiring prior authorization or other utilization control measures; or

  Limiting coverage in any manner that prevents an enrollee from accessing necessary health services.

 

Most health insurers in Oregon are licensed as health care service contractors. The new law establishes the above requirements for insurers and defines “insurer” as a person with a certificate of authority to transact insurance in this state. The department received a recommendation from the Department of Justice to clarify in rule that the provisions of the law applicable to insurers also apply to entities licensed as health care service contractors or multiple employer welfare arrangements.

Filed: October 20, 2017

Public hearing: November 27, 2017, 1:30 p.m.

Last day for public comment: December 4, 2017, 5:00 p.m.

The agency requests public comment on whether other options should be considered for achieving the rule's substantive goals while reducing the negative economic impact of the rule on business.

For more information on this proposed rule, please visit the Division's website:

http://dfr.oregon.gov/laws-rules/Pages/proposed-rules.aspx

 

The Oregon Division of Financial Regulation recently announced the following Proposed Rulemaking:

Adopt changes to NAIC Models 205 and 312, quarterly and annual statement blanks

Amend: OAR 836-011-0000

Is amended to specify the annual statement blank versions to be used for submission of 2017 annual statement and 2018 quarterly statement reporting years.

The addition of quarterly statement blank language is in response to issues that arose out of a recent regulatory experience with an insurer. Inclusion of quarterly statement blank requirements in administrative rule will provide the department with necessary support for future regulatory action. Updating the version of the statement blanks for the annual and quarterly statements is to ensure correct submission of this data.

The NAIC Model 205 Annual Financial Reporting Model Regulation was amended in 2014 to incorporate an internal audit function for large insurers into the regulation. The revisions require individual insurers writing more than $500 million or insurance groups writing more than $1 billion in annual premium to maintain an internal audit function providing independent, objective and reasonable assurance to the audit committee and insurer management regarding the insurer’s governance, risk management and internal controls. The division did not take action to adopt the revisions to these rules to align with the NAIC model until now. The additional oversight for insurers of this size provides another level of protection for consumers.

AIC Model 312 The Risk-Based Capital for Insurers Model Act was revised in 2011 to increase the life risk-based capital (RBC) trend test trigger point from 2.5 to 3.0. This enhancement to consumer protections increases the confidence that the insurer has adequate resources to maintain solvency by requiring additional capital. The department did not take action to adopt the revisions to these rules to align with the NAIC model until now.

Filed: October 23, 2017

Public hearing: November 29, 2017, 10:00 a.m

Last day for public comment: December 6, 2017, 5:00 p.m.

The agency requests public comment on whether other options should be considered for achieving the rule's substantive goals while reducing the negative economic impact of the rule on business.

For more information on this proposed rule, please visit the Division's website:

http://dfr.oregon.gov/laws-rules/Pages/proposed-rules.aspx

 

The Oregon Division of Financial Regulation recently announced the following Proposed Rulemaking:

Adoption of Rules Defining Coordinated Care and Case Management for Behavioral Health Care Services

Adopt: OAR 836-053-1403

Defining coordinated care and case management for behavioral health care services.

Although existing law requires health carriers to cover services in emergency settings and to adhere to mental health parity requirements, certain patients were not receiving behavioral health assessments as part of care during a behavioral health crisis and were not adequately transitioning from an acute care setting to community-based care. House Bill 3091, passed during the 2017 legislative session, provides clarity regarding the services to be provided during these events and requires the Department of Consumer and Business Services to adopt rules defining coordinated care and case management to ensure patients with coverage through coordinated care organizations or the commercial health insurance market are properly assessed and receive the support necessary for transition to community-based care.

Filed: October 30, 2017

Public hearing: November 27, 2017, 10:00 a.m

Last day for public comment: December 4, 2017, 5:00 p.m.

The agency requests public comment on whether other options should be considered for achieving the rule's substantive goals while reducing the negative economic impact of the rule on business.

For more information on this proposed rule, please visit the Division's website:

http://dfr.oregon.gov/laws-rules/Pages/proposed-rules.aspx

 

The Oregon Division of Financial Regulation recently announced the following Proposed Rulemaking:

Adoption of Valuation Manual for Principle-based Reserving

Amend: OAR 836-031-0605

Is amended to specify the edition of the NAIC Valuation Manual insurers must use when establishing principle-based reserves beginning January 1, 2018

Oregon laws allow insurers to use actual experience of policyholders rather than a formulaic table when calculating statutory claims reserves via principle-based reserving. The proposed rules designate the version of the NAIC Valuation Manual insurers must use in establishing principle-based reserves for life insurance and in establishing reserves using other reserving methods for health insurance.

Filed: October 30, 2017

Public hearing: November 29, 2017, 10:00 a.m

Last day for public comment: December 6, 2017, 5:00 p.m.

The agency requests public comment on whether other options should be considered for achieving the rule's substantive goals while reducing the negative economic impact of the rule on business.

For more information on this proposed rule, please visit the Division's website:

http://dfr.oregon.gov/laws-rules/Pages/proposed-rules.aspx

 

Washington — From the Office of the Insurance Commissioner: Title rating organization rule stakeholder draft posted

One of the comments we did receive was that if the Title Rating Organization did not refile its base rates in the time period set out in the proposed rule that the title insurers can continue to use the latest filed rates of the Title Rating Organization until new rates were approved. This would result in there being no consequence to the Rating Organization if it did not update its base rates. We are open to other suggestions as to the consequences if the Title Rating Organization does not update its base rates, but merely indefinitely continuing on until new rates are filed will not work.

Comments on this updated stakeholder draft are due November 15, 2017; please send them to rulescoordinator@oic.wa.gov.

For more information, including the text of the stakeholder draft, please visit the rule's webpage: https://www.insurance.wa.gov/title-insurance-rating-and-advisory-organizations-r-2017-06?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=

 

Surplus line broker licensing rule adopted

We adopted the rule addressing surplus line broker licensing (R 2017-10) on November 2, 2017. The rule takes effect on January 1, 2018. This rule will amend WAC 284-15-010.

For more information, including the adopted rule (CR-103P) and the concise explanatory statement, please visit the rule's webpage: https://www.insurance.wa.gov/addressing-surplus-line-brokers-licensing-r-2017-10?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=

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

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