Notice of Proposed Rulemaking – Medicare Supplement Insurance

On October 16, 2015, the Department published a Notice of Rulemaking in the Arizona Register, (21 A.A.R. 2401, October 16, 2015).  The rulemaking proposes to amend Article 11 – Medicare Supplement Insurance, AAC R20-6-1101, to update the incorporation by reference of the NAIC Model Regulation to Implement the NAIC Medicare Supplement Insurance Minimum Standards Model Act which includes the Genetic Information Nondiscrimination Act of 2008 (Model Regulation).  Currently, AAC R20-6-1101 incorporates the Model Regulation published in 2008.  The amended rule will incorporate the Model Regulation published in January, 2015, which corrects some deficiencies of the 2008 version.  The proposed rulemaking also amends Section 3(A)(2) of the Model Regulation to specify that the Model Regulation applies to “All certificates issued under group Medicare supplement policies, which certificates have been delivered or issued for delivery in this state including association plans.”

Anyone who wishes to request an oral proceeding on the proposed changes to AAC R20-6-1101 should contact Mary Kosinski at [email protected] or (602) 364-3471.

Rulemaking Moratorium
DOI Regulatory Agenda for 2017
Insurance Rules (Arizona Administrative Code Title 20)
GO-PRO Video Leads to Conviction of Insurance Fraud Suspect

Phoenix, AZ – Robert Atlas falsely reported to GEICO that he had crashed his 2012 Corvette Stingray while exiting the I-10 freeway, on the exit ramp at Wild horse pass in Chandler Arizona. Robert was paid $61,465.11 by GEICO for the loss of his Corvette. It was later discovered that on 10/10/2015, Robert Atlas had actually raced his Corvette Stingray in a drag race at a drag racing event at Wild Horse Pass Motorsports Park. He subsequently lost control of his corvette during the race and crashed into the concrete barrier totaling his Corvette Stingray. This crash was captured on a Go-Pro video and published on YouTube. The policy does not cover damage caused to the vehicle if it was involved in drag racing. Robert was later shown the video footage and he admitted to making the false claim to GEICO Insurance.


On 1-25-17, Robert Atlas pled guilty to Insurance Fraud as a Class 6 Undesignated offense and as required by the Plea Agreement he paid the entire amount of restitution back to GEICO Insurance prior to sentencing. He was sentenced to two years supervised probation and was assessed $1,560.00 in court costs.


The case was investigated by the Arizona Department of Insurance Fraud Unit and prosecuted by the Arizona Attorney General’s Office.


YouTube video below.


https://www.youtube.com/watch?v=j-xdgp3x4g0

Extension of Major Medical Transitional Policies through Calendar Year 2018

Phoenix - The Arizona Department of Insurance (ADOI) announced today that insurers in the individual and small group[1] major medical health insurance markets can choose to renew transitional policies for a policy year beginning on or before October 1, 2018, provided all transitional coverage ends by December 31, 2018.    Transitional policies are non-Affordable-Care-Act-compliant policies that have been continuously in effect since by or before December 31, 2013.  At least 6 health insurers have individual or small group transitional policies still in effect in Arizona.

This extension is the maximum extension permitted under the Insurance Standards Bulletin issued on February 23, 2017 by the Center for Consumer Information and Insurance Oversight (CCIIO), and gives insurers the option to continue the pre-2014 individual and small group policies covering approximately 70,000 Arizonans through the end of 2018.  Insurers that offer this extension of transitional coverage are required to send each policyholder a renewal notice that explains the offer to continue the transitional policy through the end of 2018 and includes information regarding any related price increase.  Insurers must also send a 90-day notice for the final discontinuation of the transitional plans.

The extension does not affect grandfathered policies issued prior to March 23, 2010.  These policies can remain in effect as long as they maintain grandfathered status.

For additional information on the Affordable Care Act, please visit the Arizona Department of Insurance website or call Consumer Assistance at (602) 364-2499. 

 

[1] Small Group refers to a policy issued to an employer who employs at least two but not more than fifty eligible employees

(ARS § 20-2301(A)(21)).