Category(s): National - 05/25/2022

The NAIC Executive (EX) Committee appointed Superintendent Beth Dwyer to serve as the NAIC members’ representative on the Financial Stability Oversight Council (FSOC). Superintendent Dwyer will succeed recently retired Superintendent Eric Cioppa of the Maine Bureau of Insurance.

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

Category(s): Florida - 05/25/2022

Avatar Property & Casualty Insurance has been deemed insolvent as of April 13, 2022. Avatar had approximately 37,000 policyholders in Florida. This brings the number of Florida property insurance firms in liquidation to seven since 2014 according to Chief Financial Officer Jimmy Patronis.

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

Category(s): Florida - 05/25/2022

The Department of Financial Services, Division of Workers’ Compensation held a meeting of its Three-Member Panel, Insurance Commissioner David Altmaier, Tammy Perdue, and David Robbins. The Panel approved methodologies for maximum reimbursement allowances for hospital inpatient and outpatient services as well as ambulatory surgical centers. The Division of Workers’ Compensation will now enter into administrative rulemaking to adopt the methodologies into the healthcare manual.

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

Category(s): Florida - 05/25/2022

Florida’s Insurance Commissioner David Altmaier announced that Florida insurers will be allowed to offer coverage that will not cover the full cost of a roof replacement. The reduced coverage will be voluntary to homeowners likely in exchange for lower insurance premiums.

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

Category(s): Florida - 05/25/2022

The 2022 legislative session ended in mid-March without a consensus on reforms that could have curbed the growth of unsubstantiated claims and frivolous lawsuits, lowered some costs for insurers and slowed the growth of Citizens Property Insurance, the state-run insurer of last resort. That has left many Florida insurance companies struggling financially and the likelihood of more turbulence for the market ahead for many homeowners and businesses. Read the article here. 

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

Category(s): Georgia - 05/25/2022

On March 31, 2022, Commissioner John F. King issued Directive 22-EX-3 to advise that unlicensed persons or entities selling, soliciting, or negotiating insurance in Georgia prior to obtaining an insurance license in this state is not permitted under O.C.G.A §33-23-4(a)(1) (the “Code”), and therefore subject to a fine.  It appears that the Directive is intended to focus on sales of policies for a Risk Retention Group without a license.
Beginning July 1, 2022, the Office of Commissioner of Insurance and Safety Fire will implement the below tiered fine schedule for any person or entity selling, soliciting, or negotiating insurance in Georgia without a license or charter (for Risk Retention Groups) in violation of the Code.
Number of Policies   Fine Amount
1st Policy	                           $100
2nd Policy	                           $500
3rd Policy	                           $1,000
4th Policy	                           $1,500
5th Policy	                           $2,000
6th Policy and Up	   $5,000 each

Tony Roehl, Esq. - BAKER HOSTETLER LLP, (404) 256-8419 , troehl@bakerlaw.com

Category(s): Georgia - 05/25/2022

Georgia passed the Mental Health Parity Act (HB 1013) which is intended to assure that the state will enforce parity in insurance coverage for behavioral health care for the first time. It will require Medicaid care management organizations and private insurance plans that are regulated by the state to follow the federal parity law; the Georgia Department of Community Health and Department of Insurance to regularly monitor parity compliance and take action when violations occur; making it easier for families to file parity complaints with the state; making parity compliance data transparent and publicly available; and ensuring medical necessity determinations are based on generally accepted standards of care.  Georgia passed other mental health legislation, including: HB 752 which creates/allows for Psychiatric Advanced Directives; SB 341 which ensures that prior authorization from an insurer to cover a chronic condition would last a year; SB 566 which adds mental health/substance use to existing rules preventing surprise billing.

Julie M. Pomerantz, Esq. - MITCHELL, WILLIAMS, SELIG, GATES & WOODYARD, P.L.L.C, (512) 480-5100 , jpomerantz@mwlaw.com

Category(s): Georgia - 05/25/2022

Northside Hospital, one of the largest hospital systems in the Atlanta metropolitan area, has been embroiled in a lawsuit since late last year with Anthem’s Blue Cross Blue Shield Healthcare Plan of Georgia over its attempt to terminate, effective as of January 1, 2022, its network provider agreements with the hospital system. Northside Hospital obtained a temporary injunction against the terminations in late December 2021. A court order issued on April 13, 2022 extended that injunction indefinitely and sent the dispute for resolution to the Georgia Insurance Commissioner under the doctrine of primary jurisdiction and deference to the view of the state agency, even though the doctrine of exhaustion of administrative remedies is not in play in this case. The court has instructed the Georgia Insurance Commissioner to make a declaratory ruling on the issue of whether O.C.G.A. § 33-20C-2(g)(2), which, during a public health emergency and the 150 day period following its termination, prohibits an insurer from terminating its health care provider and requires an insurer to reimburse providers in the network at its most recent contracted in-network rates, applies to this controversy. In a consent order issued on March 29, 2022, the Georgia Insurance Commissioner fined Blue Cross Blue Shield Healthcare Plan of Georgia $5 million, the largest fine ever levied by a Georgia Insurance Commissioner, based on certain violations of the Georgia Insurance Code following a market conduct examination of its health care provider database system and in-network claims having being processed as out-of-network claims and other claims processing errors during 2015-2018.

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

Category(s): Louisiana - 05/25/2022

The Louisiana Department of Insurance (“LDOI”) promulgated Directive 219, on January 24, 2022, directing insurers, defined under the Louisiana Insurance Code (“Code”) as every person engaged in the business of making contracts of insurance, to review all policy forms and endorsements to ensure compliance with La. R.S. 22:1704(E)(2). This provision, according to the LDOI, grants insureds the right to hire a public adjuster to help meet obligations under their insurance policies. The LDOI cites reports that insurers are seeking to prohibit the use of public adjusters by insureds through policy provisions or endorsements. These anti-public adjuster clauses reportedly attempt to prohibit insureds from hiring, engaging, retaining, contracting with, or otherwise utilizing the services of a public adjuster. The LDOI interprets such a prohibition to directly contravene La. R.S. 22:1704(E)(2).

Van R. Mayhall, Jr., Esq. - BREAZEALE, SACHSE & WILSON, L.L.P., (225) 381-8009 , van.mayhall.jr@bswllp.com
Kristin E. Oglesby, Esq. - BREAZEALE, SACHSE & WILSON, L.L.P., (225) 381-3166 , Kristin.oglesby@bswllp.com

Category(s): New York - 05/27/2022

On May 20, 2022, Superintendent of Financial Services Adrienne A. Harris announced that the Department of Financial Services (“DFS”) had entered into a Consent Order with Nationwide Life Insurance Company (“Nationwide”) for violations of New York Insurance regulations with respect to deferred to immediate annuity replacement transactions. Nationwide will pay approximately $3.4 million in restitution to New York State consumers as a result of the settlement in addition to $2.24 million in penalties. Impacted consumers will also receive higher monthly payouts for the remainder of their contract terms. 
DFS's investigation found that Nationwide failed to properly disclose to consumers income comparisons and suitability information, causing consumers to exchange more financially favorable deferred annuities with immediate annuities. Hundreds of New York consumers – primarily elderly individuals - received incomplete information regarding the replacement annuities, resulting in less income for identical or substantially similar payout options.

Frederick J. Pomerantz, Esq. - INSURANCE LEGAL & REGULATORY CONSULTING, PLLC, (516) 297-3101 , PomerantzF35@gmail.com