Due to updated guidance from the United States Center for Disease Control (“CDC”) and recently issued state guidelines regarding COVID-19, a few state insurance departments have announced they are closing their offices...more
The Kansas Insurance Department (“Kansas Department”) recently issued a Summary Order against a Missouri-domiciled third party administrator (“Company”) revoking the Company’s Kansas non-resident TPA license....more
In response to calls for greater transparency in the prescription drug industry, 2019 continued a nationwide trend of increased state licensing and regulation of pharmacy benefit managers (“PBMs”). In the last year, laws...more
Vermont Regulatory Action: A Reminder that Insurers Must Maintain Oversight of Their TPA and PBM Business Partners
The Vermont Department of Financial Regulation (the “Department”) recently took significant enforcement...more
The Vermont Department of Financial Regulation (the “Department”) recently took significant enforcement action against an insurer after determining that the insurer had violated various provisions of Vermont’s insurance laws,...more
Hawaii Insurance Department Establishes TPA Application Requirements -
Recently enacted Hawaii Senate Bill (SB) 1212 imposes extensive licensing and regulatory requirements on third party administrators (TPAs) operating in...more
The Texas Insurance Department (TDI) recently issued Commissioners’ Bulletin No. B-0007-19 (the “Bulletin”) to Third Party Administrators (“TPAs”) and agents licensed in Texas. Specifically, the Bulletin is a reminder to TPAs...more
Hawaii Legislature Passes New TPA Law -
Hawaii is expected to adopt legislation in the coming weeks that will impose licensing and other regulatory requirements on third party administrators (TPAs). Currently, Hawaii is one...more
Hawaii is expected to adopt legislation in the coming weeks that will impose licensing and other regulatory requirements on third party administrators (TPAs). Currently, Hawaii is one of only a handful of states that do not...more
The Chair of the National Association of Insurance Commissioners (“NAIC”) Regulatory Framework (B) Task Force recently announced that the Pharmacy Benefit Manager Regulatory Issues (B) Subgroup’s (“PBM Subgroup”) will...more
The Oregon Department of Consumer and Business Services (“Oregon Department”) recently announced it had entered into an Order to Cease and Desist, Final Order Assessing Civil Penalty and Consent to Entry of Order (“Order”)...more
The Nevada Division of Insurance (“Division”) recently issued Bulletin 18-006 to provide guidance to TPAs regarding the due date for filing their annual reports with the Division pursuant to NRS 683A.08528....more
The Kansas Insurance Department (“Department”) recently took regulatory action against an insurer which allegedly violated Kansas insurance laws. Specifically, the Department initiated a Market Conduct inquiry of accident and...more
The Polsinelli Third Party Administrator Team presents the 2018 TPA Newsletter. The newsletter is a compilation of recent news and alerts of interest to the TPA industry.
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The Kansas Insurance Department (“Department”) sent out an e-mail recently reminding TPAs that due to recent revisions to Kansas TPA statutes, any TPAs who held a Kansas TPA license as of March 2017 must submit either a...more
The New York Department of Financial Services’ (“DFS”) recently announced an extraordinary regulatory action in which two insurers have entered into a Consent Order with the DFS under which one of the insurers will pay a $15...more
NEVADA:
The Nevada Division of Insurance is in the process of adopting proposed insurance regulation R087-17 (the “Regulation”) which is entitled “Third Party Administrator Parental Guaranty and Notification Requirements.”...more
In light of the recent settlement between the U.S. Department of Labor (DOL) and a health plan third-party administrator (TPA), plan fiduciaries and TPAs should re-examine, or even re-negotiate, portions of their current TPA...more
Polsinelli is pleased to share the September 2017 Third Party Administrator Newsletter. The link is provided below. This newsletter covers topics throughout the year that impact TPAs.
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Connecticut Bulletin MC-23. The Connecticut Insurance Department issued Bulletin MC-23 on June 13, 2017. The Bulletin addresses certification and notice requirements for data security requirements applicable to TPAs and PBMs...more
On the heels of the Kansas Legislature’s recent adoption of Senate Bill No. 22 regarding third party administrators, the Kansas Insurance Department issued Bulletin 2017-2 to identify the states the Department has determined...more
Kansas Senate Bill No. 22, which became effective on March 9, 2017, amends the Kansas Third Party Administrator laws and appears designed to make them more robust by incorporating much of the language from the new National...more
A recent Indiana Department of Insurance Bulletin announces a change regarding how the Department will issue initial third party administrator licenses and renew existing licenses for nonresident third party administrators in...more
Recent regulatory actions against Zenefits, a cloud-based software company, demonstrate the importance for companies to be properly licensed where they are conducting business. Zenefits has reached regulatory settlements with...more
Two states recently enacted new pharmacy benefit manager licensing requirements that affect pharmacy benefit managers in Kentucky and New Mexico. It is important for Pharmacy Benefit Managers to ensure they are in compliance...more