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Massachusetts Shares 2025 Guide to Medicare With Insurers and HMOs

MO| The 2025 Massachusetts Consumer Guide to Medicare provides a comprehensive overview of Medicare options, enrollment processes, and available plans for Massachusetts residents. It emphasizes the importance of understanding Medicare’s components (Parts A, B, C, and D), enrollment periods, and potential penalties for late enrollment. Additionally, it offers guidance on choosing between Original Medicare with […]

Colorado Announces Amended Regulation 4-2-49 on Uniform Drug Benefit Prior Authorization Process and Requires Appeals Process

CO| Amended Regulation 4-2-49, from the Colorado Division of Insurance, establishes requirements for prescription drug prior authorization processes. The regulation, effective March 30, 2025, applies to all carriers offering health benefit plans with prescription drug benefits in Colorado. Key points: Please note that Regulation 4-2-101 and Regulation 4-2-102 have been withdrawn to allow for additional […]

Colorado Adopts Regulation Concerning Transparency in Coverage Reporting Requirements for Carriers and PBMs

CO| Regulation 4-2-103, concerning Transparency in Coverage Reporting Requirements, aims to establish guidelines for carriers and pharmacy benefit managers (PBMs) to submit price transparency files and prescription drug data collection reports. The regulation applies to all carriers and plans subject to the federal Transparency in Coverage rule and the Consolidated Appropriations Act of 2021. Effective […]

Illinois DOI Issues CSR Load Data Call for 2026 Benefit Year

IL| The Illinois Department of Insurance (DOI) issued Bulletin 2025-02 to insurance companies writing individual comprehensive major medical insurance in Illinois, requesting data to develop the Cost-Sharing Reduction (CSR) load for the 2026 benefit year. Risk and Regulatory Consulting, LLC (RRC) is assisting with the data call, and submissions are due by March 14, 2025. […]

Michigan Issues Bulletin Regarding Auto Insurance: Fee Schedule CPI Adjustment

MI| Michigan Department of Insurance and Financial Services Bulletin 2025-05-INS, announces that for dates of service from July 2, 2025, through July 1, 2026, any amount payable that was in effect on January 1, 2019, for the purposes of MCL 500.3157(7) or MCL 500.3157(8) shall be increased by 13.12%. This adjustment is based on the […]

Michigan DIFS Releases Bulletin on Qualified Health Coverage Deductible Adjustment

MI| Michigan Department of Insurance and Financial Services, issued Bulletin 2025-06-INS, on February 18, 2025. It addresses the annual adjustment of the maximum deductible for Qualified Health Coverage (QHC) in relation to no-fault auto insurance. The bulletin states that the Director has determined that the $500 threshold for adjusting the deductible has not been met, […]

New York DFS Issues Circular Letter on Disability Income Insurance Policies

NY| Circular Letter No. 1 (2025) from the New York Department of Financial Services provides guidance on government benefit offset provisions in disability income insurance policies, including: Social Security Disability Income, Workers’ Compensation, Employers’ Liability, and Occupational Disease Law Benefit Offset Provisions in Individual, Group, and Blanket Disability Income Insurance Policies . It clarifies that […]