Browsing: Legislation

Below you will find legislative updates important to our members and to the health insurance industry.

Out-of-Network Claims Mediation

One of the services you may offer as a life and health agent is assisting your clients with the claims process. They may call you after they receive that rather large emergency room bill and question why one of the doctors they saw was out-of-network when the hospital was in-network. You can offer the typical advice, such as matching up the explanation of benefits with the itemized bill, but did you know that you can suggest mediation for certain out-of-network claims?

Industry News
it just depends on how you look at it

understandably, there has been a lot of concern and many questions and a bunch of worry over the NAIC’s recent decision to not make a pronouncement in its current recommendations about how NAIC thinks agents commissions should be treated for the purposes of a carrier complying with the new medical loss ratio requirement.