Regulatory Framework (B) Task Force
Health Insurance and Managed Care (B) Committee

Mission
AAs a standing Task Force under the Health Insurance and Managed Care (B) Committee, the mission of the Regulatory Framework (B) Task Force is to develop NAIC model laws and regulations for state health care initiatives and consider policy issues affecting state health insurance regulation.

The Task Force performs a vital role in protecting the interests of insurance consumers in the ever-changing health care insurance market through the development of model laws and regulations and other activities.

The following group reports to the Task Force. Please see the group’s page for specific information and charges.

• ERISA Subgroup

2008 Charges

Ongoing Maintenance of NAIC Programs, Products and Services

1. Coordinate and develop the provision of technical assistance to the states regarding state level implementation issues raised by federal health legislation. Report quarterly.
2. Monitor, report, and analyze developments related to ERISA, and make recommendations regarding NAIC strategy and policy with respect to those developments. Report quarterly (Delegated to ERISA Subgroup).
3. Review the NAIC’s ERISA Handbook and modify as necessary to reflect developments related to ERISA. Report annually (Delegated to ERISA Subgroup).
4. Review managed health care reforms, their delivery systems occurring in the marketplace, and other forms of health care delivery; recommend appropriate revisions to regulatory jurisdiction, authority and structures. Report annually.
5. Review issues surrounding internal appeals and external review with respect to regulatory modernization and determine whether national standards are appropriate. If so, recommend an appropriate vehicle to achieve goals. Report by 2008 Winter National Meeting.
6. Review model laws adopted in 2003 and recommend whether they be retained, revised or deleted. Report by 2008 Winter National Meeting.
7. Review and revise, as necessary, NAIC model laws and regulations identified as in need of review and revision as a result of the NAIC model law review initiative. Report annually.
8. Consider the revision of NAIC model laws and regulations affected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and final federal regulations promulgated pursuant to HIPAA to comport with the requirements of HIPAA and final federal regulations. Report quarterly.
9. Develop a Model Regulation to Implement the Small Employer and Individual Health Insurance Availability Model Act (Prospective Reinsurance With or Without an Opt-Out), once final federal regulations are issued. Report by 2008 Winter National Meeting.
10. Revise the Model Regulation to Implement the Small Employer Health Insurance Availability Model Act (Prospective Reinsurance With or Without an Opt-Out) and the Model Regulation to Implement the Individual Health Insurance Portability Model Act to comport with revisions to the model acts once final federal regulations are issued. Report by 2008 Winter National Meeting.

New Objectives and Goals

1. Review issues concerning the standardization of forms practices and procedures in health insurance underwriting with respect to regulatory modernization that promotes administrative efficiency and the reduction of associated costs. Report by 2008 Winter National Meeting.