State insurance departments across the country are continuing to provide guidance in response to the COVID-19 outbreak. In this update, Faegre Drinker spotlights the current Florida Office of Insurance Regulation (OIR) guidance with respect to COVID-19 issues.
OIR Informational Memoranda
- Leniency on Premium Payments
- Regulated entities are encouraged, when prudently possible, to be flexible with premium payments in order to avoid a lapse in coverage (including relaxing due dates, extending grace or reinstatement periods, waiving late fees and penalties, and allowing payment plans). Regulated entities are encouraged to only consider cancellation of policies if all possible efforts to work with consumers to continue coverage have been exhausted.
- Removing Exclusions on Certain Personal Auto Exclusions
- For insureds that may be temporarily utilizing their personal automobile for purposes that might otherwise be considered commercial use, regulated entities are encouraged to consider allowing such use for insureds, provided that such use is limited to the duration of the Emergency Orders.
- Underwriting and Claims Inspections
- Regulated entities, agents, consumers and employers are strongly encouraged to explore virtual options for underwriting and adjusting claims in lieu of in-person property inspections and for premium audits of employers’ records.
- General Considerations
- In any case where handwritten statements are required from policyholders or customers, regulated entities are encouraged to accept electronic communications.
- OIR will accept certain electronic signatures and notarizations on documents required to be filed with OIR through May 1, 2020.
- OIR granted a 30-day extension for any annual statements due to be filed with OIR by a regulated entity on or before May 1, 2020, for the following regulated entities: (i) HMOs; (2) administrators; (3) continuing care providers; and (4) multiple-employer welfare arrangements.
Informational Memorandum OIR-20-03M: Guidance for Business Continuity and Continuity of Operations Plans (March 16, 2020)
- All companies regulated by OIR are directed to review and update their Business Continuity Plans and/or Continuity of Operation Plans immediately.
- The plans must provide a framework for the continuation of company operations, including key insurance functions such as policy issuance, premium collection, claims adjustment, and payment and policyholder service.
- The continuity plans should also account for Department of Health (DOH) and Centers for Disease Control and Prevention (CDC) guidance surrounding COVID-19, including executive orders issued at the state and national levels, and consider all potential impacts of COVID-19, including impacts to essential operations, key personnel, supply chain, vendors, contractors and policyholders.
- If an insurer or other entity regulated by OIR activates its Business Continuity and/or Continuity of Operations Plan in response to COVID-19, the company must notify OIR within the same day.
- If in response to COVID-19, business operations are compromised to the extent that it jeopardizes the company’s ability to provide essential insurance services to policyholders, the company must immediately notify OIR, detailing the extent to which operations are compromised.
- Contact Christopher Struk at Christopher.Struk@floir.com and Christina Huff at Christina.Huff@floir.com to provide: (i) detailed information regarding the extent to which business operations are compromised, including information on how it may impact services to policyholders; and (ii) the name, phone number and email address of the point of contact for this issue.
Informational Memorandum OIR-20-02M: Early Prescription Refills Pursuant to Executive Order 20-52 (March 10, 2020)
- All health insurers, HMOs and other health entities must allow early prescription refills because the Governor issues an Executive Order declaring a State of Emergency and gives guidelines for insurer and pharmacy compliance. This mandate remains in effect until the Executive Order is rescinded or expires.
- Heightened Communication and Customer Service
- Insurers are directed to use every channel available to them to communicate with their policyholders, agents, providers and employees to share official CDC and DOH information regarding the prevention and treatment of COVID-19, including directing the public to the official DOH website.
- Insurers are directed to devote resources to inform consumers of available benefits, quickly respond to consumer inquiries, avoid and dispel misinformation, and review their processes to streamline consumer services.
- As part of the state’s coordinated response to COVID-19, insurers are directed to work with public health officials and do everything possible from the prevention level.
- Testing and Coverage for COVID-19
- Insurers are directed to consider all practicable options to reduce the barriers of cost-sharing for testing and treatment of COVID-19 during the public health emergency.
- Insurers are reminded that emergency services for an emergency medical condition must be covered at the in-network level regardless of which provider performs the services.
- When consumers receive emergency services from a health care provider that does not participate in the issuer’s provider network, providers are directed to ensure that consumers incur no greater out-of-pocket costs for the emergency services as they would have incurred with a participating provider.
The deadline to report claims data for the Assignment of Benefits (AOB) Data Call has been extended until July 1, 2020. OIR is also waiving the affidavit requirement within the Data Call.
For additional Florida COVID-19 information, please visit:
- Florida OIR’s COVID-19 website
- Florida CFO’s COVID-19 website
- Florida’s current number of COVID-19 cases
Faegre Drinker’s Coronavirus Resource Center is available to help you understand and assess the legal, regulatory and commercial implications of COVID-19.