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Connecticut and Nevada TPA Requirements

New Connecticut Insurance Department Bulletin on Data Security Requirements

Connecticut Bulletin MC-23. The Connecticut Insurance Department issued Bulletin MC-23 on June 13, 2017. The Bulletin addresses certification and notice requirements for data security requirements applicable to TPAs and PBMs (among other entities) per Conn. Gen. Stat. § 38a-999b.

The Bulletin reminds the recipients about the requirement to implement a comprehensive information security program ("ISP") by October 1, 2017, in order to safeguard the personal information of insureds and enrollees. The Bulletin also reminds TPAs and PBMs that, beginning October 1, 2017, they must begin annually certifying to the Connecticut Insurance Department, under penalty of perjury, that they maintain an ISP in compliance with 38a-999b.

The Bulletin states that the certification shall be in the form as shown in the attachment to the Bulletin and signed by an officer of the certifying TPA or PBM. Note that pursuant to 38a-999b(d), the Connecticut Insurance Commissioner or Connecticut Attorney General may request a copy of such program to determine compliance. If either one determines the ISP is noncompliant, the ISP Entity must amend it to bring it into compliance to the Commissioner's or Attorney General's satisfaction.

Failure to Timely File Written Agreements in Nevada

NAC 683A.125(s) requires TPAs to provide to the Nevada Insurance Commissioner a copy of each written agreement that the administrator enters into with an insurer or other entity within 90 days after the TPA enters into the agreement.

Recently, the Nevada Insurance Division has entered into a number of Administrative Fine and Consent to Fine settlement agreements involving the failure of these TPAs to provide the Division with a copy of each agreement that the TPA entered into with an insurer or other entity within 90 days of entering into the agreement in violation of NAC 683A.125(2).

Pursuant to NRS 683A.0892(1)(e), the Nevada Insurance Commissioner may, in addition to or in lieu of the suspension or revocation of the certificate of registration of the administrator, impose a fine of $2,000 for each act or violation.

TPAs not wishing to enter into a Consent to Fine with the Division for failing to timely submit their written agreements with the Division may submit a written application requesting a hearing to the Division's Legal Department.

© Polsinelli PC, Polsinelli LLP in California

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About this Author

Steven L. Imber, Polsinelli PC, Insurance Regulatory Attorney, Enforcement Actions Lawyer,
Shareholder

Steve Imber chairs Polsinelli's Insurance Business and Regulatory group.  As a former General Counsel at a state insurance department, Steve Imber has the knowledge and experience to provide quality counsel to insurers, third party administrators, insurance agencies, medical discount plans and other insurance regulated entities. His practice includes representing and assisting clients on multi-state and national licensing projects, research projects, enforcement actions, market conduct examinations, audits and compliance programs and various other regulatory and...

913.234.7469
Shareholder

Justin Liby has a talent for organizing and managing large national and multi-state licensure and research projects. This knack provides him with a solid foundation for crafting and implementing sound, efficient strategies that achieve success for his clients. Justin concentrates his efforts on helping the insurance industry navigate the formidable federal and state regulatory maze to achieve the industry’s business needs. He stays current in the insurance industry's evolution, as well as the legislation and regulatory activity impacting the industry.

Justin is a former regulator for the Kansas Insurance Department and in-house counsel for a national third-party administrator.

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Counsel

Jennifer Osborn Nix works diligently for insurance companies, third-party administrators, and other regulated entities to further their goals and help them remain compliant within the 50-state regulatory scheme. She focuses on insurance regulatory and compliance issues, with a primary emphasis on life and health insurance matters.

Jennifer works with many regulated entities, including many in the health care sector, who rely on her for research, advice, strategic counsel, and licensing.

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