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LATEST NEWS

Memo Regarding Termination of Appointments

It has come to the attention of the Department that some insurers and producers are not aware of their rights and responsibilities with respect to termination of appointments, employment contracts, or other insurance business relationships between insurers and producers. This Memorandum is intended to clarify the statutory requirements on both insurers and producers should this circumstance arise.

Pursuant to Wyo. Stat. § 26-9-214, if an insurer terminates the appointment, employment, contract or other insurance business relationship with an insurance producer for any reason, there are specific notification requirements for the insurer as follows:

  1. Within thirty (30) days following the effective date of the termination, the insurer must notify the Department using a form prescribed by the commissioner. Under Chapter 16 of the Department rules and regulations, if the termination is for cause and involves activities that could lead to probation, suspension, revocation or refusal to issue or renew a license pursuant to Wyo. Stat. § 26-9-211, the Department requires the insurer to use the Termination for Cause form*. The insurer must provide supporting documentation or other information pertaining to the termination or activity of the producer to the Department. An insurer has a continuing duty to update the information provided to the Department regarding the reason for the termination if additional relevant information is subsequently discovered.

  2. Within fifteen (15) days after notifying the commissioner of the termination of the business relationship with the producer, the insurer is also required to mail a copy of the termination notification to the producer at his/her last known address.

When a producer receives the written notification from the insurer regarding the termination of the business relationship, the producer then has the opportunity to provide rebuttal information to the Department regarding the allegations in the termination notice. If the producer wishes to rebut the allegations of the insurer, the producer must follow the deadlines identified in Wyo. Stat. § 26-9-214(d). Specifically:

  1. Within thirty (30) days after the producer has received the notification of termination, he/she may file with the Department written comments concerning the substance of the termination notification. A copy of the producer’s written comments must also be sent to the insurer.

The statute is explicit that the obligation to provide rebuttal information to the Department is on the producer and not on the insurer. The process identified in Wyo. Stat. § 26-9-214 affords the producer the opportunity to present their position regarding the termination.

If there are further questions regarding the reporting obligations with regard to termination of appointments, please feel free to contact Bryan Stevens, Licensing Supervisor, at the Wyoming Department of Insurance.

Extension of Transition Plans

To: All Companies Writing Individual & Small Group Health Insurance in Wyoming

From: Jeffrey P. Rude, Insurance Commissioner

Date: May 5, 2022

Subject: Extension of Transition Plans

On March 23, 2022, the Center for Consumer Information and Insurance Oversight (CCIIO) issued guidance that allows states the option to extend transitional policies for individual and small group health insurance plans to policy years beginning after October 1, 2022. The bulletin from CIIO can be found at:

https://www.cms.gov/files/document/extension-limited-non-enforcement-policy-through-calendar-year-2023-and-later-benefit-years.pdf

Under this guidance, states may allow issuers that have renewed coverage under the non-enforcement policy continually since 2014 to renew such coverage for policy years beginning October 1, 2022. The CCIIO guidance further states that the extended non-enforcement policy would remain in effect until Centers for Medicare & Medicaid Services (CMS) announces that coverage renewed under this non-enforcement policy must come into compliance with the relevant requirements.

Pursuant to the option provided to the states by CCIIO, the State of Wyoming will allow transitional policies for both the individual and small group health insurance markets to continue indefinitely until CMS announces that coverage renewed under their non-enforcement policy must come into compliance with the relevant requirements. Carriers who wish to renew coverage under the extended non-enforcement policy must, for each policy year, comply with the notice and rate increase requirements identified in the March 23, 2022 guidance from CCIIO.

A carrier is not required to continue to offer the transitional policies and may discontinue them, subject to state and federal rules on discontinuance, at their discretion. The Department advises insurers to continue to monitor CCIIO’s website for any subsequent guidance that may be issued on this subject and to follow it accordingly. As before, all other plans issued after January 1, 2014 must be compliant with the Affordable Care Act (ACA).

The Department is not requiring insurers to renew their transitional policies. Insurers may determine at their discretion whether to renew transitional policies, so long as the determination is made on a non-discriminatory basis. Furthermore, consumers may not purchase new transitional policies or switch to a different insurer to replace an existing transitional policy. Transitional policies that have been cancelled cannot be reinstated.

Questions regarding this notice can be directed to Tana Howard, Section Manager at Tana.Howard@wyo.gov. The Department’s main desk can be reached at 307-777-7401 and the receptionist will see that your calls are directed to the appropriate person.

New Licensing & Renewal Application Requirements for Pharmacy Benefit Managers

During Wyoming’s 2016 Legislative session, Wyo. Stat. § 26-52-103 and Wyo. Stat. § 26-52-104 were passed, requiring all Pharmacy Benefit Managers (PBMs) operating in Wyoming to establish a written internal appeal process for PBM audits of pharmacies and an internal appeal process for resolution of disputed claims under the PBM’s established Maximum Allowable Cost (MAC) list, respectively. The statute went into effect on July 1, 2016.

In accordance with this statute, the Department has elected, effective July 1, 2022, to begin requiring these procedures to be disclosed upon initial license application or upon application for license renewal by any PBM planning to operate in the state of Wyoming. A new field in the application will allow for upload of any documents related to these internal procedures, which the Department will review for sufficiency under the referenced statutes. An application submitted after the effective date will be deemed incomplete without these documents.

Please contact the Department at 307-777-2450 if you have questions or to obtain more information.

The mission of this agency is to enforce the insurance laws and regulations of the State impartially, honestly, and expeditiously; to serve the consumer of insurance; to encourage a healthy insurance marketplace; and to promote change to better serve the public interest. To this end, the highest ethical, professional, and work quality standards will be exercised in all formal and informal relationships with individuals, agencies, and companies affected by the policies and actions of the department. It is our commitment to be the best insurance regulatory agency in the United States.