26-06 - Health Insurance Rate Filings - Filing Dates for Plan Year 2027, April 2, 2026

DEPARTMENT OF COMMERCE AND INSURANCE
                                P.O. Box 690, Jefferson City, Mo. 65102-0690

        INSURANCE BULLETIN 26-06
        Health Insurance Rate Filings - Filing Dates for Plan Year 2027

        Issued: April 2, 2026
The following Bulletin is issued by the Missouri Department of Commerce
and Insurance ("Department") to inform and educate the reader on the
specified issue. It does not have the force and effect of law, is not an
evaluation of any specific facts or circumstances, shall not be considered a
statement of general applicability and is not binding on the Department.
See § 37 4.015, RSMo (2016).

To:       Health carriers writing health insurance or health benefit plan coverage in
          Missouri

From: Angela L. Nelson, Director

Re:       Health Insurance Rate Filing Key Dates (2027 Plan Year)

This Bulletin provides notice to health carriers of key filing dates for health benefit plans
that will be offered during 2027, as required by§ 376.465, RSMo (2016) 1 , and 20 CSR
400-13.100. These dates are based on current federal guidance contained in the
Patient Protection and Affordable Care Act, HHS Proposed Notice of Benefit and
Payment Parameters for 2027; and Basic Health Program, 91 Fed. Reg 6292 (Feb.11,

1 All statutory references herein are to RSMo (2016) unless otherwise noted.
 2026), and are subject to change.

In recent plan years, similar bulletins also included technical information. For this plan
year, any necessary technical information will be provided separately.

                   Summary of Filing Timeframes for Plan Year 2027
        Type of Plan                             Filing Timeframe
Single Risk Pool – Plans   File by June 3, 2026, to meet federal and state guidelines.
in Individual and Small
Group ACA markets
Transitional               File at least 60 days prior to use. Filings, which include
                           finalized rates, that are submitted on or before August 12,
                           2026, will have their reviews prioritized.
                           Filings submitted later than August 12 may have
                           reviews extend beyond the intended implementation
                           date.
Grandfathered              File at least 30 days prior to use.
Student Health Plans       File at least 60 days prior to use.
Other Health Benefit Plans File at least 30 days prior to use.
(Dental, Vision, etc.)

For additional detail regarding the timeframes in the chart above, please see the
following sections.

Applicability
The rate filing timeframes apply to plan types subject to a determination of
“reasonableness” pursuant to § 376.465.7. For ease, this Bulletin will refer to the
following plans as “Subsection 7 Plans”:
    • “Health benefit plans” as defined in § 376.465 (excluding plans sold in the large
       employer group market);
    • Individual and small employer group plans subject to the requirements of the
       single risk pool;
    • Student health plans; and
    • Transitional plans.

Section 376.465 specifies the timeframes applicable to rate filings for all other health
benefit plans including, but not limited to, grandfathered plans and excepted benefit
plans.
File Rates for Individual and Small Group ACA Plans No Later than June 3, 2026
The Centers for Medicare and Medicaid Services (CMS) Center for Consumer
Information and Insurance Oversight (CCIIO) designated Missouri as an “Effective Rate
Review” state in 2017. To retain that status, the Department must ensure rate filings
meet federal guidelines. This Bulletin serves to indicate that the Department intends to
follow federal filing and posting guidelines to the extent possible under Missouri law.

For Plan Year 2027, proposed rates for Individual and Small Group ACA plans must be
submitted to the Department no later than June 3, 2026.

Federal law exempts student health plans from the filing deadlines applicable to single
risk pool plans. Likewise, federal guidance indicates that transitional plans have
different deadlines than single risk pool plans. However, to comply with Missouri law,
rates for student health plans and transitional plans should be filed with the Department
at least 60 days prior to the proposed effective date.

Post Proposed Rates for Individual and Small Group ACA Plans – July 31, 2026
Current federal guidelines require “Effective Rate Review” states to publicly post
proposed rates for single risk pool plans no later than July 31, 2026. The Department
does not intend to publicly post proposed rates earlier than this date.

Optional Quarterly Rate Filings for the Small Group Market
Current federal law permits single risk pool plans in the small group market to adjust
rates as often as quarterly. As Missouri law does not limit the frequency of rate filings,
health carriers may submit quarterly rate filings for small group market plans.

   •   2027 Plans: Health carriers should submit rate filings by June 3, 2026. Rate
       filings for subsequent quarters should be filed at least 60 days prior to the
       proposed effective date, as required by § 376.465.

Transitional Plan Rate Filings
Missouri law does not differentiate between transitional plans and other Subsection 7
plans. Therefore, transitional plan rates must be filed at least 60 days prior to
implementation, and are subject to the same standards of review as other Subsection 7
plans. However, while current federal guidance for transitional health plans only requires
rate submissions where the proposed rate increase exceeds the federally identified rate
review threshold, under Missouri law all transitional plan rate changes must be filed with
the Department, regardless of the magnitude or direction of the rate change.

Please note, for transitional plan rate changes that are less than the federal threshold,
the Department will not require companies to also file concurrently with CMS per 20
CSR 400-13.100(8).

For Additional Rate Filing Guidance
General Instructions are available via the System for Electronic Rate and Form Filing
(SERFF) for Missouri. Additional filing guidelines will be posted on the Department’s
website and updated as necessary.

Rate Filings for other Health Benefit Plans
For filing requirements applicable to grandfathered and excepted benefit plans that are
not Subsection 7 plans, please see § 376.465. For dental plans that a health carrier or
licensed pre-paid dental plan intends to make available on the exchange, rates must be
filed in accordance with § 376.465, or thirty (30) days prior to the intended effective
date.

Any questions or comments regarding this Bulletin should be directed to Camille
Anderson-Weddle at 573-522-3311 or productfilings@insurance.mo.gov.

                                          ###


26-04 – Claims Valuation Software, March 17, 2026

insurance.mo.gov; gate-zero TOP-20 MO-a.

Insurers that rely on valuation software should be aware of potential issues that may
lead to the undervaluation of total loss vehicles, potentially in violation of the Unfair
Claims Settlement Practices Act. These issues include arbitrary or undocumented
condition adjustments and other vehicle-specific factors not captured by the software.
Condition adjustments are increases or decreases to the vehicle's value to account for
its condition at the time of the loss. Typically, these adjustments involve reductions in
value for pre-existing wear and tear, including dents, stains, or mechanical issues.

Valuation software typically establishes a base value for a loss vehicle by comparing it
to similar vehicles. Insurers also often have the option to choose a starting base value
that may include a reduction of the comparable vehicles initially from dealer level (ready
to sell) to varying levels of privately owned. A starting level less than the highest
includes deductions for wear and tear on the vehicle. The valuation software may apply
a weighting factor to the comparable vehicles to approximate an actual cash value
(ACV) that is closest to the vehicle most resembling the loss vehicle. The claims handler
may also further adjust the value based on vehicle-specific factors, such as dealer
packages, other options, condition, and mileage of the loss vehicle.

Pursuant to section 375.1007,RSMo, insurers are required to conduct a reasonable
investigation and ensure that a prompt, fair, and equitable settlement is achieved where
liability has become reasonably clear. During the investigation and settlement process,
insurers are encouraged to consider the following when determining a fair and equitable
settlement:

   •   Identify and apply any vehicle-specific options, including dealer trim packages;

   •   Consider post-purchase upgrades that may be compensable under the terms of
       the policy;

   •   Ensure that any deductions due to the condition applied by the claims handler
       are not duplicative of deductions already applied by the valuation software;

   •   Apply increases to the value of the loss vehicle, if the loss vehicle is in better
       condition than the condition ratings provided by the valuation software vendor,
       and;

   •   Avoid modifying or adjusting values based on negotiation tactics, such as
       haggling, because these practices are highly subjective and may lead to unfair
       settlements.

                                             2
Consistent with 20 CSR 100-1.050(2)(E), all adjustments based on betterment or
depreciation must be documented in the claim file, itemized, explained, and must be fair
and reasonable. Insurers are instructed to clearly state what was deducted from the
value, how the loss vehicle differs from the comparable vehicles and why those
deductions were made. Additionally, 20 CSR 100-8.040(3)(B) requires the file to be
maintained in a manner that clearly shows the inception, handling, and disposition of
each claim. Therefore, pertinent factors and selections built into the valuation software,
such as weighting and condition adjustments, must also be maintained in the claim file.
These inputs are needed to audit the vehicle's value.

If an internal review identifies missing documentation for total loss claims, insurers are
encouraged to notify the Department in accordance with section 374.049.9,RSMo.

For inquiries regarding this Bulletin, please contact the Market Conduct Section at
marketconduct@insurance.mo.gov.

                                            ###

                                             3


26-05 – Conduent Cybersecurity Breach, March 17, 2026

portion of its network from October 21, 2024 to January 13, 2025. The affected files
contained names, addresses, and social security numbers.

Conduent has taken steps to notify insurers, members, and law enforcement of the
cybersecurity breach. Conduent is offering affected members access to 12 months of
credit monitoring and identity restoration services at no charge. To take advantage of
this offer, members must enroll by April 30, 2026.

The Department strongly encourages insurers and other entities regulated by the
Department that have utilized Conduent to determine if their members have been
affected by the cybersecurity breach, and, if so, to ensure that their members have been
notified by Conduent. Insurers are also encouraged to provide information on their
websites relating to the cybersecurity breach, to alert members to the April 30, 2026
deadline to take advantage of credit monitoring services, and to provide a point of
contact with the insurer or with Conduent where members can address concerns
relating to the cybersecurity breach.

