COMMISSIONER'S CORNER

MARCH 2024

The 2024 Wyoming Budget session is complete. During the session a few bills were passed that pertain to the insurance department. The Department also amended or added new rules in 2023. A summary of the bills and rules can be found below. All bills go into effect July 1, 2024 unless otherwise specified.

2024 Legislative Update and Brief Description

The complete text of recently passed legislation can be found at: https://wyoleg.gov/Legislation/2023 .  All new laws have an effective date of July 1, 2024, unless otherwise indicated.

HB0014-Enrolled Act,  HEA No. 0014-Ch. 19- Prior Authorization Regulations

The prior authorization act regulates the prior authorization process. The bill requires health insurers to follow prior authorization regulations that are specified within the bill. Some requirements are:

• Insurers shall have prior authorization information posted on their website

• Authorizations or adverse determinations on urgent  health care services shall be provided with seventy-two hours (72)

• Authorization or adverse determinations on non-urgent health care services shall be provided within five (5) calendar days

• Requirements applicable to persons reviewing appeals

• No prior authorization required for opioid use disorder

• Step therapy protocols

• There are also guidelines for “gold carding”,  which will allow health care providers to forego prior authorization requirements for certain procedures if they reach a specified threshold of approved prior authorization requests.

• Gold Carding does not go into effect until July 1, 2026

• All other requirements go into effect July 1, 2024.

HB0015-Enrolled Act HEA No. 0020-Ch. 30-Health Insurance-reimbursement of overpayments

The reimbursement of overpayments act requires an action or request for reimbursement of any overpayments of health insurance claims to a health care provider, pursuant to any health insurance contract, to be brought no more than two (2) years after the date the claim was paid. The time limit does not apply to fraudulent claims. The act is effective for overpayments made on or after July 1, 2024.

SF0005-Enrolled Act, SEA No. 0007-0Ch. 27-Organ transplant recipient protection

This act prohibits discrimination against organ transplant recipients by insurers. The act also provides a definition of organ transplant recipient. The act applies to insurance issued, renewed or delivered on or after July 1, 2024.

SF0100-Enrolled Act SEA No. 0059, Ch. 73 Payment of Pharmacy Insurance Claims

This act regulates the payments of pharmacy insurance claims. For claims filed electronically payment will be made within twenty-one (21) days of a clean claim. For all claims submitted in any manner other than electronically, payment will be made within thirty (30) days from the timestamp of the transmission of the clean claim. The insurer shall notify the pharmacy of any deficiency in the claims within ten (10) days after an electronic submission and fifteen (15) days after a claim submitted by other means. Clean claim is defined. If payment is not received within the applicable number of calendar days after a clean claim is received, the insurer or the insurer’s intermediary shall pay interest to the pharmacy at the rate of eighteen percent (18%). Claims for benefits under a life, accident or health insurance policy will still be governed by Wyo. Stat. Ann. § 26-16-112(a). The act shall apply to contracts renewed, amended or entered into between insurers and pharmacies beginning on or after July 1, 2024.

Administrative Rules Update

Rules recently changed

Chapter 64 Regulation Governing Suitability and Annuity Transaction

The Department promulgated changes to Chapter 64 of its regulations to align the regulation with the wording of the NAIC model regulation and to make it consistent with federal regulations. Included in the changes were the adoption of the best interest standard for annuity transactions, and additional continuing education (CE) requirements for all producers selling variable annuities.  The regulation required producers to be compliant with the updated CE requirements by January 2024.  The current version of Chapter 64 was filed with the Secretary of State on April 5, 2023 and is available on the Wyoming Secretary of State website, https://rules.wyo.gov/.  

Chapters 54 Privacy of Consumer Financial & Health Information and 55 Standards for Safeguarding Customer Information

Changes were promulgated to these regulations to combine the language of the two regulations into the text of Chapter 54, and then repeal Chapter 55.  Additional changes were made to bring the regulation into compliance with the Gramm-Leach-Bliley Act with respect to the annual privacy notices, and to conform the language with the NAIC model regulation.  The current version of Chapter 54 was effective April 25, 2023 and is available on the Wyoming Secretary of State website, https://rules.wyo.gov/.  

Chapter 28:  Regulation Governing Perpetual Care Trust Funds for Privately Owned Cemeteries

Changes were promulgated to Chapter 28 to allow for privately owned cemeteries that contract with municipalities or cemetery districts for the perpetual care of the cemetery to be exempt from certain portions of the regulation.  Pursuant to the changes to the regulation, the Department continues to exercise limited oversight of the perpetual care funds so long as the perpetual care contract with the municipality or cemetery district remains in place.  The current version of Chapter 28 was effective as of May 16, 2023 and is available on the Wyoming Secretary of State website, https://rules.wyo.gov/.  

