A common question in the context of Medicare Advantage (“MA”) distribution and compensation is how agents and brokers may be compensated for commissions and administrative payments and whether, and to what extent, referral...more
6/21/2023
/ Agents ,
Beneficiaries ,
Brokers ,
Centers for Medicare & Medicaid Services (CMS) ,
Competition ,
Executive Compensation ,
Fair Market Value ,
Healthcare ,
Medicare Advantage ,
Referral Fees ,
Remuneration
A common question that arises in the insurance-regulatory context, including in the context of insurance scoring and modelling, is whether, and to what extent, the McCarran-Ferguson Act applies to the FCRA. The information...more
On June 1, 2023, the Federal Advisory Committee on Insurance (“FACI”) held its June meeting. Below is a summary of the topics discussed with emphasis on areas we found particularly interesting. FACI intends to hold two more...more
In the course of corporate development, either by an extant insurance holding company structure or in another context such as private equity, the question may arise: “How do we diligence an insurance company?” This Article...more
As insurers consider augmenting the quoting process with algorithmic predictive models, including those aided by artificial intelligence, machine learning, and/or robotic process automation (“Models”) for which core inputs...more
For those participating in corporate development in the health plan space in Florida, the question may arise: “What is a provider service network?” This Article provides the definitional traits of a provider service network...more
For those considering forming an insurer domiciled in California, a key question arises: “What is an Organizational Securities Permit Application, and how do I draft it?” This Article provides an overview of the Application...more
When an insurer discovers that insureds are being treated differently in any scenario, it is important to consider very seriously whether such differential treatment could be contrary to unfair trade practices laws....more
The COVID-19 pandemic has had far-reaching effects to date, including economic uncertainty and widespread business interruptions. This environment may raise unique considerations for parties contemplating an M&A transaction....more
10/9/2020
/ Alternative Fee Arrangements ,
Alternative Financing and Procurement (AFP) ,
Business Interruption ,
CARES Act ,
Coronavirus/COVID-19 ,
Data Privacy ,
Department of Justice (DOJ) ,
Due Diligence ,
Families First Coronavirus Response Act (FFCRA) ,
Federal Trade Commission (FTC) ,
Investment Banks ,
IRS ,
Loan to Own ,
Mezzanine Lenders ,
Representations and Warranties Insurance
The National Association of Insurance Commissioners (NAIC) Cybersecurity (EX) Task Force released its second version of the Insurance Data Security Model Law (Model) on August 17. The first version was exposed on March 3, and...more
The Court of Appeals for the District of Columbia affirmed the District Court’s decision in Central United Life v. Burwell on July 1, 2016. This decision is very significant for those assessing the future strength of, and...more
7/8/2016
/ Administrative Authority ,
Affordable Care Act ,
Attestation Deadlines ,
Department of Health and Human Services (HHS) ,
Enforcement Authority ,
Exceptions ,
Health Insurance ,
Individual Mandate ,
Minimum Essential Coverage ,
Permanent Injunctions ,
Public Health Service Act
Last week, the National Association of Insurance Commissioners (NAIC) hosted the 2016 NAIC International Insurance Forum. The Forum addressed topics such as the management of catastrophic disaster risks, industry perspectives...more
The National Association of Insurance Commissioners (NAIC) Spring 2016 National Meeting, which was held from April 3 – 6 in New Orleans, offered insight into numerous issues being considered by state commissioners nationwide....more
4/19/2016
/ Accreditation ,
Affordable Care Act ,
Annuities ,
Big Data ,
Cybersecurity ,
Department of Labor (DOL) ,
Fiduciary Duty ,
Health Insurance ,
Insolvency ,
Insurance Industry ,
Life Insurance ,
Mortgage Insurance ,
NAIC ,
NARAB ,
Peer-to-Peer ,
Popular ,
Receivership ,
Reinsurance ,
Sharing Economy ,
Surplus Lines Insurance ,
Workers Compensation Reform
The last 15 years have seen the advent of a new reinsurance platform, where hedge funds have sponsored non-U.S. reinsurers, who in turn invest their capital in the sponsoring hedge funds. While there are business rationales...more
3/29/2016
/ Bermuda ,
Capital Gains ,
Exceptions ,
Foreign Insurance Companies ,
Hedge Funds ,
Hillary Clinton ,
Insurance Industry ,
Passive Foreign Investment Company ,
Proposed Legislation ,
Reinsurance ,
Tax Loopholes ,
U.S. Treasury
On November 11, 2015, Governor Scott Walker signed Senate Bill 287 into law as 2015 Wisconsin Act 90. The law is a collection of miscellaneous changes and updates to Wisconsin’s Insurance Code, including technical corrections...more
On November 9, 2015, the New York Department of Financial Services (NYDFS) issued a letter that describes what insurers can expect from the Department’s ongoing assessment of cybersecurity measures. The letter parallels...more
On October 14, 2015, the National Association of Insurance Commissioners’ (NAIC) Cybersecurity Task Force adopted the Cybersecurity Bill of Rights, a document meant to inform consumers of the services they can expect from...more
11/5/2015
/ Breach Notification Rule ,
Consumer Reporting Agencies ,
Credit History ,
Cyber Incident Reporting ,
Cybersecurity ,
Data Breach ,
Data Breach Plans ,
Data Collection ,
Data Privacy ,
Data Protection ,
Data Security ,
Data-Sharing ,
Fair Credit Reporting Act (FCRA) ,
Fraud Alerts ,
Free Identity Theft Protection ,
Insurance Industry ,
NAIC ,
Personal Data ,
Privacy Policy