The Department also reminds insurers and other regulated entities of their duties to
report cybersecurity breaches to the Director. Entities should review Insurance Bulletins
23-04 and 26-01, section 407.1500 RSMo, and the Insurance Data Security Act,
sections 375.1400 to 375.1427 RSMo Supp. 2025. Questions for the Department
regarding an entity’s duties can be sent to cyberbreach@insurance.mo.gov.

Questions relating to the Conduent cybersecurity breach may be directed to Conduent.
Conduent has a dedicated assistance line at 877-332-1658 (toll free), Monday-Friday,
from 9:00 a.m. to 9:00 p.m. Eastern Time, and may also be contacted at Attn: Data
Incident, 100 Campus Drive, Suite 200, Florham Park, New Jersey 07932.

Questions relating to the content of this bulletin may be directed to the Department’s
Market Conduct Section at marketconduct@insurance.mo.gov

                                           ###

                                            2


26-03 – Annual Statistical Reporting Requirements, February 4, 2026

DEPARTMENT OF COMMERCE & INSURANCE
                              P.O. Box 690. Jefferson C ity, Mo. 65102·0690

        INSURANCE BULLETIN 26-03

        Annual Statistical Reporting Requirements

        Issued: February 4, 2026

The following Bulletin is issued by the Missouri Department ofCommerce and Insurance
("Department'') to inform and educate the reader on the specified issue. It does not have the
force and effect oflaw, is not an evaluation ofany specific facts or circumstances and is not
binding on the Department. See Section 374.015, RSMo.

To:       All insurers writing insurance coverages in th      •        • ouri

From:     Angela L. Nelson, Director

Re:       Annual Statistical Reporting Requirements

The purpose ofthis Bulletin is to provide a helpful reminder to all insurers of the annual statistical
reporting obligations.

      NOTE: There are!!!! new statistical reporting requirements specified in this Bulletin;
      this Bulletin only provides a reminder and reference guide to assist insurers so they
      may timely provide the statistical data as required.

Insurers doing business in Missouri are required to annually report certain aspects of their
business. The statutory authority for each filing requirement, the applicable filing deadline and
detailed reporting instructions can be found on Appendix A of this Bulletin and on the Department's
website at: https://insurance.mo.gov/industry/filings/stats/statreprt.php.

All statistical reports (with the exception of the private passenger automobile/residential property
Missouri ZIP code data) can be submitted online. Insurers are encouraged to file the required
reports using the Statistics Claims Reporting Portal found at
https://apps.dci.mo.gov/ProfLiab/MedMal/Login.aspx.

The private passenger automobile/residential property Missouri ZIP code data should be submitted
via email to statistics@insurance.mo.gov.

Any questions or comments regarding this Bulletin or the statistical reporting requirements should
be directed to the Department’s Business Analytics/Statistics Section at
statistics@insurance.mo.gov.

                                                 ###

                                                   2
Appendix A

                               Property and Casualty Reports

                                        Statutory/Regulatory                              Filing
                 Filing                         References          Filing Deadline      Method
 Annual Statement: Page 19          374.040, 374.045 RSMo.,      March 1st              Reporting
 Supplement                         20 CSR 200-1.037                                    Portal
 Commercial liability               379.895 RSMo.                April 15th             Reporting
 profitability/loss                                                                     Portal
 development/closed claims
 Dram shop liability insurance      375.1730 RSMo,               March 31st             Reporting
 premium and loss report            20 CSR 600-1.020                                    Portal
 Legal malpractice open/closed      383.077, 383.079, 383.081,   January 1st / within   Reporting
 claims                             383.083 RSMo.                6 months of final      Portal
                                                                 disposition
 Medical malpractice open/closed    383.105, 383.110, 383.115,   Quarterly              Reporting
 claims                             383.120, 383.125 RSMo.                              Portal
 Mortgage guaranty                                               July 1st               Reporting
                                                                                Portal
 Private passenger                  374.400, 374.405 RSMo.,      March 1st              Via
 automobile/residential property    20 CSR 600-3.100                                    Email
 Missouri ZIP code
 Products liability closed claims   374.415 RSMo.                March 1st              Reporting
                                                                                Portal
 Real estate open/closed claims     383.060, 383.067, 383.069    January 1st / within   Reporting
                                    RSMo.                        6 months of final      Portal
                                                                 disposition

                             Life, Health and Accident Reports
                                       Statutory/Regulatory                               Filing
              Filing                        References            Filing Deadline        Method
 Annual Statement: Supplement        374.040, 374.045 RSMo.,     March 1st              Reporting
 for Missouri                       20 CSR 200-1.037                                    Portal
 Medicare supplement                 374.045, 374.190, 376.874   April 1st              Reporting
 experience                         RSMo., 20 CSR 600-1.010                             Portal

                                                 3


21-02 - Health Insurance Rate Filings - Filing Dates for Plan Year 2022, March 5, 2021

INSURANCE BULLETIN 21-01
          Updated Disaster Contact Information

          Issued: January 14, 2021

The following Bulletin is issued by the Missouri Department of Commerce and Insurance (“Department”) to
inform and educate the reader on the specified issue. It does not have the force and effect of law, is not an
evaluation of any specific facts or circumstances, and is not binding on the Department. See section 374.015,
RSMo.

To:              All insurers issuing policies covering real or personal property in Missouri

From:            Chlora-Lindley Myers, Director

Re:              Updated Disaster Contact Information

In anticipation of the upcoming spring storm season, and to ensure prompt and efficient communications with
the insurance industry following a disaster, the DCI requests each insurer insuring real or personal property in
the state to provide the following contact information to the DCI:

         Primary regulatory contact: This contact should be available to directly communicate with the
          Director and senior DCI leadership following a disaster within the state. These would be high-level
          communications about the DCI’s response efforts, the company’s response efforts, logistic issues and
          other urgent regulatory matters following a disaster.
      Secondary regulatory contact: This secondary contact should be able to discuss non-urgent regulatory
       issues with DCI staff as well as participate in industry conference calls and meetings regarding disaster
       response matters.

      Communications contact: This contact should be available to discuss inquiries received from press
       outlets and to coordinate joint communication and consumer outreach efforts.

For each insurer contact type identified above, the DCI is requesting contact information (name, title telephone
numbers, email address) be submitted on the accompanying Excel spreadsheet form. Responses can be emailed
to CompanyContacts@insurance.mo.gov

Where there are multiple insurers within a larger group, a single response may be submitted if the individuals
identified for the larger group can speak to the issues identified above for each insurer within the group.

Any questions or comments regarding this Bulletin should be directed to Samantha Mueller at 573-751-2430 or
via email to Samantha.Mueller@insurance.mo.gov


Temporary External Appeal Application Procedures for the Independent Health Care Appeals Program

nj.gov legal.shtml §F affirmative copy/distribute grant; gate-zero NJ-a. Incapsula WAF: keep cadence polite.


90-Day Grace Period for Property and Casualty Insurance Premium Payments Due to the Disruption Caused by COVID-19

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                                 MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-15

 TO:             ALL INSURERS TRANSACTING PROPERTY AND CASUALTY
                 INSURANCE IN NEW JERSEY, ALL LICENSED INSURANCE
                 PRODUCERS, INSUREDS, AND OTHER INTERESTED PARTIES

 FROM:           MARLENE CARIDE, COMMISSIONER

 RE:             90-DAY GRACE PERIOD FOR PROPERTY AND CASUALTY
                 INSURANCE PREMIUM PAYMENTS DUE TO THE DISRUPTION
                 CAUSED BY COVID-19

         On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Exec. Order No. 103 (March 21, 2020) ___ N.J.R. ___ (“EO
 103”) to contain the spread of the Coronavirus (“COVID-19”) pandemic. Governor Murphy later
 directed New Jersey residents to remain in their homes unless leaving was essential through the
 issuance of Exec. Order No. 107 (March 21, 2020) ___ N.J.R. ___ (“EO 107”). These Executive
 Orders were issued to contain the spread of the COVID-19 pandemic. On April 9, 2020, Governor
 Murphy issued Executive Order No. 123 (“EO 123”). EO 123 directed insurers transacting
 property and casualty to refrain from cancelling any policy or contract for nonpayment for a period
 of time as directed by the Commissioner of the Department of Banking and Insurance
 (“Commissioner”); to exercise appropriate forbearances on collection documentation; to amortize
 any unpaid payments over the remainder of the policy term or a period of up to 12 months, as
 appropriate, as directed by the Commissioner; and to refrain from seeking recoupment of any
 unpaid claims paid during the emergency grace period. The Department of Banking and Insurance
 (“Department”) is issuing this Bulletin to direct all property and casualty insurance carriers to
 extend a grace period to their insureds as set forth herein.

         Since the outbreak of the respiratory disease COVID-19, individuals and businesses in the
 State of New Jersey have been negatively impacted in a variety of ways. For example, small
 businesses in the travel, entertainment, hospitality, and food service industries, have been
 adversely impacted by significant drops in business activities resulting, for some entities, in
 dramatic declines in revenue. Employees of these industries will be impacted, which may include
 the failure to be paid their regular salary or receive reimbursements when normally due. This, in
 turn, can adversely affect the ability of these individuals or businesses to make payments for
 obligations, such as insurance coverage, when due.