Chapter 10 Coordination of Benefits

The Department promulgated changes to Chapter 10 primarily to bring the regulation into conformity with the NAIC model regulation, and to change the name of the regulation.  Specifically, the title of the regulation was changed from Use of Overinsurance:  Reduction of Benefit Provisions Group Disability, to Coordination of Benefits.   Changes were also made to remove unnecessary language in the regulation.  The current version of Chapter 10 was effective as of September 13, 2023 and is available on the Wyoming Secretary of State website, https://rules.wyo.gov/.  

Chapter 68 Opt-Out of Provisions of the IIPRC

The Interstate Insurance Product Regulation Commission (IIPRC) is a compact of member states formed in order to provide uniformity of insurance product standards across states.  Wyoming adopted the Interstate Insurance Product Regulation Compact (IIPRC) by enacting W.S. § 26-15-201.  On March 24, 2023, the IIPRC adopted Insurance Uniform Standards regarding Individual Disability Income Buy-Sell Insurance Policies and Individual Disability Income Key Person Replacement Insurance Policies which provided less protection to Wyoming consumers than what is already in place through Wyoming statutes.  Pursuant to W.S § 26-15-201, Article VII, (d), Wyoming elected to opt-out of the March 24, 2023 IIPRC standards by filing the revisions to Chapter 68. 

The current version of Chapter 68 was effective as of September 25, 2023 and is available on the Wyoming Secretary of State website,  https://rules.wyo.gov/.  

Proposed changes to regulations

Chapter 26 Adjustment of Damages to Dwelling Roofs Under Homeowners Policy

Changes were promulgated to Chapter 26 to clarify what constitutes obsolete roofing products for purposes of the regulation, to clarify the Department's position regarding the use of photo adjustment procedures, and to allow consumers to consent to the use of different roofing materials other than the materials existing on the insured dwelling, so long as the consent is in writing and given after full disclosure by the insurer of any adverse consequences that may exist if a different roofing product is used.  Finally, the revisions to Chapter 26 were promulgated to provide guidance regarding what constitutes a fair and equitable settlement of a roofing claim under Wyo. Stat. § 26-13-124 and addresses the Department's position regarding the depreciation of labor.  

Public comment closes on the proposed changes to Chapter 26 on March 22, 2024. Additional information regarding the proposed changes to this regulation can be found at the Wyoming Secretary of State website, https://rules.wyo.gov/.  

The Department is continuing to update its existing rules and regulations and will be implementing new regulations as required by recent legislation.  Please continue to monitor the Department’s administrative rules updates through the Secretary of State’s website.  If you have any questions regarding how to monitor regulatory updates through the Secretary of State website, please contact the Secretary of State’s office or the Department of Insurance. 

Jeff Rude, Wyoming Insurance Commissioner

2023 HIGHLIGHTS

During the 2023 legislative session, the DOI monitored eighteen bills. Of those eighteen, ten were passed into law.  You can view the bills and the changes that were made by visiting the Legislative Service Office website and select 2023 bills. The 2024 session is a budget session, but we expect to follow a few bills through the process.

The DOI also did extensive outreach during 2023. Public Service Announcements are published each month in statewide papers. Some of the topics in 2023 were choosing an agent, preparing for severe weather, and information regarding the Medicaid unwind. Additionally, the agency did presentations and articles for Cover Wyoming, AARP and AWIA.

In 2023, the agency brought in over $50 million to the general fund from licensing fees and premium taxes. The agency also collected $55,736 in fines. These fines were collected from both agents and companies.

The agency was also busy with licensing applications and form reviews. The licensing section issued 42,773 licenses and manually processed 5,026 applications. The Rate and Form filing section reviewed 1,520 Life & Health filings and 2, 225 Property & Casualty filings. The licensing section consists of three employees and the rate and form filing section has five employees.

Our legal section was busy revising rules. They revised Chapters 10, 64, 54, 55, 28 and 68. Once again you can find these rules on the Secretary of State’s website. They also handled eighty public records requests and opened 65 administrative matters.

The agency also has a complaint section. This section handles complaints regarding improper denial of claims; delays in claim handling; cancelation or termination of an insurance policy or misrepresentation of policy coverage or misappropriation of premiums paid to an agent or broker. The section cannot act as legal representation, recommend an insurance agency, agency or policy, determine property value, regulate rates, make an insurance company insure you, decide who is as fault for an accident, force a company to pay your claims or decide the amount of loss. During 2023 the section received 1,459 complaints and closed 1,453.

Also of significance this year is the DOI successfully passed NAIC accreditation. The NAIC Financial Regulation Standards and Accreditation Program (Accreditation Program) serves as the backbone of the U.S. national system of state-based regulation. The Accreditation Program defines baseline standards deemed essential for effective solvency regulation in each state. Accreditation assures states are regulating their domestic multistate insurers according to national standards agreed to by the NAIC. For the insurance industry, accreditation means insurers will not require additional independent exams from the other states in which the insurers do business. 

Jeff Rude, Wyoming Insurance Commissioner