Category(s): Florida - 09/14/2020

Citizens Property Insurance Corporation (Citizens) paused cancellations and nonrenewal notices on March 27, 2020  in response to COVID-19. On July 9, 2020 , Citizens announced that it would resume cancellations and nonrenewals on August 5, 2020; however, on July 25, 2020 , the cancellation moratorium was extended until the end of the year. The decision was the result from concerns raised by CFO Jimmy Patronis and discussions held with the Citizens Board of Governors over timing. Further details on the continued moratorium were released on August 10, 2020 . Customers with questions about premium payments can contact their agent or Citizens directly at 1.866.411.2742 or via email at customer.care@citizensfla.com.

Fred E. Karlinsky, Esq. - GREENBERG TRAURIG, P.A., (954) 768-8278 , karlinskyf@gtlaw.com

Category(s): Florida - 09/14/2020

On July 6, 2020, Citizens Property Insurance Corporation (Citizens) unveiled its Citizens Learning Center (CLC), available to credentialed agents and licensed customer service representatives. The CLC is comprised of online learning modules, recorded webinars, and registration for various Citizens webinars and classroom trainings. For further details and access instructions, please see the Citizens Agent Bulletin. 

Richard J. Fidei, Esq. - GREENBERG TRAURIG LLP, (954) 592-5530

Category(s): Florida - 09/14/2020

In August, the Florida Division of Workers’ Compensation (DWC) released an updated data summary report outlining the effects of COVID-19 on Florida’s workers’ compensation system. The DWC intends to continually update this report as new data is reported and analyzed. The 2020 report, as of July 31, 2020, can be found here. 

Richard J. Fidei, Esq. - GREENBERG TRAURIG LLP, (954) 592-5530

Category(s): Florida - 09/14/2020

On July 17, 2020, the Florida Office of Insurance Regulation (OIR) proposed amendments to Rule 69O-142.015, Standardized Requirements Applicable to Insurers After Hurricanes or Natural Disasters, to change the manner in which insurers report certain information to the OIR as a consequence of a hurricane or other natural disaster and create separate subsections covering contracts of insurance entered into by property and casualty insurers and health and life insurers.  The proposed rule amendments can be found here . If requested in writing and not deemed unnecessary by the agency head, a rule development workshop will be noticed in the Florida Administrative Register. Please contact Michael Lawrence, Jr. , Assistant General Counsel, Florida Office of Insurance Regulation, with any questions regarding the proposed rule development.

Richard J. Fidei, Esq. - GREENBERG TRAURIG LLP, (954) 592-5530

Category(s): Florida - 09/14/2020

In light of the anticipated above-average 2020 Atlantic Hurricane Season, the Florida Office of Insurance Regulation (OIR) issued an Informational Memorandum to provide insurers with guidance and instructions on claims handling and communications, encouraging compliance with COVID-19 response and safety protocols. Click here  to view Informational Memorandum OIR-20-07M.

Fred E. Karlinsky, Esq. - GREENBERG TRAURIG, P.A., (954) 768-8278 , karlinskyf@gtlaw.com

Category(s): Georgia - 09/14/2020

The Georgia Insurance Commissioner issued Bulletin 20-EX-8 on June 2, 2020, which imposed, effective July 1, 2020, a new $5.00 “processing fee” for all transactions for which a filing fee is payable to the Georgia Insurance Department. The purposes of the new fee is to defray the Department’s costs in upgrading its information technology systems.

Brian T. Casey, Esq. - LOCKE LORD LLP, (404) 870-4638 , bcasey@lockelord.com

Category(s): Georgia - 09/14/2020

SB 462, transfers the Georgia Industrial Loans’ regulation and oversight from the Department of Insurance and to the Department of Banking and Finance in Chapter 3 of Title 7. Governor Kemp signed this legislation on June 30, 2020. The Act took effect upon signature and applies to any loans made on and after July 1, 2020.

HB 716, amends O.C.G.A. § 33-24¬59.23 to require that all carriers that issue a health benefit plan in the state file proposed agent commission rates with the Department of Insurance. The bill also specifies that no commission must be given to an agent for the first term of a plan sold during a special enrollment period; however, any renewal of such plan must be granted commission. Governor Kemp signed the legislation on August 4, 2020. The Act takes effect on January 1, 2021.

HB 789, creates the "Surprise Bill Transparency Act" in Chapter 20C of Title 33. It establishes a health benefit plan surprise bill rating system based on the number of checkmarks and X-marks between zero and four that a health benefit plan's in-network hospital has earned. Governor Kemp signed this bill on July 16, 2020. The bill becomes effective on November 1, 2020.

HB 888, amends Title 33 to create the “Surprise Billing Consumer Protection Act.” Specific provisions of the bill include:

Definitions added in O.C.G.A. § 33-20E-2 including:

Balance Bill: the amount that a nonparticipating provider charges for services provided to a covered person. Such amount equals the difference between the amount paid or offered by the insurer and the amount of the nonparticipating provider’s bill charge, but shall not include any amount for coinsurance, copayments, or deductibles due by the covered person.
Contracted amount: the median in-network amount paid during the 2017 calendar year by an insurer for the emergency or nonemergency series provided by in-network providers engaged in the same or similar specialties and provided in the same or nearest geographical area. Such amount shall be annually adjusted by the department for inflation which may be based on the Consumer Price Index but shall not include Medicare or Medicaid rates.
Surprise bill: a bill resulting from the occurrence in which charges arise from a covered person receiving healthcare services from an out-of-network provider at an in-network facility.

