Source: http://www.forc.org/Public/Alerts/2015/AlertsForNov2015.aspx
Timestamp: 2019-04-25 13:43:22+00:00

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Welcome to the November 2015 edition of the FORC Alert. If you have any colleagues that may be interested in this publication, please forward it on. There is a link below this message allowing them to opt-in so they can receive these FORC Alerts automatically.
On November 12, the Connecticut Insurance Department (“Department”) issued Bulletin Numbers HC-108 & PC-80, which applies to entities authorized to write P&C and A&H policies. The Bulletin announces that stop-loss filings will no longer be approved if they contain provisions related to medical necessity determinations, experimental/investigational determinations, or case management requirements, among numerous other provisions specifically prohibited for stop-loss policies in the Bulletin. Additionally, earlier this year, Commissioner Wade appointed John Thomson, who joined the Department in 2012 to develop a new Captive Insurance Unit, as Deputy Commissioner.
Will the Regulators Ever Reach an Agreement on an Approach to the New Fiduciary Standard?
Establishing a fiduciary standard for investment professionals is proving more difficult than expected.  In April of 2015, the U.S. Department of Labor (“DOL”) introduced a proposed rule to extend the definition of who constitutes a fiduciary under the Employment Retirement Income Security Act of 1974 (“ERISA”).  While the rule is only applicable to those who are providing retirement-related investment advice under the jurisdiction of ERISA and the Internal Revenue Code, the Securities and Exchange Commission (“SEC”) is working on establishing a fiduciary standard to be broadly applied to all investment professionals that it regulates, including broker-dealers.  The Financial Industry Regulatory Association (“FINRA”) has called upon the SEC to establish a uniform fiduciary standard that would apply across all investment professionals and stated that the SEC is the appropriate regulatory authority to address a uniform standard.  The National Association of Insurance Commissioners ("NAIC"), on the other hand, acknowledges that the oversight of the retirement plan marketplace is a shared regulatory responsibility and reinforces its duty to consider the implications of any proposed rule on the consumer protection standards developed and enforced by state insurance regulators, as well as its impact on the insurance marketplace.
CFO Jeff Atwater has decided against running for the U.S. Senate seat being vacated by Marco Rubio.  Atwater decided not to run earlier this year.  However, supporters encouraged him to reconsider after no Republican has gained significant momentum in the race.  Atwater briefly revisited his decision but again decided to continue serving as Florida's Chief Financial Officer.
The Florida Office of Insurance Regulation (the "Office") has joined as the 55th jurisdiction internationally to be admitted as a signatory to the International Association of Insurance Supervisors ("IAIS") Multilateral Memorandum of Understanding ("MMoU").   The MMoU is a global framework for cooperation and information exchange among insurance supervisors. It sets minimum standards to which signatories must adhere, and all applicants are subject to review and approval by an independent team of IAIS Members. Through membership in the MMoU, supervisors are able to exchange relevant information with and provide assistance to other signatories.
The Florida Office of Insurance Regulation has approved an average rate reduction of 4.7% in NCCI's most recent workers' compensation rate filing.  Workers' compensation rates have decreased by about 60% in Florida since reforms to the sytem were enacted in 2003.  However, cases pending before the Florida Supreme Cout might call some of these reforms into question and are being closely monitored by the industry.
A general lines agent may charge a per-policy fee not to exceed $10 to cover the administrative cost associated with selling motor vehicle insurance if the policy coverage is limited to Personal Injury Protection ("PIP") and Property Damage ("PD") under § 627.7295(5)(a), F.S.  Also, a general lines agent may seek reimbursement from a consumer for the exact amount charged to the agent or agency for a motor vehicle report (MVR) required to underwrite a motor vehicle policy under § 627.7295(5)(b), F.S.
A MGA may charge up to a per-policy fee not to exceed $25 in the aggregate, .i.e., if the consumer purchases more than one policy, only one policy fee may be charged under § 626.7451(11), F.S.
A Surplus Lines Agent may charge up to a $35 policy fee (taxable as premium) per policy under § 626.916(4), F.S.
Any agent or agency accepting premium payments by credit card may seek reimbursement up to the exact amount charged for premium payments made by credit card transaction under § 626.9541(1)(o)2., F.S.
The Florida Office of Insurance Regulation (the "Office") and the state's Insurance Consumer Advocate have requested information from insurers regarding the "assignment of benefits" issue.  Property insurers in Florida are seeing an increased number of instances in which policyholders assign their policy rights to third party vendors performing repair work.  Some of these vendors then submit invoices for inflated amounts to the insurers and use the one-way right of attorneys' fees to pursue payment or extract settlements.  This is leading to higher claims costs and ultimately higher rates, as seen in a recent rate filing by Citizens Property Insurance Corporation.
On August 11, 2015, the Georgia Department of Insurance issued Directive 15-EX-3 which reminds insurers providing eye-care benefits that covered persons may obtain eye care services from any licensed provider as required under O.C.G.A. § 33-24-59.12(c).  This issue was recently addressed by the Georgia Supreme Court in the case of Spectera, Inc. v. Wilson et al., 294 Ga. 23, 749 S.E.2d 704 (2013), which decision makes it clear that a provider may provide all eye care services for which he or she is authorized and/or licensed to provide and may receive provider panel reimbursement from the insurer insofar as such services are covered by the relevant insurance policy.

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