State insurance regulators are looking at updating two major sets of model rules to reflect the changes made by the Patient Protection and Affordable Care Act of 2010 (PPACA).
The regulators, members of the Regulatory Framework Task Force at the National Association of Insurance Commissioners (NAIC), are asking for comments on a draft of revisions to Model 170, the Accident and Sickness Insurance Minimum Standards Model Act and a draft of revisions to Model 171, the model regulations that go along with the model act.
The NAIC is a trade group for regulators. In most cases, it can only have a direct effect on state insurance rules in states that have created mechanisms for automatically adopting NAIC rules. But NAIC models can have a major influence on the rules states set for themselves.
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The accident and sickness models apply to health products other than major medical coverage, or products “excepted” from the Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules that apply to major medical coverage.
Drafters and implementers of PPACA have taken a similar approach to excepting non-medical health products from PPACA.
The current text of the NAIC’s model act states that the act does not apply to Medicare supplement insurance policies, long-term care insurance (LTCI) policies and some other types of non-medical health policies. The model does apply to hospital indemnity coverage, disability income protection coverage, accident-only coverage, specified disease coverage, specified accident coverage and limited-benefit health coverage, according to the text.
Many agents and brokers who sell non-medical health products have been happy about how stable those markets have been in comparison with the major medical market.
Discussions about the NAIC models could affect the rules for those products.
See also: 5 battles over the PPACA-free zone
For a look at some of the areas of disagreement between commenters at America’s Health Insurance Plans (AHIP), a group that represents health insurers, and the people appointed by the NAIC to represent consumers’ interests in NAIC proceedings, read on.