Health Insurance and Managed Care (B) Committee
December 4, 2007

The Health Insurance and Managed Care (B) Committee met on Tuesday, Dec. 4, 2007.

During this meeting, the Committee:

• Discussed its priorities for 2008. From this list, the Committee identified a few issues to definitely pursue. One of those was to develop a white paper on state extra-territoriality best practices. The Committee also plans to continue reorganizing the catalog of state initiatives to make it more of a resource that states can use as they pursue health insurance reform.

• Received the Regulatory Framework Task Force report. The Regulatory Framework Task Force is continuing to work on a new model – Uniform Health Carrier External Review Model Act. The Task Force reviewed and discussed comments received on the current draft. Another draft will be developed and distributed for comment sometime next month. The Task Force plans to hold a conference call prior to the 2008 Spring National Meeting to discuss any comments received on this draft and, possibly, adopt it. The ERISA Subgroup is developing two advisory alerts in response to recent Department of Labor Advisory Opinions regarding what is a fully-insured MEWA and the single-employer status of PEOs. Drafts of the alerts will be circulated for comment sometime in mid-January 2008.

• Adopted the Senior Issues Task Force report. The Task Force adopted amendments to the Guidance Manual for Rating Aspects of the Long-Term Care Insurance Model Regulation. The Task Force received an update on the joint Market Analysis Working Group and Senior Issues Task Force data call.  The data call sought information from the 25 highest premium volume long-term care companies.  The deadline for responding was Nov. 15, 2007.  The data is being analyzed by the NAIC. The Task Force also received an update on the implementation of the long-term care Partnership Program. The Task Force received an update on implementation of an information-sharing Memorandum of Understanding (MOU) between state Departments of Insurance and CMS.  Forty-five states, Puerto Rico and the District of Columbia have signed the MOU.  The Task Force also received an update on the Medicare Private Plans Subgroup activities.  The Subgroup will continue development of a white paper with various policy issues and possible solutions. 

• Received the Accident and Health Working Group report. The Working Group discussed revisions to the actuarial opinion section of the health annual statement instructions.  These revisions involve the appointment of the actuary and the sections on the actuarial report.  The revised document was returned to the Health Actuarial Opinion subgroup. The Working Group also discussed the section of the proposed valuation manual, VM-25 Health Insurance Reserves Minimum Requirements, and health reserve requirements under PBR.

• Received an update on federal issues. NAIC staff highlighted a number of federal bills.

Action Items:

1. Adopted the Senior Issues (B) Task Force report.