O.C.G.A. § 33-20E-4 requires that an insurer providing benefits for emergency medical services must pay for the services regardless of whether the provider or facility is a participating provider. Insurers are prohibited from requiring prior authorization or retrospectively denying payment for medically necessary services. If a covered person receives service from a nonparticipating provider, the provider must not bill more than the person’s deductible, coinsurance, copayment, or other cost-sharing amount under their plan. The insurer must then pay the greater of:

verifiable contracted rate paid by all eligible insurers;
most recent verifiable amount agreed to by the insurer and nonparticipating provider for the same services when the provider was in-network; or
higher amount as determined by the insurer based on the complexity of the services.

Any services from a nonparticipating provider must count towards a covered person’s deductible or out-of-pocket maximum.

O.C.G.A. § 33-20E-6 prohibits insurers from denying or restricting covered benefits from a participating provider for a covered person because they received out-of-network services.
O.C.G.A. 33-20E-7 clarifies that a person knowingly obtaining out-of-network care does not constitute a surprise bill.
O.C.G.A. 33-20E-8 provides for an all-payer health claims database to be maintained by the Department of Insurance.
O.C.G.A. 33-20E-9 et seq. provide for an arbitration process between insurers and providers in the case of disputed claims.

Governor Kemp signed this legislation on July 16, 2020. The Act takes effect on January 1, 2021.

HB 1050, adds health maintenance organizations to the entities paying into the Georgia Life and Health Insurance Guaranty Association. Governor Kemp signed this legislation on June 30, 2020. The Act took effect on July 1, 2020.

SB 303, creates the “Georgia Right to Shop Act” in O.C.G.A. § 33-24-59.27. Specifically, the bill:

Requires that insurers must make an interactive online mechanism for the public to compare payment amounts accepted by in network providers, obtain an estimate of the average amount accepted by in-network providers, obtain an estimate of out-of-pocket costs, compare quality metrics, and access an all payer claims database.
Requires insurers to provide notification that the actual amount that a covered person would be responsible to pay could vary depending on unforeseen costs arising during the provision of health care.
Requires insurers provide estimates of both out-of-pocket costs incurred by a person that has exceeded their deductible and those that have not exceeded their deductible.

Governor Kemp signed this legislation on August 4, 2020. The Act took effect upon his signature.

Brian T. Casey, Esq. - LOCKE LORD LLP, (404) 870-4638 , bcasey@lockelord.com

Category(s): NAIC - 09/15/2020

On August 14, the National Association of Insurance Commissioners (NAIC) adopted principles for artificial intelligence that were developed over the last year by the NAIC’s Artificial Intelligence Working Group.
  
Among other things, the principles require that insurers and others using AI:

Take proactive steps to avoid proxy discrimination against protected classes.  (As NAIC President Ray Farmer (S.C.) noted, this is part of the NAIC’s broader effort to address racial equality issues.)
Monitor the operation of its A.I. system and remediate harmful, unintended consequences;
Provide responsible disclosures, and give consumers an opportunity to inquire about and seek review of A.I.-driven decisions; and
Take a risk management approach to each phase of the A.I. system's life cycle.

The principles do not have the effect of law, but they will form the basis for future regulatory workstreams, and they set out the regulators’ expectations. If your organization is using AI, it’s time to consider how your systems measure up.

Scott M. Kosnoff, Esq. - FAEGRE DRINKER, (317) 237-1201 , scott.kosnoff@faegredrinker.com

Category(s): South Dakota - 09/14/2020

The South Dakota Governor and the legislative leadership in the House appear to be on different tracks as it concerns the need to call a special session of the Legislature in order to determine how the Federal COVID dollars flowing to the State will be spent. Legislative leadership positions for both the House and Senate are in play so the move to call a special session of Legislature is seen by many to be a play to burnish up the credentials of members interested in House and Senate leadership positions.

Dennis Duncan, Esq. - THE DUNCAN LAW FIRM, L.L.P., (605) 361-9840 , dlduncan@ddlawsd.com

Category(s): Washington - 09/14/2020

A survey delivered at the end of August jointly for the Washington Office of Insurance Commissioner and Department of Revenue to about 5,000 entities seeks to determine participation in captive insurance for a report to the Legislature.  The survey includes questions to try to discern if the target has any captive insurance involvement.  If yes, then many more specific questions follow. The surveyor promises that information provided will be treated as confidential tax information, and provided only in redacted form to the OIC, Legislature, and others.   Curiously, despite assurances of confidentiality, the communications accompanying the survey include a threat for those not participating that “further investigation and enforcement will be pursued”.

Steven Beeghly, Esq. - BEEGHLY RICOY LAW GROUP, (206) 618-6110 , sb@BeeghlyRicoy.com