Determination for 2016 Transition to Affordable Care Act-Compliant Policies

NEW ADDRESS


Arizona Department of Insurance
100 North 15th Avenue, Suite 261

Phoenix, AZ  85007-2630


Starting July 1, 2020, we will be the
Department of Insurance and Financial Institutions (DIFI).

The Department has considered all relevant factors in making its determination that insurers that renewed existing plans, on or before December 31, 2014, that otherwise would have been modified or canceled under the Affordable Care Act (ACA), may renew those transitional policies in the individual and small group markets through October 1, 2016.  The transitional policies may not extend to policy years beginning after October 1, 2016, but by renewing the policies on or before October 1, 2016, carriers are extending coverage through September 30, 2017.  This constitutes a one-year extension of the Department’s May 8, 2014 determination regarding transition policies and is consistent with the Center for Consumer Information and Insurance Oversight’s (CCIIO’s) March 5, 2014 bulletin.

Further, this determination applies to policies sold to large businesses of 51-100 employees currently in the large group market but that, for policy years beginning on or after January 1, 2016, will be redefined as small businesses purchasing insurance in the small group market.

The Department will not compel any carrier to renew transition policies if it chooses not to do so

Priority: 
Germaine L. Marks
Small Business Bill of Rights
Insurers Offering Individual Health Insurance in Arizona

Lists insurance companies that are offering health insurance to individuals and families in Arizona in 2020.  Open enrollment starts November 1st and now runs through December 17th, 2019.  Individuals can start shopping for coverage now at healthcare.gov or cuidadodesalud.gov (Spanish)

New Rate & Form Division at ADOI

The Arizona Department of Insurance begins 2015 with a reorganization that will streamline management and optimize resources by merging similar operations of two divisions into a new Rate & Form Division.

The Rate & Form Division now combines the rate and form review and analysis for both the Life & Health Division and what had been the Property & Casualty Division. 

There will no longer be an independent Property & Casualty Division, which had been administered by Dean Ehler. Ehler retired Dec. 31, 2014 after nearly twenty years of service to the Department.

“Dean ran the Property & Casualty Division efficiently and effectively, and he had a wealth of institutional knowledge. He will be missed by everyone here,” said Germaine Marks, Director of the Arizona Department of Insurance. “His retirement, however, forced us to consider how we could more effectively maximize Department resources.”

Erin H. Klug, who most recently served as the Assistant Director of the Life & Health Division, will lead the new Rate & Form Division. The new Rate and Form Division now includes three sections:  the Property & Casualty Section, Life & Health Section and the Health Insurance Oversight Section (to include Affordable Care Act and network/managed care activities).

The licensing functions performed by the Life & Health and Property & Casualty divisions will now be overseen in the Financial Affairs Division by Cary W. Cook, the Chief Financial Compliance Officer

Phone and fax numbers, as well as e-mail addresses, of ADOI employees within the two divisions are not expected to change with the creation of the new Rate and Form Division.

Notice of Proposed Rulemaking - Corporate Governance Annual Disclosure Model Regulation In 2019, the Arizona Legislature adopted the NAIC Corporate Governance Annual Disclosure Model Act at Arizona Revised Statutes (“ARS”) by enacting the Corporate Governance Act at Title 20, Chapter 2, Article 16 (Laws 2019, 1st Reg. Sess., Ch. 180, § 1).   The Department of Insurance (“Department”) seeks to adopt the correlate Corporate Governance Annual Disclosure Model Regulation.  ARS § 20-492.02 allows the Department to adopt rules to carry out the Act upon notice and an opportunity to be heard.  The Legislature has exempted the Department from Title 41, Chapter 6 for one year after the effective date of the Act.  (Laws 2019, 1st Reg. Sess., Ch. 180, § 2.)
Arizona's Surprise Bill Resolution Report for 2019

As shown in the attached report prepared pursuant to A.R.S. § 20-3118(A), the Department of Insurance received 91 requests for dispute resolution in Calendar Year 2019.  Of those, 53 have been resolved or closed, and health plan enrollees saved $41,538 by submitting their surprise bills for resolution.  

Not all health care bills qualify for the surprise bill resolution process.  The Department's Suprise Out-of-network Billing Dispute Resolution website (https://insurance.az.gov/soonbdr, and especially the section entitled, "I got a surprise bill. Can I submit a request for arbitration?") lists conditions when a health care bill may not qualify under Arizona law for the dispute resolution process.  But for those that do, the enrollee will only be responsible for paying the enrollee's cost-sharing amounts (copay, coinsurance and deductible) if the enrollee provides information the Department needs, and participates in an informal settlement teleconference with the health care insurer and the health care provider.

Regulatory Bulletin 2020-02

Implementation of Executive Order 2020‐07 Proactive Measures to Protect Against COVID‐19 and Executive Order 2020‐15 Expansion of Telemedicine.

Regulatory Bulletin 2020-03

Complying with Regulatory Requirements during the Public Health Emergency

Regulatory Bulletin 2020-04

COVID-19 and Insurance Customer Relief; Flexibility

Regulatory Bulletin 2020-01

Uninsured and Underinsured Motorist Coverage Offer Form; SB1087