AN ACT TO EXPAND THE CHOICES FOR HEALTH INSURANCE IN NORTH CAROLINA BY EXEMPTING HEALTH INSURANCE COMPANIES FROM OUTDATED RISK EXPOSURE REQUIREMENTS; TO REMOVE A PHOTO IDENTIFICATION REQUIREMENT FOR NEW DOMESTIC COMPANIES; TO HELP MORTGAGE GUARANTY COMPANIES ADJUST THEIR CAPITAL AND SURPLUS REQUIREMENTS; TO REVISE CERTAIN RISK-BASED CAPITAL REQUIREMENTS IN ORDER TO MAINTAIN NORTH CAROLINA'S NAIC ACCREDITATION; TO CLARIFY CONSUMER CHOICE IN HOMEOWNER'S COVERAGE FOR WIND AND HAIL; TO CLARIFY THE CERTIFICATION REQUIREMENTS FOR AN ACTUARY WHO PRESENTS A SCHEDULE OF PREMIUM RATES; TO SHORTEN CERTAIN TIME PERIODS FOR AN EXTERNAL REVIEW BY THE COMMISSIONER OF CERTAIN INSURER DETERMINATIONS; TO EXPAND ACCESS OF COVERAGE TO BUSINESSES WHO NEED BLANKET ACCIDENT AND HEALTH COVERAGE; TO MAKE CERTAIN CONFORMING CHANGES RELATED TO THE RENAMING OF THE OFFICE OF MANAGED CARE PATIENT ASSISTANCE PROGRAM AS HEALTH INSURANCE SMART NC; TO AMEND THE DEFINITION OF PRIVATE PASSENGER MOTOR VEHICLE; TO CLARIFY WHEN AN INSURER CAN COMMUNICATE WITH THE INSURED AFTER A PUBLIC ADJUSTER HAS BEEN RETAINED; AND TO CLARIFY WHEN AN AUTOMATIC STAY OF PROOF OF LOSS REQUIREMENTS, PREMIUM AND DEBT DEFERRALS, AND LOSS ADJUSTMENTS ARE TRIGGERED; TO PROVIDE NOTICE AND AN OPPORTUNITY FOR A HEARING WHEN A SUPERIOR COURT JUDGE IS CALLED UPON TO SELECT AN UMPIRE IN CERTAIN PROPERTY INSURANCE DISPUTES; AND TO ALLOW THE DEPARTMENT OF INSURANCE TO ENFORCE CERTAIN PROVISIONS OF THE PUBLIC HEALTH SERVICE ACT BY REQUIRING INSURANCE COMPANIES TO COMPLY WITH THOSE PROVISIONS WITHIN THIS STATE. Enacted June 26, 2013. Section 10 is effective January 1, 2016. Section 20 is effective January 1, 2015. Sections 22 and 24 are effective June 26, 2013. Section 23 is effective October 1, 2013. The remainder is effective July 1, 2013.
Summary date: Jul 1 2013 - View summary
Summary date: Jun 6 2013 - View summary
Senate committee substitute makes the following changes to the 3rd edition.
Changes the long title.
Amends GS 58-2-46, making clarifying changes to language added in the previous edition.
Enacts new section GS 58-3-300, Health insurance issuers subject to certain requirements of federal law, providing that pursuant to authority granted under specified federal law, health insurance issuers that issue, sell, renew, or offer health benefit plans, defined in GS 58-3-167(a)(a), in North Carolina in the individual or group market must meet the requirements found in Title 42 USC 6A Subchapter XXV, Part A.
Amends the enactment clause, providing that Section 20 of the act becomes effective January 1, 2015, and applies to policies whose effective date is on or after that date. Sections 22 and 24 of this act are effective when they become law. Section 23 of this act becomes effective October 1, 2013.
Summary date: Apr 11 2013 - View summary
House amendment to the 2nd edition makes the following changes. Adds an amendment to GS 58-44-35 to prohibit a judge from selecting the umpire until (1) proof of notice to all parties has been filed with the court and at least 15 days have passed since the proof was filed and (2) upon request of any party, the judge has conducted a hearing, which is governed by the practice for hearings in other civil actions before a judge without a jury and is limited to the issue of umpire selection. Effective October 1, 2013. Makes a conforming change to the act's long title.
Summary date: Apr 4 2013 - View summary
House committee substitute makes the following changes to the 1st edition.
Changes long title.
Amends GS 58-36-42, providing that consumers can also choose residential property insurance coverage in the beach areas defined in GS 58-45-5(2), (previously, only referred to the coastal areas). Deletes provision limiting those coverages to when requested by the insured.
Deletes Section 19 from the 1st edition, concerning expedited external review.
Adds new Section 20, amending GS 58-40-10 (Definitions), providing that a private passenger motor vehicle, for the purposes of Articles 36, 37 and 40, can be a motor vehicle that is a pickup truck or van that is owned by private citizens who are residents of the same household if it has a gross vehicle weight as specified by the manufacturer of less than 14,000 pounds (was, 10,000).
Adds new Section 21, amending GS 58-33A-65(f)(3), deleting the requirement that once a public adjuster has been retained, the company adjuster or other insurance representative may not communicate directly with the insured without the permission or consent of the public adjuster or the insured's legal counsel.
