Life and Health Hot Topics

Read The Latest Hot Topics Released by the Life and Health Division

Life and Health Bulletins, Advisory Notices, and Hot ACA Related Topics

Life and Health Bulletins

Life and Health Bulletins

Bulletin Released:  August 2, 2020

Bulletin 20-B-12 – Extra Prescriptions During a State of Emergency or Disaster

Hurricane Isaias – North Carolina Operations

Bulletin 20-B-12 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, per N.C.G.S. § 58-3-228. This authorization of extra prescriptions during this state of emergency in the State of North Carolina is valid for prescription medication requests made within 29 days of issuance of this bulletin, unless extended by an order issued by the Commissioner.

Bulletin 20-B-12 – Extra Prescriptions During a State of Emergency or Disaster

 

Bulletin Released:  April 21, 2020

Bulletin 20-B-07 and  Extended COI Order - COVID-19 Pandemic - Stay of Proof of Loss Requirements, Premium and Debt Deferrals, and External Review Extension

BULLETIN HAS EXPIRED

Bulletin 20-B-07 and Extended COI Order provide information on the activation of the procedures under N.C.G.S. 58-2-46.  The Extended COI Order immediately goes into effect at 12:01 a.m. on April 27, 2020.  The order will expire 30 days from the effective date of April 27, 2020, which is May 27, 2020.  The Department also has updated the Frequently Asked Questions (FAQ) document associated with the Commissioner's Extended Order and Bulletins 20-B-06 and 20-B-07.

Bulletin 20-B-07 - COVID-19 Extended Deferral Period

Extended COI Order COVID-19

Updated Frequently Asked Questions (FAQs) - COVID-19 - Related to Bulletins 20-B-06 and 20-B-07

 

Bulletin Released:  March 27, 2020

Bulletin 20-B-06 and COI Order - COVID-19 Pandemic - Stay of Proof of Loss Requirements, Premium and Debt Deferrals, and External Review Extension

BULLETIN HAS EXPIRED

Bulletin 20-B-06 and amended COI Order provide information on the activation of the procedures under N.C.G.S. 58-2-46.  The Department also has published a Frequently Asked Questions (FAQ) document associated with the Commissioner's Order and Bulletin 20-B-07.

Bulletin 20-B-06 - COVID-19 Pandemic & FAQ Document

Amended COI Order

 

Bulletin Released:  March 12, 2020

Bulletin 20-B-05 Guidance for Insurers Regarding Coverage and Cost Sharing Requirement Related to COVID -19  

The North Carolina Department of Insurance issued Bulletin 20-B-05 to assist insurers regarding the provision of insurance-related services during the COVID-19 public health emergency.  Insurers affected by the Bulletin 20-B-05 are requested to provide information to the Department on the steps taken in response to the Bulletin.  Please file the COVID-19 Action Plan through SERFF, the Department's preferred method of filing this plan.  Please code:

TOI Code: ML02 Multi-Line - Other

Sub-TOI Code: ML02.000 Multi-Line Other

Filing Type: Certification/Attestation

Bulletin 20-B-05

 

 

Life and Health Advisory Notices

Life and Health Advisory Notices

Advisory Notice Released: May 18, 2020

Delay in Claim Payment for Death Certificate with Pending Cause of Death

The Department of Insurance has received a request for assistance from the North Carolina Office of the Chief Medical Examiner with inquiries they receive regarding life insurance companies that may unnecessarily be delaying payment on life insurance claims. The delay appears to be related to death certificates with a cause of death documented as “pending.” This advisory reminds insurers of their obligation to pay death benefits as required by law.

The Advisory Notice applies to insurance companies authorized for life insurance and accidental death coverage, including Property and Casualty companies authorized for accidental death coverage.

Delay Claim Payment for Death Certificate with Pending Cause of Death

 

Advisory Notice Released: April 17, 2020

Agent Temporary Licensing

The North Carolina Department of Insurance has been working with Pearson Vue, the Department's third-party licensing vendor, to seek a solution to allow applicants to become licensed as quickly as possible.  The Advisory Notice outlines the Commissioner's temporary licensing solution.

Agent Temporary Licensing

 

 

 

Advisory Notice Released:  March 26, 2020

Insurance Services Essential Business Throughout COVID-19 Health Emergency

The advisory notice provides information regarding the designation of financial services, including insurance services, as essential business when "Stay at Home" or "Shelter in Place" orders have been issued.

Advisory Notice - Stay at Home Orders

 

Advisory Notice Released:  March 24, 2020

Advisory to Insurance Companies Regarding Policyholders Affected by the COVID-19 Virus

The advisory notice provides guidance on policy premium payments and cancellations.

Advisory Notice - Insurance Companies Regarding Policyholders Affected by the COVID-19 Virus

 

 

 

 

Hot ACA Related Topics

Hot ACA Related Topics

2021 Plan Year Information – Released May 12, 2020

Medical Insurance Submissions:

The North Carolina Department of Insurance (NCDOI) has released important information for interested insurers to assist individuals in preparing and submitting various 2021 Plan Year medical insurance submissions (insurance forms, rates, and plan binders) to the NCDOI for review and approval.

Stand-alone Dental (SADP) Insurance Submissions

The Department has released important information for interested insurers to assist individuals in preparing and submitting various 2021 Plan Year exchange certified SADP insurance submissions (insurance forms and rates) to NCDOI for review and approval.

 

Information on Submissions Requirements for Medical and Dental Insurers

 

Student Health Insurance - 2020/21 School Year Regulatory Submissions

Insurers of student health insurance plans must submit their 2020/21 school year insurance policy forms (including certificates or other summaries of coverage issued to students).  The filing also requires the submission of rates with an actuarial memorandum, explaining the development of the rates for the Department’s review and, as appropriate, prior approval.  The rate submission is a "SEPARATE" filing from the form filing.

 

Information on Submission Requirements for Student Health Insurance

 

Single-Risk Pool Rate Filings for the 2021 Plan Year Submission Instructions

As an effective rate review state under federal regulation, the Department is required to uniformly make public certain information of 2021 Plan Year annual single-risk pool-rate filing. To satisfy this requirement, NCDOI has established a process for insurers to follow in submitting their 2021 Plan Year rate filings, a "SEPARATE" rate filing.

 

Information on Submission Requirements on Single-Risk Pool Rate Filings

 

Advisory Notice Released:  March 24, 2020

Advisory Notice - Guidance for ACA Rate Loading for Defunded CSR Payments for the 2021 Plan Year

The advisory notice provides guidance on the submission of rates assuming no Cost Sharing Reduction (CSR) payments will be made because of the continued lack of federal legislation appropriating CSR payments for the individual plans offered through the individual marketplace.

Guidance for ACA Rate Loading for Defunded CSR Payments for the 2021 Plan Year