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           New Jersey is an Equal Opportunity Employer • Printed on Recycled Paper and Recyclable
        In response to the disruption caused by COVID-19, the Department is directing all licensed
property and casualty insurance carriers to provide their insureds who may be experiencing a
financial hardship due to COVID-19 with at least a 90-day grace period to pay insurance premiums
so that insurance policies are not cancelled for nonpayment of premium during this challenging
time due to circumstances beyond the control of the insured. A policyholder may elect this 90-
day emergency grace period to begin retroactively on April 1, 2020 or opt for the grace period to
begin on May 1, 2020. During this extended grace period, insurers shall not cancel any insurance
policy for nonpayment.

    Insurers are also directed to:

   •   Waive late payment fees otherwise due, and not report late payments to credit rating
       agencies, during the 90-day period;
   •   Allow premiums due but not paid during the 90-day period to be paid over the remainder
       of the current policy term or up to 12 months in up to 12 equal installments, whichever is
       longer, except that an insurer may permit a longer repayment period; and
   •   Ensure that late payments during the 90-day period are not considered in any future
       premium calculations at any time (i.e. applicable late payments should not be counted for
       any rating, pricing, tiering attributes, etc.).

       This grace period is intended to be applied to all installment payments, including renewal
down payments, provided that the insured provides notice to the insurer that the insured wishes to
continue coverage. It is not intended to change the terms of the issued policy or be considered a
forgiveness of the premium. Rather, it is intended that the insurer grant the policyholder an
extended grace period for the payment of premium due without penalty or interest.

       Insurers are further directed to, in addition to posting information on their website, provide
each policyholder with an easily readable written description of the terms of the extended grace
period offered pursuant to this guidance, which shall be submitted to the Department through the
System for Electronic Rates and Forms Filing (“SERFF”) as an informational filing.
        In addition, to eliminate the need for in person payment methods, in order to protect the
safety of workers and customers, all agents, brokers, and other licensees who accept premium
payments on behalf of insurers must take steps to ensure that customers able to make payments
have the ability to make prompt insurance payments through alternate methods of payment, such
as online payments.

      Please note that this position may be revised or extended at any time in the discretion of
the Commissioner.

April 10, 2020
Date                                                                 Marlene Caride
                                                                     Commissioner
Jd PC Ins Prem Grace Pd Bul/COVID 19
                                                 2


Guidance Concerning Circumstances Related to the COVID-19 Pandemic (Small Employer Market)

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                              MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-12
 TO:             ALL HEALTH CARRIERS, DENTAL SERVICE CORPORATIONS, AND
                 DENTAL PLAN ORGANIZATIONS ISSUING STANDARD SMALL
                 EMPLOYER HEALTH AND DENTAL BENEFITS PLANS IN THIS STATE
                 AND ALL LICENSED BROKERS SELLING STANDARD SMALL
                 EMPLOYER HEALTH AND DENTAL BENEFITS PLANS IN THIS STATE

 FROM:           MARLENE CARIDE, COMMISSIONER
 RE:             GUIDANCE CONCERNING CIRCUMSTANCES RELATED TO THE
                 COVID-19 PANDEMIC (SMALL EMPLOYER MARKET)

        On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Executive Order No. 103 to contain the spread of the
 Coronavirus (“COVID-19”) pandemic and, on April 7, 2020, issued Executive Order No. 119
 (“EO 103” and “EO 119”) declaring that the Public Health Emergency declared in Executive Order
 No. 103 continues to exist. The Governor subsequently issued Executive Order 104 on March 16,
 2020 which required some businesses to close, followed by Executive Order 107 on March 21,
 2020 which required all non-essential employees to stay home.

         Thus, many small businesses have closed and/or substantially reduced the hours and
 services they offer. For a variety of reasons associated with the pandemic, many employees
 currently covered under small employer health and dental benefits plans are being laid off,
 furloughed and are thus not actively at work, or given reduced work hours. The health coverage
 of employees no longer working is in jeopardy. The renewal of group policies of employers whose
 plans are under review prior to renewal may be threatened.

         On April 9, 2020, Governor Murphy also issued Executive Order No. 123 (“EO 123”). EO
 123 directed carriers to refrain from cancelling any policy or contract for nonpayment for a period
 of time, to exercise appropriate forbearances on collection documentation, to amortize any unpaid
 payments, and to refrain from seeking recoupment of any unpaid claims paid during the emergency
 grace period. The Department of Banking and Insurance (“Department”) is issuing this Bulletin
 to provide required guidance to all to health carriers, dental service corporations, and dental plan
 organizations (carriers) issuing small employer health and dental benefits plans in this State as
 well as brokers selling such plans regarding circumstances related to the COVID-19 pandemic.
 The following guidance is effective immediately and continues for the duration of the state of

                                        Visit us on the Web at dobi.nj.gov
            New Jersey is an Equal Opportunity Employer • Printed on Recycled Paper and Recyclable
emergency and public health emergency declared pursuant to EO 103 and EO 119. The
Department will continue to review this guidance during the duration of EO 119 to ensure
consumers receive the intended relief.

         Small Employer: Refers to an employer who employed an average of at least 1 but not
more than 50 employees on business days during the preceding calendar year and who employs
at least 1 employee on the first day of the plan year.

Guidance Related to the COVID-19 Pandemic

2020 Renewals
Carriers must deem all small employers that have group plans with anniversary dates occurring
during the month of March through the end of the state of emergency period as eligible for
renewal.
Carriers must rescind the termination notices that may already have been sent to small employers
for small employer health benefits plans with anniversary dates occurring during the month of
March and through the end of the state of emergency period. Those small employers shall be
deemed eligible.
If a group wishes to terminate its small employer health benefits plan(s), the small employer
must submit a written termination letter to the carrier prior to the renewal date.
Carriers must delay renewal reviews as may be necessary during the state of emergency.

2021 Renewal Review
The employees of an inforce group are reviewed annually prior to renewal with the renewal review
starting about 150 days prior to renewal. That review looks at the number of employees on
business days in the preceding calendar year. For many businesses in New Jersey, the period of
time encompassed within the state of emergency did not constitute normal business days.
Therefore, when groups are renewing in 2021 and the business days in 2020 are reviewed, the
State of Emergency period must be excluded from review.

Waiting Period
A small employer that lays off one or more employees may seek to re-hire those employees once
business resumes operations. Carriers must waive any applicable waiting period that would apply
to employees who were laid off after March 1, 2020 and again become full time employees eligible
for health insurance under the small employer’s policy.

Actively at Work or Active Work Requirement
Since the Health Insurance Portability and Accountability Act (HIPAA), the active work
requirement has not applied when absence from work is due to health status-related factors.
“Health status” is one such factor. When a temporary lay-off or furlough is the result of a
government declaration of a public health emergency requiring small employer businesses to close
or substantially reduce hours, and non-essential employees are directed to stay home generally to
mitigate the spread of a virus and the consequent health effects of it, then it is reasonable to

                                                2
determine failure to be actively at work under these circumstances is due to health status and is
thus a health status related factor under HIPAA.

Carriers may consider the public health emergency as health status. Thus, employees who are
furloughed or temporarily laid off during this public health emergency are not required to be found
ineligible due to not being actively at work. Employers who continue to cover furloughed or
temporarily laid-off employees must remit the required premium for such coverage to the carrier.

Full -Time Requirement
Carriers must relax the full-time requirement to allow continued employee coverage for employees
whose hours have been reduced. The reduced hour requirements would apply only to employees
who are currently covered and whose hours have been reduced. By relaxing the full-time
requirements, the employee may remain covered under the group policy without having to elect
COBRA.

Extended Grace Period
Carriers shall make available an emergency 60-day grace period to any small employer that
requests it.

The grace period may be initially applied towards the April or May premium as the policyholder
determines and will continue for 60 calendar days from that date. During this emergency grace
period, a carrier shall not terminate that policy for nonpayment of premium. Coverage must remain
in force and claims must be paid and may not be pended.

If a carrier has already provided a policyholder with a legally required grace period for April 2020
premiums, the time period for which a grace period has already been granted shall be applied
toward the emergency grace period. This 60-day grace period shall only apply to policyholders
that were in good standing with their insurance carrier on March 1, 2020 and shall only apply to
premiums due after the initial premium has been made to secure coverage.

After the 60-day emergency grace period, a policyholder must be offered the option of amortizing
any unpaid premium over the remaining months of the policy, but for not less than six months.
For example, if six months are remaining on the policy, the policyholder must be given the option
to pay the unpaid premium in six installments in addition to the regular monthly premium. If less
than three months remain on the policy, the carrier must allow at least six months for the deferred
premium to be paid.

Carriers are directed that they are not to seek recoupment from any policyholder for any claims
incurred during this emergency grace period. Carriers shall not report late payments to credit
reporting agencies, consistent with this guidance, for policyholders taking advantage of COVID-
19-related relief.

Carriers are further directed to, in addition to posting information on the carrier’s website, provide
each small employer policyholder with an easily readable written description of the terms of the
extended grace period offered pursuant to this guidance. Carriers must also report to the
Department the manner in which they will comply with this bulletin concurrent with those changes
                                                  3
taking effect. All carrier changes must be uniformly applied to all small employer health benefits
plans to which the changes would be applicable. Carriers are directed to file this information with
the Department’s Office of Life and Health at lifehealth@dobi.nj.gov.

