Life and Health Hot Topics
Life and Health Bulletins, Advisory Notices, and ACA Related Hot Topics
Bulletin 24-B-01 - Extra Rx During State of Emergency
Re: Extra Prescriptions
On January 8, 2024, Governor Cooper issued EXECUTIVE ORDER NO. 300, for the State of North Carolina due to anticipated severe weather event (“Severe Weather Event”) possible impact on the State of North Carolina. The impact from the Severe Weather could have a significant impact on public and private property and could seriously disrupt essential utility services and systems. Executive Order 300 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. §§ 166A-19.20(b) exists in the State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. §§ 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. §§ 58‑3‑167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand‑alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 23-B-09 - Extra Rx During State of Emergency
Re: Extra Prescriptions
On November 8, 2023, Governor Cooper issued EXECUTIVE ORDER NO. 293, for the State of North Carolina due to existing and potential wildfires possible impact on the State of North Carolina. The impact from the wildfires could have a significant impact on public and private property and could seriously disrupt essential utility services and systems. Executive Order 293 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. §§ 166A-19.20(b) exists in the State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. §§ 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. §§ 58-3-167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand-alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 23-B-08 - Extra RX During State of Emergency
Re: Extra Prescriptions
On September 22, 2023, Governor Cooper issued EXECUTIVE ORDER NO. 288, for the State of North Carolina due to Potential Tropical Cyclone Storm Sixteen (“Tropical Storm”) possible impact on the State of North Carolina. The impact from the Tropical Storm could have a significant impact on public and private property and could seriously disrupt essential utility services and systems.
Executive Order 288 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. §§ 166A-19.20(b) exists in the State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. §§ 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. §§ 58-3-167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand-alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 23-B-06 - Extra RX During State of Emergency
Re: Extra Prescriptions
On August 28, 2023, Governor Cooper issued EXECUTIVE ORDER NO. 284, for the State of North Carolina due to Tropical Storm Idalia’s (“Tropical Storm”) possible impact on the State of North Carolina. The impact from the Tropical Storm could have a significant impact on public and private property and could seriously disrupt essential utility services and systems. Executive Order 284 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. §§ 166A-19.20(b) exists in the State of North Carolina. ("the Emergency Area").
Executive Order 284 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. §§ 166A-19.20(b) exists in the State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. § 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. § 58-3-167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand-alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 22- B-11 Extra Prescriptions due to State of Emergency (Released 12-20-2022)
Re: Extra Prescriptions
On December 20, 2022, Governor Cooper issued EXECUTIVE ORDER NO. 274, for the State of North Carolina due to the forecasted threat of a prolonged period of cold weather in the State of North Carolina has increased the demand for drivers of propane and other heating fuels. Due to a shortage of licensed commercial drivers, and the ongoing COVID-19 pandemic and seasonal flu, this state of emergency is essential to enable drivers transporting propane and other heating fuels across the state to do so quickly and efficiently.
Executive Order 247 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. 166A-19.20(b) exists in the State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. § 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. § 58-3-167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand-alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 22-B-10 - Underwriting for Opioid Antagonist Drugs Such as Naloxone
RE: Underwriting
The N.C. Department of Health and Human Services issued a standing order, most recently on March 24, 2022, authorizing any pharmacist practicing in the State of North Carolina and licensed by the N.C. Board of Pharmacy to dispense Naloxone Hydrochloride (Narcan) to persons who voluntarily request it and are the family member or friend of a person at risk of experiencing an opiate-related overdose, or a person who is in the position to assist a person at risk of experiencing an opiate-related overdose.
The Department of Insurance is issuing this Bulletin to highlight that these prescriptions are different from other prescriptions written, as the medications may be issued to a named individual for use by a different individual or prescribed to specifically prevent illness or disease.
It would negatively affect North Carolina's crucial public health efforts if insurers decline applications, rescind coverage, or charge a person carrying naloxone a higher premium for life insurance, annuity contracts, sickness and accident insurance, and/or disability insurance solely because the applicant had obtained Naloxone Hydrochloride (Narcan) to help respond to opioid overdoses. We expect insurers to carefully consider the reason for and intended user of the prescription prior to issuing an underwriting decision. See N.C. Gen. Stat. § 58-58-35.