Adds new Section 22, amending GS 58-2-46, changing the title to State of disaster automatic stay of proof of loss requirements; premium and debt referrals; loss adjustments for separate windstorm policies (was, State of emergency automatic stay of proof of loss requirements; premium and debt referrals; loss adjustments for separate windstorm policies). Makes conforming changes by substituting "state of disaster" for "state of emergency." Requires the Commissioner of Insurance (Commissioner) to issue an order declaring GS 58-2-46(1-4) effective in order for the provisions of this section to take effect. Provides that the application of any provision in an insurance policy insuring real property can be stayed for the time period not exceeding the earlier of the expiration of the disaster proclamation or declaration and all renewal proclamations or the expiration of the Commissioner's order declaring subdivisions (1) through (4) effective for the specific disaster. Also provides that certain companies must give their customers who reside in the geographic area designated in the disaster proclamation or declaration the option of deferring premium or debt payments during the time period prior to the expiration of the Commissioner's order declaring subdivisions (1) through (4) effective.
Adds new Section 22(b), amending GS 58-2-47 (Incident affecting operations of the Department; stay of deadlines and deemer provisions), adding "disaster" and a reference to GS 166A-19.21 (Gubernatorial disaster declaration) to the section in regards to incidents beyond the Department of Insurance's (Department's) reasonable control.
Adds new Section 22(c), amending GS 58-33-70(e), adding "disaster" and a reference to GS 166A-19.21, in regards to when an experienced adjuster licensed in another state can act as an adjuster in North Carolina.
Adds new Section 22(d), amending GS 58-44-70, replacing references to a state of "emergency" with a state of "disaster." Replaces a reference to GS 166A-19.20 with GS 166A-19.21.
Adds new Section 22(e), amending GS 58-44-75 (Definitions), deleting the term and definition for disaster.
Provides new effective dates. Section 10 of this act becomes effective January 1, 2016. Section 22 of this act is effective when it becomes law. The remainder of this act becomes effective July 1, 2013.
Summary date: Mar 6 2013 - View summary
Amends GS 58-3-105 to add accident and health insurance to the types of insurance exempt from the provisions of this section regarding risk exposure requirements.
Amends GS 58-7-37(a) to eliminate the photo identification requirement for receipt of a license by a new domestic insurance company.
Current law requires a mortgage guaranty insurerto maintain at all times a minimum policyholders position of not less than one twenty'fifth of the insurer's aggregate insured risk outstanding; however, this requirement may be waived by the Commissioner of Insurance (Commissioner) for a specified time period. Amends GS 58-10-125 to delete provision that the Commissioner cannot grant a waiver that extends beyond July 1, 2015. Makes a conforming change to Section 2 of SL 2009-254, as amended.
Amends GS 58-12-11 to specify that in the event of a company action level event, as defined in this statute, the comprehensive financial plan prepared by the insurer and submitted to the Commissioner must provide that forecasts for all insurers must include forecasts of statutorybalance sheets, operating income, net income, capital and surplus (was, capital or surplus), and risk-based capital levels. Makes an organizational change.
Amends GS 58-12-35(a) regarding confidentiality and prohibition on announcements, to provide that certain risk-based capital reportspertaining to domestic and foreign insurers arenot to be made public and are not subject to subpoena, discovery, or admissible in evidence in any private civil action (was, not subject to subpoena) other than by the Commissioner. Provides that the Commissioner may share and receive confidential information and privileged risk-based capital information consistent with information shared and received under GS 58-2-132(g) and (h). Prohibits permitting or requiring the Commissioner or any person who received documents, materials, or other information while acting under the authority of the Commissioner to testify in any private civil action concerning any confidential documents, materials, or information subject to subsection (a).
Amends GS 58-30-60(b) to revise certain risk-based capital requirements in order to maintain North Carolina's National Association of Insurance Commissioners accreditation. Amends GS 58-31-45 to remove the requirement that the report which the Commissioner must submit to the Governor on the Commissioner's official action under Article 31 of GS Chapter 58 must be embodied or attached to the Commissioner's biennial report to the General Assembly.
Amends GS 58-36-42 to clarify that consumers may choose residential property insurance coverage in the coastal counties as defined in GS 58-45-5(2b) that does not include coverage for the perils of windstorm or hail.
Amends GS 58-50-131(a) to clarify thequalification standards foran actuary providing certification for the filing of a schedule of premium rates for health benefit plans.
Amends GS 58-50-82 to provide that the Commissioner must perform certain designated actions within two (was, three) days of receiving a request for an expedited external review. Provides that the insurer or its designee must provide or transmit all documents and information to the assigned review organization as soon as possible but within the same day after(was, same business day of) receiving notice that the request has been assigned to a review organization. Requires that a decision be rendered on the expedited request no more than three business days (was, four business days) after the date the request for expedited external review is received.
Changes the name of the Office of Managed Care Patient Assistance Program to Health Insurance Smart NC. Makes multipleconforming changes to insert the name change. Also removes the reporting requirement in GS 58-36-42.
Amends GS 58-71-75 to expand access of coverage to businesses that need blanket accident and health coverage.
Effective July 1, 2013.