April 10, 2020
Date                                                        Marlene Caride
                                                            Commissioner

Small Employer Bulletin/COVID-19

                                                4
                                   STATE OF NEW JERSEY
                      DEPARTMENT OF BANKING AND INSURANCE
                             NOTICE OF RULE MODIFICATION
   PURSUANT TO EXECUTIVE ORDER NO. 103 (MURPHY)(MARCH 9, 2020) AND
                  EXECUTIVE ORDER NO. 123 (MURPHY)(APRIL 9, 2020)
                             COVID-19 STATE OF EMERGENCY

Temporary Rule Modification adopted by Marlene Caride, Commissioner, Department of Banking
and Insurance

Date: April 10, 2020
Authority: N.J.S.A. App.A:9-45 & App. A:9-47; Exec. Order No. 103 (March 9, 2020) ___ N.J.R.
___ (“EO 103”); Exec. Order No. 123 (April 9, 2020) ___ N.J.R. ___ (“EO 123”)
Effective Date: April 10, 2020
Expiration Date: Concurrent with end of EO 103
          This is an emergency adoption of a temporary rule modification of the Department’s
Insurance rules at N.J.A.C. 11:21-7.11, N.J.A.C. 11:21-7.5, N.J.A.C. 11:21-7.6, N.J.A.C. 11:21-
6.2, and N.J.A.C. 11:21-1.2. Section 6 of EO 103, issued in response to the COVID-19 pandemic,
authorizes agency heads to waive/suspend/modify any existing rule, where the enforcement of the
rule would be detrimental to the public welfare during the emergency, notwithstanding the
provisions of the Administrative Procedure Act or any law to the contrary. Further, Section 5 of
EO 123 authorizes the Commissioner of the Department of Banking and Insurance to take all
appropriate steps to effectuate EO 123. Pursuant to that authority, and with the approval of the
Governor and in consultation with the State Director of Emergency Management and the
Commissioner of the Department of Health, the Department of Banking and Insurance
(“Department”) is modifying certain rules as follows:
          In order to provide relief to insureds with health coverage under small employer health
benefits plans designed by the Small Employer Health Benefits (“SEH”) Program, so that their
policies are not cancelled for nonpayment of premium, the Department is taking the following
action:

                                                 5
       N.J.A.C. 11:21-7.11 states a carrier may discontinue a health benefits plan if the
policyholder does not meet the minimum participation and contribution requirements. These
requirements are modified as it relates 2020 renewals, as all carriers must keep small employers
that have group plans with anniversary dates occurring during the month of March until the end of
the state emergency period, as eligible for renewal. Further, carriers must rescind termination
notices that may already have been sent to small employers for small employer health benefits
plans with anniversary dates occurring during the month of March and through the end of the state
of emergency period. Those small employers shall be deemed eligible. If a group wishes to
terminate its small employer health benefits plan(s), the small employer must submit a written
termination letter to the carrier prior to the renewal date. Carriers must delay renewal reviews as
may be necessary during the state of emergency.
       Further, N.J.A.C. 11:21-7.5 requires a minimum participation of 75 percent of full-time
employees under a small employer’s health benefits plan for purposes of eligibility of coverage
and N.J.A.C. 11:21-7.6 requires a small employer carrier shall not require a minimum small
employer contribution of more than 10 percent of the annual cost of the small employer’s health
benefits plan. As carriers must keep all small employers with anniversary dates occurring during
the month of March until the end of the state emergency period as eligible, these requirements are
being relaxed.
       In addition, employees of an inforce group are reviewed annually pursuant to N.J.A.C.
11:21-6.2. The review looks at the number of employees on business days in the preceding
calendar year. For many businesses in New Jersey, the period of time encompassed within the
state of emergency did not constitute normal business days. Therefore, when groups are renewing
in 2021 and the business days in 2020 are reviewed, the state of emergency period must be
excluded from review.
       N.J.A.C. 11:21-1.2 defines “full time employee” as an employee who works 25 hours per
week. This requirement is modified as it relates to employees who are currently covered under
SEH plan whose hours have been reduced so that these employees may remain covered under the
group policy without having to elect continuation of benefits.

                                                6
       I find that modification of the rules above is necessary because enforcement of the existing
rules would be detrimental to the public welfare during this emergency.

April 10, 2020
Date                                                                Marlene Caride
                                                                    Commissioner

AR Small Employer Notice of Modification/COVID

                                                 7


No Action Position Regarding Potential Disruptions Due to COVID-19

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                                 MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-09
 TO:             ALL LICENSED NEW JERSEY REAL ESTATE LICENSEES, SCHOOL
                 DIRECTORS, INSTRUCTORS, AND OTHER INTERESTED PARTIES

 FROM:           MARLENE CARIDE, COMMISSIONER

 RE:             NO ACTION POSITION REGARDING POTENTIAL DISRUPTIONS DUE
                 TO COVID-19

 On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency to contain the spread of COVID-19. As Governor Murphy has stated, “The State of
 New Jersey is committed to deploying every available resource, across all levels of government,
 to help respond to the spread of COVID-19 and keep our residents informed.”

 Due to the heightened concern regarding the outbreak of the respiratory disease COVID-19, the
 Department of Banking and Insurance (“Department”) encourages you to continue to meet the
 needs of your clients while recognizing the potential impact of COVID-19 on the operations of
 many real estate brokerages, schools, and licensees. We recognize the potential impact of COVID-
 19 on the employees and operations of many real estate brokerages and will provide appropriate
 regulatory assistance to affected institutions subject to our supervision.

 EDUCATION

 The Department recognizes that real estate schools may need to close in response to orders issued
 by the Department of Health, or due to real estate classes taught in a public school, college,
 university, or other public building that may have been closed or inaccessible during the state of
 emergency and public health emergency. While Exec. Order No. 103 (March 9, 2020) ___ N.J.R.
 ___(“EO 103”) is active, real estate prelicensure courses may be taught in an on-line format, such
 as in a webinar, a virtual classroom, or by video conferencing. Persons seeking to teach these
 courses online should direct questions by email to Gwendolyn Cobb, Supervisor of Licensing and
 Education, at Gwendolyn.Cobb@dobi.nj.gov. Courses must still meet the regulatory requirements
 regarding length and subject matter.

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LICENSURE TEST

In the normal course, applicants must pass the licensure test within one year of passing a
prelicensure course. While EO 103 is in effect, the Department will evaluate any applications for
licensure where the applicant passed the licensure test after one year of passing the prelicensure
course. As part of that process, the Department may request the submission of additional
documents and undertakings by the requesting applicant or related parties.

LICENSURE APPLICATION

In the normal course, applications for licensure must be submitted within one year following the
date an individual passes the real estate prelicensure course. While EO 103 is in effect, the
Department will evaluate any applications for licensure that are submitted after one year of passing
the real estate prelicensure course. As part of that process, the Department may request the
submission of additional documents and undertakings by the requesting applicant or related
parties.

This position may be revised or extended at any time at the discretion of the Commissioner and
does not constitute a statutory or regulatory exemption from the educational requirement for
licensure.

We will continue to process applications and respond to your requests. Effective immediately
and until further notice, all notices, inquiries, and correspondence, must be submitted
electronically by email, to the appropriate contacts listed below, rather than by courier,
overnight, mail or fax.

All submissions and inquiries should be directed by e-mail to relic@dobi.nj.gov with copy to:

Gwendolyn Cobb, Supervisor of Licensing and Education, 609-292-7272 or 609-940-7373
Gwendolyn.Cobb@dobi.nj.gov

For other inquiries:
Aurelio Romero, Executive Director of Real Estate, 609-940-7474
Aurelio.Romero@dobi.nj.gov

3/30/20
Date                                                                 Marlene Caride
                                                                     Commissioner

Jd Covid19 RE/Covid 19
                                                 2
                                    STATE OF NEW JERSEY
                      DEPARTMENT OF BANKING AND INSURANCE
                                NOTICE OF RULE SUSPENSION
      PURSUANT TO EXECUTIVE ORDER NO. 103 (MURPHY)(MARCH 9, 2020)
                              COVID-19 STATE OF EMERGENCY

Temporary Rule Suspension adopted by Marlene Caride, Department of Banking and Insurance
Date: March 30, 2020
Authority: N.J.S.A. App.A:9-45 & App. A:9-47; Exec. Order No. 103 (March 9, 2020) ___ N.J.R.
___(“EO 103”)
Effective Date: March 30, 2020
Expiration Date: Concurrent with end of EO 103
This is an emergency adoption of a temporary rule suspension of the Department’s Real Estate
rules at N.J.A.C. 11:5-2.2(f), N.J.A.C. 11:5-3.6(c), and N.J.A.C. 11:5-3.8(e). Section 6 of EO 103,
issued in response to the COVID-19 pandemic, authorizes agency heads to waive/suspend/modify
any existing rule, where the enforcement of the rule would be detrimental to the public welfare
during the emergency, notwithstanding the provisions of the Administrative Procedure Act or any
law to the contrary. Pursuant to that authority, and with the approval of the Governor and in
consultation with the State Director of Emergency Management and the Commissioner of the
Department of Health, Department of Banking and Insurance is suspending certain rules as
follows:
In order to facilitate social distancing and other virus mitigation strategies in real estate offices and
schools, licensed under the N.J.S.A. 45:15-1 et seq., the Department is taking the following action:
N.J.A.C. 11:5-2.2(f) requiring that every licensed school maintain a bona fide office open to the
public during normal business hours for the purpose of assisting former and current students and
meet certain other requirements to adequately serve their students is suspended, so that real estate
schools may be able to operate online, if the building where the school is held either closed or is
otherwise inaccessible for a reason related to COVID-19. Persons seeking to teach these courses
online should direct questions by email to Gwendolyn Cobb, Supervisor of Licensing and
Education at Gwendolyn.Cobb@dobi.nj.gov. Courses must still meet the regulatory requirements
regarding length and subject matter.

