Presentation Transcript

1. Inducements HB 333 2011 Legislative Session Creation of 31A-23a-402.5 Inducements Services Prohibited Providing a premium or commission rebate Paying the salary of an employee of a person who purchases an insurance product from the licensee Paying the salary, by an insurer or TPA, of an onsite staff member to perform an act prohibited Services NOT prohibited Social courtesy of $25 not conditioned on a sale Extending premium credit Providing limited Human Resources Guidance related to federal and state laws Workshops directly related to an insurance product Education on how product relates to tax law Preparing/providing forms directly related to insurance product Preparing/providing docs related to Section 125 IRS Code
2. Inducements Services NOT Prohibited (cont.) Providing enrollment and billing assistance Communicating coverage in writing/materials Providing claims management as allowed by appropriate license Recommending/negotiating for placing and pricing of insurance product Providing health fair or assistance on wellness program Providing COBRA , ERISA, HIPAA information or services Providing Proof of Coverage to 3rd party w/legitimate int. Facilitating risk management services directly related to product sold or offered Risk management Claims and loss control services Risk assessment consulting Providing services that are legitimately part of servicing the contract Providing other related services approved by the department
3. Inducements Services Allowed if Charged ‘Fair Market Value’ Performing background checks Providing legal services by a licensed attorney Preparing and providing employee handbooks Providing job descriptions, postings, applications Providing payroll services Providing performance reviews/performance review training Providing union advice Providing accounting services Providing data analysis info. technology programs Providing administration of HRA or HSA accounts
4. 2013 Inducement Changes HB 47 2013 Legislative Session 31A-23a-402.5(4)(a) Social Courtesy cannot be conditioned on a quote or a sale 31A-23a-402.5(4)(v) Allowed Risk Management services directly related to P&C insurance product include analysis of: Employer Job Descriptions Employer’s Safety Procedures or Manuals Providing Info and Training on Best Practices 31A-23a-402.5(6) Billable services in Section 31A-23a-402.5(5) must be itemized and billed separately from premium billing
5. Inducement Changes (cont.) 31A-23a-402.5(7) $25 Social Courtesy allowance cannot be connected to a quote or sale of insurance 31A-23a-402.5(7) New section allowing for a $10 de minimis gift to be conditioned on a quote, but must be paid for by the insurer 31A-23a-402.5(7) New section allowing for a $10 de minimis gift to be conditioned on a quote, but must be paid for by the insurer
6. Inducement Changes (cont.) R590-154 Defines social courtesy to be a respectful act or expression of generosity not conditioned on a quote, sale or retention of an insurance product and not to exceed $25 Defines fair market value to mean what a willing, unpressured buyer would pay for a product or service in the open market without any connection to other goods, services or contracts sold by the licensee Bulletin2013-5