Bulletin 22-B-09 - Extra Prescriptions due to a State of Emergency (Released September 28, 2022)
RE: Extra Prescriptions
On September 28, 2022, Governor Cooper issued EXECUTIVE ORDER NO. 270, for the State of North Carolina due to the imminent threat of Hurricane Ian in the State of North Carolina. It is expected that the storm will cause significant damage to public and private property and may seriously disrupt essential utility services and systems in North Carolina. Executive Order 270 declares a state of emergency pursuant to N.C.G.S. §§ 166A-19.10 and N.C.G.S. 166A-19.20 in the entire State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. § 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. § 58-3-167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand-alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 22-B-02 - Extra Prescriptions due to a State of Emergency (Released January 20, 2022)
Re: Extra Prescriptions
On January 19, 2022, Governor Cooper issued EXECUTIVE ORDER NO. 248, for the State of North Carolina due to the imminent threat of a winter storm in the State of North Carolina. It is expected that the storm will cause significant damage to public and private property and may seriously disrupt essential utility services and systems in North Carolina. Executive Order 248 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. 166A-19.20(b) exists in the entire State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. § 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. § 58‑3‑167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand‑alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 22-B-01 - Extra Prescriptions due to a State of Emergency (Released January 14, 2022)
Re: Extra Prescriptions
On January 14, 2022, Governor Cooper issued EXECUTIVE ORDER NO. 247, for the State of North Carolina due to the imminent threat of a winter storm in the State of North Carolina. It is expected that the storm will cause significant damage to public and private property and may seriously disrupt essential utility services and systems in North Carolina. Executive Order 247 declares a state of emergency as defined in N.C.G.S. §§ 166A-19.3(7) and N.C.G.S. 166A-19.20(b) exists in the State of North Carolina. ("the Emergency Area").
Pursuant to N.C.G.S. § 58-3-228, this bulletin pertains to all health benefit plans as defined in N.C.G.S. § 58‑3‑167, the State Health Plan for Teachers and State Employees, and any optional plans or programs operating under Part 2 of Article 3 of Chapter 135 of the General Statutes, and other stand‑alone prescription medication plans issued by entities that are licensed by the Department of Insurance.
This bulletin is to remind health benefit plans of compliance requirements for operations under a state of emergency for purposes of obtaining extra prescriptions during a state of emergency or disaster.
Bulletin 21-B-09 – COVID-19 - Health benefit plans urged to waive prior authorization (Released August 26, 2021)
Re: COVID-19 Delta Variant Surge
Due to the COVID-19 delta variant surge, in-patient admissions due to the virus are increasing. The North Carolina Department of Health and Human Services (NC DHHS) reports that as of August 25, 2021, 3,552 people are currently hospitalized due to COVID-19. NC DHHS has stated that this increase in hospitalizations is placing extreme pressure on hospital capacity in North Carolina. The North Carolina Department of Insurance (the Department) is issuing this advisory to encourage insurers that offer health benefit plans to North Carolina residents to temporarily waive prior authorization requirements for post-acute care.
Advisory Notice - Moore County Electric Power Outage - 12-06-2022
On Saturday, December 3, 2022, many residents of Moore County experienced power outage as a result of what has been described as vandalism to multiple electrical substations.
North Carolina Commissioner of Insurance Mike Causey is working with the insurance industry to ensure that appropriate accommodations are being made for those consumers living in the affected areas of Moore County. Commissioner Causey urges insurers to consider relaxing due dates for premiums payments, extending grace periods, waiving late fees and penalties, and allowing payment plans for premiums payments to otherwise avoid a lapse in coverage for those consumers living in the affected areas of Moore County and surrounding areas.
Affected policyholders should notify their insurance carriers and agents and explain their individual situation and difficulties complying with payment schedules.
Advisory Notice - 2023 Annual Certification - On-site Audit of TPA Operations for Calendar Year 2022
The North Carolina Department of Insurance is issuing this advisory to inform insurers that use the services of Third Party Administrators (TPA) that an on-site audit of TPA operations is required in accordance with NCGS 58-56-26(c) for the annual insurer TPA audit certifications for calendar year 2022 which will be due July 1, 2023. Virtual audits will continue to be acceptable for the annual insurer TPA audit certifications for calendar year 2021, which are due July 1, 2022.
Advisory Notice - North Carolina Life and Health Insurance Guaranty Association - Change of Address 03-18-2022
The North Carolina Department of Insurance is issuing this advisory to communicate the recent address change for the North Carolina Life and Health Insurance Guaranty Association, and to facilitate the administrative change to the required Summary Document.
Advisory Notice - COVID-19 Variant Surge - released 01-10-2022
The North Carolina Department of Insurance is issuing this advisory to encourage insurers that offer health benefit plans to North Carolina residents to take immediate measures related to the COVID-19 variant surge.
2022 ACA Related Topics coming latter part of May.