N.J.A.C. 11:5-3.6(c) requiring that salespersons and referral agents pass the examination and apply
for a license not later than one year after the date of successful completion of a prelicensure course
is suspended. The Department will evaluate any applications for licensure where the applicant
passed the examination after one year of passing the prelicensure course or where the applicant
applies for licensure after one year of passing the prelicensure course.
Similarly, N.J.A.C. 11:5-3.8(e), requiring that an applicant for a real estate broker or broker-
salesperson license must pass the broker license examination and apply for a license as a broker or
broker-salesperson not later than one year after successful completion of prelicensure education
requirements is suspended. The Department will evaluate any applications for licensure where the
applicant passed the licensure examination after one year of passing the prelicensure course or
where the applicant applies for licensure after one year of passing the prelicensure course.

Please note that this Notice may be revised or extended at any time in the discretion of the
Commissioner and does not constitute a statutory or regulatory exemption from licensure.

I find that suspension of the rules above is necessary because enforcement of the existing rules
would be detrimental to the public welfare during this emergency.

3/30/20
Date                                                                Marlene Caride
                                                                    Commissioner

Jd COVID 19 Suspensions


90-Day Grace Period to Clients of Insurance Premium Finance Companies Due to the Disruption Caused by COVID-19 Bulletin 20-17 Frequently Asked Questions

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                                 MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-17

 TO:             ALL INSURANCE PREMIUM FINANCE COMPANIES, INSUREDS, AND
                 OTHER INTERESTED PARTIES

 FROM:           MARLENE CARIDE, COMMISSIONER

 RE:             90-DAY GRACE PERIOD TO CLIENTS OF INSURANCE PREMIUM
                 FINANCE COMPANIES DUE TO THE DISRUPTION CAUSED BY
                 COVID-19

         On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Exec. Order No. 103 (March 21, 2020) ___ N.J.R. ___ (“EO
 103”) to contain the spread of the Coronavirus (“COVID-19”) pandemic. Governor Murphy later
 directed New Jersey residents to remain in their homes unless leaving was essential through the
 issuance of Exec. Order No. 107 (March 21, 2020) ___ N.J.R. ___ (“EO 107”). These Executive
 Orders were issued to contain the spread of the COVID-19 pandemic. On April 9, 2020, Governor
 Murphy Issued Exec. Order No. 123 __ N.J.R. __ (“EO 123”). EO 123 directed insurance
 premium finance companies to refrain from cancelling any policy or contract for nonpayment for
 a period of time as directed by the Commissioner of the Department of Banking and Insurance
 (“Commissioner”), to exercise appropriate forbearances on collection documentation, amortizing
 any unpaid payments over the remainder of the policy term or a period of up to 12 months, as
 appropriate, as directed by the Commissioner, and to refrain from seeking recoupment of paid
 claims during the emergency grace period. The Department of Banking and Insurance
 (“Department”) is issuing this Bulletin to direct all insurance premium finance companies licensed
 pursuant to N.J.S.A. 17:16D-1 to -16 (“Insurance Premium Finance Company Act”) to extend a
 grace period for the payment of premiums to their clients as set forth herein.

         Since the outbreak of the respiratory disease COVID-19, individuals and businesses in the
 State of New Jersey have been negatively impacted in a variety of ways. For example, small
 businesses in the travel, entertainment, hospitality, and food service industries, have been
 adversely impacted by significant drops in business activities resulting, for some entities, in
 dramatic declines in revenue. Employees of these industries will be impacted, which may include
 the failure to be paid their regular salary or receive reimbursements when normally due. This, in
 turn, can adversely affect the ability of these individuals or businesses to make payments for
 obligations, such as insurance coverage, when due.

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         Currently, an insurance premium finance company may cancel an insurance contract for
failure to pay premium upon not less than 10 days’ notice. In response to the disruption caused by
COVID-19, all licensed insurance premium finance companies are directed to provide their clients
who are experiencing a financial hardship due to COVID-19 with a 90-day grace period to pay for
their insurance premiums so that insurance policies are not cancelled for nonpayment of premium
during this challenging time due to circumstances beyond the control of the insured. A
policyholder may elect this 90-day emergency grace period to begin retroactively on April 1, 2020
or opt for the grace period to begin on May 1, 2020. During this extended grace period, insurance
premium finance companies shall not cancel any insurance policy for nonpayment of installment
payments for the term of the insurance policy.

       Insurance premium finance companies are also directed to:

       •       Waive late payment fees, finance charges, and delinquency charges otherwise due,
               and not report late payments to credit rating agencies, during the 90-day period;
       •       Allow premiums due but not paid during the 90-day period to be paid over either
               12 months or the remainder of the current policy term, whichever is longer, except
               that a premium finance company may provide a longer repayment period; and
       •       Ensure that late payments during the 90-day period are not considered in any future
               premium calculations at any time.

         The extended grace periods described above shall apply to policyholders that were in good
standing with their insurance carrier on March 1, 2020. This grace period is intended to be applied
to all installment payments, including renewal down payments, provided that the insured provides
notice to the insurer that the insured wishes to continue coverage. If renewal is due during the
term of the grace period, the contract can be renewed with the same terms with client approval,
even if the client has not paid the installment during the grace period. The grace period is not
intended to change the terms of the issued policy or be considered a forgiveness of installment
payments. Rather, it is directed that the insurance premium finance company grant COVID-19
impacted clients an extended grace period for the payment of installments due without penalty or
interest.

       Insurance premium finance companies are further directed to, in addition to posting
information on the its website, provide each policyholder with an easily readable written
description of the terms of the extended grace period offered pursuant to this guidance, which shall
be submitted to the Department at bliconline@dobi.nj.gov as an informational filing.

        In addition, to eliminate the need for in person payment methods, in order to protect the
safety of workers and customers, all agents, brokers, and other licensees who accept premium
payments on behalf of insurers must take steps to ensure that customers able to make payments
have the ability to make prompt insurance payments through alternate methods of payment, such
as online payments.

                                                 2
       The Department will monitor events as they develop to determine if this emergency grace
period must be extended.

April 10, 2020
Date                                                             Marlene Caride
                                                                 Commissioner

Jd prem fin co grace pd Bul/COVID 19

                                              3


90-Day Grace Period for Life Insurance Premium Payments Due to the Disruption Caused by COVID-19

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                                 MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-16

 TO:             ALL INSURERS AUTHORIZED OR ADMITTED TO TRANSACT LIFE
                 INSURANCE IN NEW JERSEY, LICENSED INSURANCE PRODUCERS,
                 INSUREDS, AND OTHER INTERESTED PARTIES

 FROM:           MARLENE CARIDE, COMMISSIONER

 RE:             90-DAY GRACE PERIOD FOR LIFE INSURANCE PREMIUM
                 PAYMENTS DUE TO THE DISRUPTION CAUSED BY COVID-19

          On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Exec. Order No. 103 (March 21, 2020) ___ N.J.R. ___ (“EO
 103”) to contain the spread of the Coronavirus (“COVID-19”) pandemic. Governor Murphy later
 directed New Jersey residents to remain in their homes unless leaving was essential through the
 issuance of Exec. Order No. 107 (March 21, 2020) ___ N.J.R. ___ (“EO 107”). These Executive
 Orders were issued to contain the spread of the COVID-19 pandemic. On April 9, 2020, Governor
 Murphy Issued Exec. Order No. 123 __ N.J.R. __ (“EO 123”). EO 123 directed insurance
 companies to refrain from cancelling any policy or contract for nonpayment for a period of time
 as directed by the Commissioner of the Department of Banking and Insurance (“Commissioner”);
 to exercise appropriate forbearances on collection documentation; to amortize any unpaid
 payments over the remainder of the policy term or a period of up to 12 months, as appropriate, as
 directed by the Commissioner; and to refrain from seeking recoupment of any unpaid claims paid
 during the emergency grace period. The Department of Banking and Insurance (“Department”) is
 issuing this Bulletin to direct all life carriers to extend a grace period for the payment of premiums
 to their insureds as set forth herein.
         Since the outbreak of the respiratory disease COVID-19, individuals and businesses in the
 State of New Jersey have been negatively impacted in a variety of ways. For example, small
 businesses in the travel, entertainment, hospitality, and food service industries, have been
 adversely impacted by significant drops in business activities resulting, for some entities, in
 dramatic declines in revenue. Employees of these industries will be impacted, which may include
 the failure to be paid their regular salary or receive reimbursements when normally due. This, in
 turn, can adversely affect the ability of these individuals or businesses to make payments for
 obligations, such as insurance coverage, when due.
        Currently, traditional life insurance policies include a grace period of not less than 30 days,
 and in certain circumstances for account value life insurance policies not less than 60 days. In

