COMMISSIONER'S CORNER

NOVEMBER 2022

Q. Is there anything new or different that I should know this year about Open Enrollment for health insurance?

A. Great question. Yes, there are a few things.

Perhaps the biggest impacting change is the fixing of the so-called “family glitch” on the Individual Exchange. In previous years, the “glitch,” created by a federal IRS rule, prevented family members of an employee who had access to an affordable employer-sponsored health plan under the ACA from receiving subsidies to buy their own insurance coverage. This was due to the fact that the affordability question was based solely on the cost of health insurance for the covered employee, and didn’t include the cost of adding additional family members, which is more expensive.

This year, that “glitch” has been fixed through new federal rules allowing the family members of the employee to base the affordability of the employer’s plan on the total cost of covering both the employee and the additional family members under the plan, and not only the employee. If the plan is then not affordable based on this calculation, the family members will be eligible for premium subsides on the ACA Marketplace. The new federal rules will take place on December 12, but Exchange applications will be already completing this calculation during Open Enrollment.

It is also worth noting that Congress passed a bill over the summer which placed a cap on the monthly cost of insulin to Medicare Part D recipients to $35. Starting in 2023, Part D beneficiaries cannot pay more than that amount per month, regardless of whether or not they have met their deductible. The same bill also extended the granting of Advance Premium Tax Credits (APTC) to people over 400% of the Federal Poverty Level for another two years.

Finally, we have a new insurer on the Exchange in the dental market. Wyoming welcomes competition and hopes that the issuer will continue to write policies in our state for many years to come. So, take the time to compare insurers and policies and select the one which works best for you.

Jeff Rude, Wyoming Insurance Commissioner

SEPTEMBER/OCTOBER 2022

I recently met with the Association of Wyoming Insurance Agents, where we had a great discussion and covered a wide range of topics. One thing I mentioned was the DOI’s increased attention to agent exams. I noted that over the past few years the number of exams had fallen off and that I wanted to focus on conducting more exams. Since there would be more exams, I wanted to be sure agents to know what we were looking for and what we have found in the past.

The purpose of producer and agency examinations is to assist the producer and/or agency in complying with the Wyoming Insurance Code and DOI regulations. If we identify any deficiencies, we will make corrective recommendations. If necessary, we will follow up to ensure changes are made.

In addition, we also want to acknowledge what is being done well. In the course of an examination, we will take note of best practices in place that go beyond mere compliance.

The Wyoming Insurance Code provides the statutory framework for producer and agency compliance, and is the basis under which examinations are designed. Some deficient findings from previous exams have referenced:

1. W.S. § 26-9-213; All producers must hold a current appointment with an insurer.

2. W.S. § 26-9-206(b); A business entity acting as a producer (i.e., an agency) is required to obtain a producer license.

3. W.S. § 26-9-206(b)(ii); Agencies shall specify a licensed producer responsible for compliance with the Code and DOI regulations.

4. W.S. § 26-9-207(f); Licensed producers shall inform the Commissioner of any change in name, address, phone number, or other contact information within 30 days of the change.

5. W.S. § 26-9-233; A producer doing business under any name other than the producer's legal name shall notify the Commissioner prior to using the assumed name. Note that this includes businesses/agencies.

6. W.S. § 26-9-229; All insurance financials must be accurately recorded and maintained.

7. W.S. § 26-9-228(c); Producers and agencies shall keep a record of all transactions for inspection at least three (3) years subsequent to the end of each transaction.

8. W.S. § 26-13-102; Unfair and/or deceptive trade practices prohibited.

9. W.S. § 26-13-110 & 26-13-112; Rebates and favors prohibited.

10. W.S. § 26-13-121; Illegal dealing in premiums and excess charges for insurance.

I hope this helps agents, brokers, and agencies understand the process and what we are looking for. If you have any questions about agent and agency exams that I may not have touched on, please feel free to call our office at (307) 777-7401.

Jeff Rude, Wyoming Insurance Commissioner