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RFP FOR INSURANCE REGULATORY & INNOVATION CONSULTING SERVICES

The Wyoming Procurement Office posts bid and RFP opportunities through the Public Purchase website. You must be registered to submit questions and ultimately upload your response to this opportunity (RFP #0106-G). There is no charge for this service.

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Medicare Advantage Guidance and Information

A Medicare Advantage Plan is another way to get your Medicare Part A and Part B coverage. Private insurance companies that are approved by Medicare offer Medicare Advantage Plans, also called “Part C” or “MA Plans”. Most Medicare Advantage Plans include drug coverage (Part D). Medicare pays a fixed amount for a beneficiary’s coverage each month to these approved companies. Despite the coverage being offered by a private insurance company, which are generally regulated at the state level, the plan must follow rules set by Medicare and the federal government. A major selling point to a Medicare Advantage Plan is that they may offer coverage for services Original Medicare does not cover such as vision, hearing, and dental services. These additional benefits are not required to be a part of the MA Plan and vary from plan to plan on the coverage amount and participating providers. Plans can also choose to cover even more benefits, for example, some plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs, and services that promote health and wellness (such as a gym membership). It’s important for beneficiaries to check with the plan before they enroll to see what benefits they offer, if they qualify, and what limitations apply.

Medicare Advantage Plans differ from Medicare Supplement (Medigap) policies, as they do not offer standardized plans (A, B, C, D, F, G, K, L, M and N) and coverages. Medicare Advantage Plans are required to provide Part A and Part B benefits, excluding clinical trials and hospice services. Plans must cover all emergency and urgent care, and almost all medically necessary services that Original Medicare covers. For beneficiaries enrolled in a Medicare Advantage Plan, Original Medicare will still help cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies depending on the plan. Each Medicare Advantage Plan sets limits on what beneficiaries have to pay out-of-pocket each year for covered services. Like traditional insurance, Medicare Advantage Plans have networks, it’s very important for beneficiaries enrolled in MA Plans to use health care providers who participate in their plan’s network. Before a beneficiary enrolls, they will need to confirm whether their providers and facilities are in network with the Medicare Advantage Plan. Some MA Plans offer non-emergency coverage out of network, but typically at a much higher cost to the beneficiary. A plan’s providers may join or leave a network any time throughout the year, when this happens beneficiaries are typically not allowed to change plans. The Medicare Advantage Plan will try to provide the beneficiaries notice of a provider leaving and will help with finding a replacement provider who is in the plan’s network.

In the past, Medicare Advantage Plans have been more common in heavily populated or urban areas due to the federal requirements on enrollment and networks. However, this trend is starting to slowly change in Wyoming as we are seeing more insurers enter the Medicare Advantage market. Currently, Wyoming has four insurance companies offering approximately 11 Medicare Advantage Plans in our state. Unlike Medigap policies, which are offered throughout the state, Medicare Advantage Plans are offered in specific counties or areas meaning a plan offered by an insurance company in one county may not be offered in other counties in the state. When beneficiaries are considering an MA Plan it’s very important that they research the specifics of each plan as each is different in its own design, coverages, availability, out of pocket costs and price. Individuals who enroll in a Medicare Advantage Plan cannot buy a Medigap policy, as it’s not needed.

Medicare, Medicare Advantage and Medigap coverage can be a complicated subject; luckily, assistance is available for free Medicare counseling in Wyoming. Through federal funding the State Health Insurance Assistance Program (SHIP) grant, helps provide unbiased counseling to Medicare beneficiaries and their families. SHIP counselors provide information and answer questions related to Medicare, Medigap and Medicare Advantage coverages and plans, ensuring beneficiaries are educated and informed when choosing the best plan to fit their needs. To schedule an appointment with a SHIP counselor in your area, please call Wyoming Senior Citizens Inc. at 1-800-856-4398.

Insurance License Scam Warning

It has come to the Department’s attention that a common fraud scheme has been adapted to target people who hold insurance licenses. In this scheme, scam artists identify themselves as Department of Insurance staff or investigators and notify the licensee that they are under investigation, that their license may be suspended or revoked, or that an arrest warrant has been issued in the licensee’s name. They will then request money to “resolve the problem”.

This scheme is similar in nature to the well-known schemes where scam artists will identify themselves as FBI, Social Security, or IRS agents. The callers may also be “spoofing” phone numbers to make the calls appear to be coming from the State of Wyoming.

While we have not heard of this particular scam being targeted towards Wyoming insurance licensees yet, it is best to be aware that it has been an issue in other states. If you do receive a call, ask the person calling to verify personal information that would be stored in our systems but not accessible to the public. This information could be a residence address, date of birth, or personal email address. The Wyoming Department of Insurance will NEVER request any form of payment other than a check. We cannot accept credit cards over the phone, and we have no desire to be paid in gift cards.

Please note that the Wyoming Department of Insurance may ask you to verify your social security number if you cannot produce your license number or national producer number. Be sure you are certain that you are speaking to a staff member of the Department of Insurance before giving out any personal information! If you are unsure, hang up, call the main line of the Department at 307-777-7401, and ask to speak with the person that called you.

The Wyoming Department of Insurance is committed to keeping personal information secure. If you ever have any suspicions that your information has been compromised please contact the Department at wyinsdep@wyo.gov or 307-777-7401.

Designated Responsible Licensed Producer Purpose and Responsibilities

TO: RESIDENT AND NON-RESIDENT INSURANCE PRODUCER FIRMS AND SURPLUS LINES BROKERAGES
FROM BRYAN STEVENS, LICENSING SUPERVISOR
RE: DESIGNATED RESPONSIBLE LICENSED PRODUCERS
DATE: SEPTEMBER 1, 2021

This memorandum serves to clarify the purpose and responsibilities of a Designated Responsible Licensed Producer, also known as a DRLP or DLP, in the State of Wyoming.

Every organization holding a business entity insurance license in the State of Wyoming must designate one to five individuals as the DLP(s). The DLP(s) are responsible for the business entity’s compliance with the insurance laws, rules, and regulations of the State of Wyoming. This includes making sure that all employees of the organization are acting within the boundaries of Wyoming statutes and regulations.

For example, if Joe Agent of ABC Insurance Agency is found to have violated Wyoming statutes or regulations ABC Insurance Agency will also be investigated. If it is found that ABC Insurance Agency did not properly supervise the actions of Joe Agent both ABC Insurance Agency and Joe Agent may be sanctioned. If ABC Insurance Agency is sanctioned all DLPs of the agency will be sanctioned as well. No one DLP may be found to have more supervisory responsibilities than another; all will be held equally accountable.

Furthermore, an entity is allowed a maximum of 5 DLPs. If an entity has more than 5 DLPs listed the Department will require them to update their list to reflect only the individuals that should be held accountable for the actions of the agency. We encourage all licensed business entities to verify their list of DLPs and keep it up-to-date.

If you have any questions about DLPs please utilize the Department’s contact form.

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.