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response to the disruption caused by COVID-19, the Department is directing all licensed life
insurers to provide their policyholders or certificate holders who may be experiencing a financial
hardship due to COVID-19 with at least a 90-day grace period to pay life insurance and annuity
contracts premiums so that insurance policies or contracts are not cancelled for nonpayment of
premium during this challenging time due to circumstances beyond the control of the insured. A
policyholder may elect this 90-day emergency grace period to begin retroactively on April 1, 2020
or opt for the grace period to begin on May 1, 2020. During this extended grace period, life
insurance companies cannot cancel any insurance policy for nonpayment of premium.
        Insurers are directed to:
    •     Waive late payment fees otherwise due, including any interest permitted pursuant to
          N.J.S.A.17B:25-3, and not report late payments to credit rating agencies, during the 90-
          day period;
    •     Allow premiums due but not paid during the 90-day period to be paid over the course of
          the following year in up to 12 equal installments, except that an insurer may permit a longer
          repayment period; and
    •     Extend to 90 days the period to exercise policyholder and contract holder rights and
          benefits under life insurance and annuity contracts.
        The extended grace periods described above shall apply to policyholders that were in good
standing with their insurance carrier on March 1, 2020. This grace period is intended to be applied
to premiums due after the initial premium has been made to secure coverage. It is not intended to
change the terms of the issued policy or contract or be considered a forgiveness of the premium.
Rather, it is intended that the insurer grant the policyholder or certificate holder an extended grace
period for the payment of premium due without penalty or interest.
       Insurers are further directed to, in addition to posting information on their website, provide
each policyholder with an easily readable written description of the terms of the extended grace
period offered pursuant to this guidance, which shall be submitted to the Department through the
System for Electronic Rates and Forms Filing (“SERFF”) as an informational filing.
        In addition, to eliminate the need for in person payment methods, in order to protect the
safety of workers and customers, all agents, brokers, and other licensees who accept premium
payments on behalf of insurers must take steps to ensure that customers able to make payments
have the ability to make prompt insurance payments through alternate methods of payment, such
as online payments.
       The Department will monitor events as they develop to determine if this emergency grace
period must be extended.

April 10, 2020
Date                                                                    Marlene Caride
                                                                        Commissioner

Jd Life ins prem grace pd Bulletin/COVID 19
                                                    2


Response to COVID-19 (Medicare Supplement)

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                              MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-14

 TO:             ALL   HEALTH   INSURANCE     COMPANIES   AND  HEALTH
                 MAINTENANCE     ORGANIZATIONS,    ISSUING    MEDICARE
                 SUPPLEMENT PLANS IN THIS STATE

 FROM:           MARLENE CARIDE, COMMISSIONER

 RE:             RESPONSE TO COVID-19 (MEDICARE SUPPLEMENT)

          On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Executive Order No. 103 to contain the spread of the
 Coronavirus (“COVID-19”) pandemic and, on April 7, 2020, issued Executive Order No. 119
 (“EO 103” and “EO 119”) declaring that the Public Health Emergency declared in Executive Order
 No. 103 continues to exist. The Governor subsequently issued Executive Order 104 on March 16,
 2020, which required some businesses to close, followed by Executive Order 107 on March 21,
 2020, which required all non-essential employees to stay home. Thus, many businesses have
 closed and/or substantially reduced the hours and services they offer. For a variety of reasons
 associated with the pandemic, many individuals covered under Medicare Supplement plans may
 experience difficulty paying premiums on a timely basis thereby jeopardizing maintenance of this
 critical coverage for these individuals.

         On April 9, 2020, Governor Murphy also issued Executive Order No. 123 (“EO 123”). EO
 123 directed carriers to refrain from cancelling any policy or contract for nonpayment for a period
 of time, to exercise appropriate forbearances on collection documentation, to amortize any unpaid
 payments, and to refrain from seeking recoupment of any unpaid claims paid during the emergency
 grace period. The purpose of this Bulletin is to provide guidance to all health insurance companies
 and health maintenance organizations issuing Medicare Supplement plans in this State
 (collectively “carriers”) as the State responds to the Coronavirus Disease 2019 (“COVID-19”)
 outbreak.

         Medicare supplement plans provide a 31-day grace period consistent with New Jersey law
 at N.J.S.A. 17B:26-6 which governs individual Medicare Supplement plans and N.J.S.A. 17B:27-
 37 which governs group Medicare Supplement plans. In the case of a 31-day grace period, the
 policyholder has 31 days from the due date in which to pay the premiums. While the state of
 emergency is in effect, the Department of Banking and Insurance is directing carriers to provide a
 60-day grace period during which Medicare Supplement plans may not be terminated for
 nonpayment of premium.

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       The grace period may be initially applied towards the April or May premium as the
policyholder determines and will continue for 60 calendar days from that date. During this
emergency grace period, a carrier shall not terminate that policy for nonpayment of premium.
Coverage must remain in force and claims must be paid and may not be pended.

       If a carrier has already provided a policyholder with a legally required grace period for
April 2020 premiums, the time period for which a grace period has already been granted shall be
applied toward the emergency grace period. This 60-day grace period shall only apply to
policyholders that were in good standing with their insurance carrier on March 1, 2020 and shall
only apply to premiums due after the initial premium has been made to secure coverage.

        After the 60-day emergency grace period, a policyholder must be offered the option of
amortizing any unpaid premium over the remaining months of the policy, but for not less than six
months. For example, if six months are remaining on the policy, the policyholder must be given
the option to pay the unpaid premium in six installments in addition to the regular monthly
premium. If less than six months remain on the policy, the carrier must allow at least six months
for the deferred premium to be paid.

        Carriers are directed that they are not to seek recoupment from any policyholder for any
claims incurred during this emergency grace period. Carriers are further directed to, in addition to
posting information on the carrier’s website, provide each policyholder with an easily readable
written description of the terms of the extended grace period offered pursuant to this guidance,
which shall be submitted to the Department through the System for Electronic Rates and Forms
Filing (“SERFF”) as an informational filing.

       The Department will continue to review this guidance during the duration of EO 103 and
EO 119 to ensure policyholders receive the intended relief. If you have any questions, please
contact the Department’s Office of Life and Health Unit at lifehealth@dobi.nj.gov.

April 10, 2020
Date                                                         Marlene Caride
                                                             Commissioner

Medicare Supplement COVID 19/COVID-19

                                                 2


Guidance Concerning Circumstances Related to the COVID-19 Pandemic (Large Employer Market)

State of New Jersey
                               DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                         OFFICE OF THE COMMISSIONER
 Governor                                      PO BOX 325
                                          TRENTON, NJ 08625-0325                           MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                TEL (609) 292-7272
 Lt. Governor

                                      BULLETIN NO. 20-13
 TO:            ALL HEALTH CARRIERS, DENTAL SERVICE CORPORATIONS AND
                DENTAL BENEFITS ORGANIZATIONS ISSUING EMPLOYER HEALTH
                AND DENTAL BENEFITS PLANS TO LARGE GROUP EMPLOYERS
                (51+) IN THIS STATE AND ALL LICENSED BROKERS SELLING LARGE
                GROUP HEALTH AND DENTAL BENEFITS PLANS IN THIS STATE

 FROM:          MARLENE CARIDE, COMMISSIONER
 RE:            GUIDANCE CONCERNING CIRCUMSTANCES RELATED TO THE
                COVID-19 PANDEMIC (LARGE EMPLOYER MARKET)

         On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Executive Order No. 103 to contain the spread of the
 Coronavirus (“COVID-19”) pandemic and, on April 7, 2020, issued Executive Order No. 119
 (“EO 103” and “EO 119”) declaring that the Public Health Emergency declared in Executive Order
 No. 103 continues to exist. On April 9, 2020, Governor Murphy also issued Executive Order No.
 123 (“EO 123”). EO 123 directed carriers to refrain from cancelling any policy or contract for
 nonpayment for a period of time, to exercise appropriate forbearances on collection
 documentation, to amortize any unpaid payments, and to refrain from seeking recoupment of any
 unpaid claims paid during the emergency grace period. The Department of Banking and Insurance
 (“Department”) is issuing this Bulletin to provide guidance to all health carriers, dental service
 corporations and dental benefits organizations (“carriers”) issuing large group employer health
 benefits plans in this State as well as brokers selling such plans regarding circumstances related to
 the COVID-19 pandemic.

        The following guidance is effective immediately and continues for the duration of the state
 of emergency and public health emergency declared pursuant to EO 103 and EO 119. The
 Department will continue to review this guidance during the duration of EO 103 and EO 119 to
 ensure policyholders receive the intended relief.

 Circumstances Related to the COVID-19 Pandemic

        As required by Executive Order Nos. 104 and 107, many businesses have been required to
 close. Others are operating with reduced hours and/or reduced services. Many of the businesses
 are considered large employers, with 51 or more employees. For a variety of reasons associated
 with the pandemic, many employees currently covered by a large employer health benefits plan
are being laid off, furloughed or given reduced work hours. The health coverage of employees no
longer working full-time is in jeopardy. The renewal of group policies of employers whose plans
are under review for renewal may be threatened.

       Carriers currently evaluating large group renewals occurring later this year will need to
consider one or more of the following provisions.

Guidance Related to COVID-19

Participation
As a result of furlough, lay-off or reduced hours, some employees may elect COBRA. Some laid-
off employees may elect individual coverage through the Marketplace where they qualify for a
subsidy. Employers may fail the participation requirement with the result being non-renewal of
the large group policy.

Guidance: Carriers must deem all employers that have policies with anniversary dates occurring
during the month of March through the end of the state of emergency period as eligible for renewal.
Carriers must rescind termination notices that may already have been sent to employers with
anniversary dates occurring during the month of March and through the end of the state of
emergency period. Those employers shall be deemed eligible. If a group wishes to terminate its
policy the employer must submit a written termination letter to the carrier prior to the renewal
date. Carriers must delay renewal reviews as may be necessary during the state of emergency.

Full-Time
Some employees are working fewer hours per week than the hours required for full-time as stated
in the group policy or contract and thus they are ineligible to be covered as employees.

Guidance: Carriers may relax the full-time requirement to allow continued employee coverage.
By relaxing the full-time requirements, the employee may remain covered under the group policy
without having to elect COBRA.

Waiting Period
An employer that lays off one or more employees may seek to re-hire those employees once
business resumes operations. Since the employees were terminated from employment, they would
be subject to the applicable waiting period.

Guidance: Carriers are required to waive any applicable waiting period that would apply to
employees who were previously laid off as a result of the pandemic and again become full time
employees eligible for health insurance under the employer’s plan.

Grace Period
Carriers shall make available an emergency 60-day grace period to any policyholder that has been
financially or physically impacted by COVID-19. Also, carriers must provide the emergency grace
period to any large employer that provides the carrier with an attestation from a senior financial
officer or certified public accountant attesting to the employer’s financial hardship caused by
COVID-19. The attestation shall only require the employer to indicate that as a result of COVID-
19 it is experiencing a financial hardship, therefore making it difficult to pay its premium

                                                2
payments. Carriers may also make the emergency grace period available to any other large
employer in the carrier’s discretion.

The grace period may be initially applied towards the April or May premium as the policyholder
determines and will continue for 60 calendar days from that date. During this emergency grace
period, a carrier shall not terminate that policy for nonpayment of premium. Coverage must remain
in force and claims must be paid and may not be pended.

If a carrier has already provided a policyholder with a legally required grace period for April 2020
premiums, the time period for which a grace period has already been granted shall be applied
toward the emergency grace period. If coverage has been terminated due to nonpayment of
premium after April 1, 2020, coverage must be reinstated for the term of the applicable emergency
grace period. This 60-day grace period shall only apply to policyholders that were in good standing
with their insurance carrier on March 1, 2020 and shall only apply to premiums due after the initial
premium has been made to secure coverage.

After the 60-day emergency grace period, a policyholder must be offered the option of amortizing
any unpaid premium over the remaining months of the calendar year. For example, if six months
are remaining in the calendar year, the policyholder must be given the option to pay the unpaid
premium in six installments in addition to the regular monthly premium. If only three months
remain on the policy, but 6 months remain in the calendar year, the carrier must allow the
policyholder the option to pay the unpaid premium in six installments in addition to the regular
monthly premium.

Carriers are directed that they are not to seek recoupment from any policyholder for any claims
incurred during this emergency grace period. Carriers shall not report late payments to credit
reporting agencies, consistent with this guidance, for policyholders taking advantage of COVID-
19-related relief.

Carriers are further directed to, in addition to posting information on the carrier’s website, provide
each large employer policyholder with an easily readable written description of the terms of the
extended grace period offered pursuant to this guidance, which shall be submitted as an
informational filing to the Department. The above guidance provides carriers with certain areas
of flexibility. Carriers are directed to advise the Department of the actions the carrier is taking.
Said information is to be submitted to the Department through the System for Electronic Rates and
Forms Filing (“SERFF”) as an informational filing.

April 10, 2020
Date                                                          Marlene Caride
                                                              Commissioner

COVID-19 Bulletin Large Employer/COVID-19

                                                  3


Guidance Concerning Circumstances Related to the COVID-19 Pandemic (Individual Market)

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                              MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-11
 TO:             ALL HEALTH CARRIERS, DENTAL SERVICE CORPORATIONS, AND
                 DENTAL BENEFITS ORGANIZATIONS ISSUING STANDARD
                 INDIVIDUAL HEALTH AND DENTAL BENEFITS PLANS IN THIS
                 STATE AND ALL LICENSED BROKERS SELLING STANDARD
                 INDIVIDUAL HEALTH AND DENTAL BENEFITS PLANS IN THIS
                 STATE

 FROM:           MARLENE CARIDE, COMMISSIONER
 RE:             GUIDANCE CONCERNING CIRCUMSTANCES RELATED TO THE
                 COVID-19 PANDEMIC (INDIVIDUAL MARKET)

        On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Executive Order No. 103 to contain the spread of the
 Coronavirus (“COVID-19”) pandemic and, on April 7, 2020, issued Executive Order No. 119
 (“EO 103” and “EO 119”) declaring that the Public Health Emergency declared in Executive Order
 No. 103 continues to exist. The Governor subsequently issued Executive Order 104 on March 16,
 2020 which required some businesses to close, followed by Executive Order 107 on March 21,
 2020 which required all non-essential employees to stay home.

         Thus, many businesses have closed and/or substantially reduced the hours and services
 they offer. For a variety of reasons associated with the pandemic, many persons currently covered
 under individual health benefits plans are struggling to pay premiums for their individual plans.

         On April 9, 2020, Governor Murphy also issued Executive Order No. 123 (“EO 123”). EO
 123 directed carriers to refrain from cancelling any policy or contract for nonpayment for a period
 of time, to exercise appropriate forbearances on collection documentation, to amortize any unpaid
 payments, and to refrain from seeking recoupment of any unpaid claims paid during the emergency
 grace period. The Department of Banking and Insurance (“Department”) is issuing this Bulletin
 to provide required guidance to health carriers, dental service corporations and dental benefits
 organizations (“carriers”) to remove possible barriers to coverage and accommodate their covered
 lives given the circumstances related to the COVID-19 pandemic. The following guidance is
 effective immediately and continues for the duration of the state of emergency and public health
 emergency declared pursuant to EO 103 and EO 119. The Department will continue to review this
 guidance during the duration of EO 119 to ensure consumers receive the intended relief.

                                        Visit us on the Web at dobi.nj.gov
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Emergency Grace Period Extension
       Currently, standard individual health benefits plans include a 31-day grace period, with the
grace period increased to 90 days when the individual policyholder is receiving advanced premium
tax credits (“APTC”). This bulletin requires an extension of these grace periods for each
circumstance as described below.

        With respect to individual market policyholders that do not receive APTC, the current 31-
day grace period must be extended to a period of at least 60 calendar days. During this period, a
carrier may not terminate a policy for nonpayment of premium. A policyholder may elect this
emergency grace period to begin retroactively on April 1, 2020 or opt for the grace period to begin
on May 1, 2020. During this extended grace period, coverage must remain in force and claims
may not be pended.

        With respect to individual market policyholders that receive APTCs, currently the federally
required grace period is 90 days. If a policyholder fails to timely make payments, issuers must
pay all appropriate claims for services rendered to the policyholder during the first month of the
three-month grace period and may pend claims for services rendered to the enrollee in the second
and third months. The Centers for Medicare and Medicaid Services (CMS) recently issued
guidance1 related to the COVID-19 emergency, which permits carriers to delay this 90-day grace
period for one or more months if premiums are not paid. Therefore, the Department is requiring
carriers to provide a one-month delay of initiation of the 90-day grace period for any policyholders
that have missed a premium payment. The one-month delay may begin retroactively on April 1,
2020 or may begin on May 1, 2020 as the policyholder determines. During this one-month delay,
carriers must pay claims. After the one-month delay of the grace period, the currently required
90-day grace period will begin, as provided under federal guidance.

         The extended grace periods described above shall apply to policyholders that were in good
standing with their insurance carrier on March 1, 2020 and shall apply to premiums due after the
initial premium has been made to secure coverage.

        After the extended grace period, policyholders must be offered the option of amortizing
any unpaid premium over the remaining months of the policy. For example, if 6 months are
remaining on the policy, the policyholder must be given the option to pay the unpaid premium in
6 installments in addition to the regular monthly premium.

        Carriers are directed that they are not to seek recoupment from policyholders for the cost
of claims incurred during this extended grace period. Carriers shall not report late payments to
credit reporting agencies, consistent with this guidance, for policyholders taking advantage of
COVID-19-related relief. Carriers are further directed to, in addition to posting information on the
carrier’s website, provide each policyholder with an easily readable written description of the
terms of the extended grace period offered pursuant to this guidance, which shall be submitted as
an informational filing to the Department at lifehealth@dobi.nj.gov.

1
    https://www.cms.gov/files/document/faqs-payment-and-grace-period-covid-19.pdf
                                                 2
       The Department will monitor events as they develop to determine if this emergency grace
period must be extended.

Recognition of a Triggering Event

        Triggering events are events that allow for a special enrollment period. There are a variety
of impacts associated with COVID-19 that will cause a triggering event, including a change in
location, a loss of minimum essential coverage, including a loss of employer sponsored coverage
or losing coverage you have through a family member. For example, due to the impacts of social
distancing and the closing of many businesses, many individuals may lose employer sponsored
coverage or coverage they have as a dependent through a family member who has lost coverage.

       Additionally, as a result of the State of Emergency, many colleges and universities have
prohibited students from living on campus. Therefore, many students have returned to a parent or
home in New Jersey. Some of these students had health care coverage, whether individual
coverage or otherwise, while they attended school and their coverage either ended or is not
accessible, effectively terminating upon the student’s move from campus.

        As such, carriers are encouraged to review all possible triggering events to determine if an
SEP is available to provide access to coverage for impacted individuals. Carriers are reminded
that the loss of coverage the student had or the student’s move from campus are triggering events
such that the student may have a 60-day special enrollment period following the date the student’s
coverage ended or the campus directed students to leave, during which to purchase an individual
policy or be added as a dependent to a parent’s existing individual policy.

       All carrier changes must be uniformly applied to all individual health benefits plans to
which the changes would be applicable. Questions may be directed to the Department’s Office of
Life and Health at lifehealth@dobi.nj.gov.

April 10, 2020
Date                                                         Marlene Caride
                                                             Commissioner

COVID-19 Individual Bulletin/COVID-19

                                                 3


Extended Transition for Certain Health Insurance Policies

State of New Jersey
                                  DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                            OFFICE OF THE COMMISSIONER
 Governor                                          PO BOX 325
                                              TRENTON, NJ 08625-0325                                MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                     TEL (609) 292-7272
 Lt. Governor

                                          BULLETIN NO. 20-10

 TO:              ALL NEW JERSEY HEALTH INSURANCE COMPANIES; HOSPITAL
                  SERVICE CORPORATIONS; MEDICAL SERVICE CORPORATIONS;
                  HEALTH SERVICE CORPORATIONS; HEALTH MAINTENANCE
                  ORGANIZATIONS; DENTAL SERVICE CORPORATIONS; DENTAL
                  PLAN ORGANIZATIONS;  PREPAID   PRESCRIPTION  SERVICE
                  ORGANIZATIONS; ORGANIZED DELIVERY SYSTEMS; AND OTHER
                  INTERESTED PARTIES

 FROM:            MARLENE CARIDE, COMMISSIONER

 RE:              EXTENDED TRANSITION FOR CERTAIN HEALTH INSURANCE
                  POLICIES

         The purpose of this Bulletin is to advise health plans, health care providers and all other
 interested parties that the Department of Banking and Insurance (“the Department”) will permit
 carriers to extend policies as outlined in the January 31, 2020 memorandum from Director Randy
 Pate of the Center for Consumer Information and Insurance Oversight. The Department extends
 the transitional policy for the full period outlined in the memorandum.
         The      January      31,     2020       memorandum        is      available                       at
 https://www.cms.gov/files/document/extension-limited-non-enforcement-policy-through-
 calendar-year-2021.pdf

         4/6/20
 Date                                                          Marlene Caride
                                                               Commissioner

 LC 2020 Extended Transition Bulletin/Bulletins

                                       Visit us on the Web at dobi.nj.gov
           New Jersey is an Equal Opportunity Employer • Printed on Recycled Paper and Recyclable


Extension of Mortgage Servicer License Application and RMLA-Licensed Mortgage Servicer Registration Deadlines

State of New Jersey
                                 DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                           OFFICE OF THE COMMISSIONER
 Governor                                         PO BOX 325
                                             TRENTON, NJ 08625-0325                                 MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                   TEL (609) 633-7667
 Lt. Governor

                                         BULLETIN NO. 20-18

 TO:            ALL NEW JERSEY STATE CHARTERED BANKS, SAVINGS BANKS,
                SAVINGS AND LOAN ASSOCIATIONS, CREDIT UNIONS, NEW JERSEY
                LICENSED   RESIDENTAL   MORTGAGE     LENDERS,   LICENSED
                CORRESPONDENT RESIDENTIAL MORTGAGE LENDERS, LICENSED
                RESIDENTIAL MORTGAGE BROKERS AND OTHER INTERESTED
                PARTIES

 FROM:          MARLENE CARIDE, COMMISSIONER

 RE:            EXTENSION OF MORTGAGE SERVICER LICENSE APPLICATION AND
                RMLA-LICENSED MORTGAGE SERVICER REGISTRATION DEADLINES

        The purpose of this Bulletin is to provide guidance to various entities regulated by the New
 Jersey Department of Banking and Insurance (the “Department”), which are being affected by the
 global Coronavirus (“COVID-19”) pandemic. The Department recognizes the impact of COVID-
 19 on the operations of many financial institutions and is taking steps to facilitate flexibility, as
 appropriate, in connection with certain regulatory timeframes. Accordingly, the Department is
 extending the deadline for license and registration applications under the Mortgage Servicers
 Licensing Act, N.J.S.A. 17:16F-27 to -46 (the “Act”), as described below.
         On December 23, 2019 the Department issued Bulletin No.19-13, regarding licensing and
 registration under the Act. The Act requires non-exempt entities that are in the business of
 servicing residential mortgage loans, and which are not already licensed as residential mortgage
 lenders, to become licensed through the Department. N.J.S.A. 17:16F-29(a). The Department is
 also requiring that entities licensed as residential mortgage lenders or correspondent residential
 mortgage lenders, pursuant to the New Jersey Residential Mortgage Lending Act, N.J.S.A.
 17:11C-51 to -89 (collectively, “RMLA- licensed mortgage servicers”), to register with the
 Department if they conduct mortgage servicing business in New Jersey. Through Bulletin No.19-
 13, the Department set the deadline for the submission of both mortgage servicer license
 applications and RMLA-licensed mortgage servicer registration applications for April 13, 2020.
        In order to facilitate flexibility to address the resource constraints and operational
 challenges caused by the COVID-19 public health emergency, the Department is extending the
 application deadline for mortgage servicer licenses and RMLA-licensed mortgage servicer
 registration by sixty (60) days, to June 12, 2020.

                                       Visit us on the Web at dobi.nj.gov
           New Jersey is an Equal Opportunity Employer • Printed on Recycled Paper and Recyclable
For all inquiries related to the Act or to this Bulletin, please contact:

   •   Howard Wegener, Office of Consumer Finance, howard.wegener@dobi.nj.gov, (609) 940-
       7460
   •   Daniel Schuster, Office of Consumer Finance, daniel.schuster@dobi.nj.gov, (609) 940-
       7459

       The Department will continue to monitor this situation and issue further communications
by bulletin or on its website, www.dobi.nj.gov, as deemed appropriate.

April 23, 2020
Date                                                        Marlene Caride
                                                            Commissioner

JR COVID-19 MSLA App Extension Bulletin/COVID-19

                                                2


Use of Telemedicine and Telehealth to Respond to the COVID-19 Pandemic

State of New Jersey
                               DEPARTMENT OF BANKING AND INSURANCE
PHIL MURPHY                         OFFICE OF THE COMMISSIONER
 Governor                                       PO BOX 325
                                           TRENTON, NJ 08625-0325                           MARLENE CARIDE
                                                                                Commissioner
SHEILA OLIVER                                 TEL (609) 292-7272
 Lt. Governor

                                       BULLETIN NO. 20-07
 TO:            ALL HEALTH INSURANCE COMPANIES, HEALTH MAINTENANCE
                ORGANIZATIONS, HEALTH SERVICE CORPORATIONS AND ANY
                OTHER ENTITY ISSUING HEALTH BENEFITS PLANS IN THIS STATE

 FROM:          MARLENE CARIDE, COMMISSIONER
 RE:            USE OF TELEMEDICINE AND TELEHEALTH TO RESPOND TO THE
                COVID-19 PANDEMIC

         On March 9, 2020, Governor Phil Murphy declared a state of emergency and public health
 emergency through the issuance of Executive Order No. 103 (“EO 103”) to contain the spread of
 the Coronavirus (“COVID-19”) pandemic. The Department of Banking and Insurance
 (“Department”) is issuing this Bulletin to provide guidance to all health insurance companies,
 health maintenance organizations, health service corporations and other entities issuing health
 benefits plans in this State (collectively “carriers”) regarding the use of telemedicine and telehealth
 to respond to the COVID-19 pandemic.

         Except as explained below, the terms telemedicine and telehealth are defined as set forth
 in P.L. 2017, c. 117.

         Effective immediately and continuing for the duration of the state of emergency and public
 health emergency declared pursuant to EO 103, the Department is requiring that carriers:

     •   review their telemedicine and telehealth networks to ensure adequacy, given the apparent
         increased demand, as well as grant any requested in-plan exceptions for individuals to
         access out-of-network telehealth providers if network telehealth providers are not
         available, including, but not limited to, mental health and behavioral health providers,
         physical therapists, occupational therapists, and speech therapists, and any other health
         providers capable and authorized to provide telehealth or telemedicine services pursuant to
         State law or other State-issued guidance;

     •   cover, without cost-sharing (i.e., copayments, deductibles, or coinsurance), any healthcare
         services or supplies delivered or obtained via telemedicine or telehealth as required by P.L.
         2020, c. 7;
    •   encourage their network providers to utilize telemedicine or telehealth services wherever
        possible and clinically appropriate in order to minimize exposure of provider staff and other
        patients to those who may have the COVID-19 virus;

    •   update their policies to include reimbursement for telehealth services that are provided by
        a provider in any manner that is practicable, including, if appropriate, and clinically
        appropriate, by telephone. Carriers should disseminate information on their website, or
        other reasonable means, to notify individuals of these updates. This would include the use
        of telephone-only communications to establish a physician-patient relationship and the
        expanded use of telehealth for the diagnosis, treatment, ordering of tests, and prescribing
        for all conditions. Carriers are required to update telehealth policies to include telephone-
        only services within the definition of telehealth;

    •   reimburse providers that deliver covered services to members via telemedicine or telehealth
        in accordance with P.L. 2020, c.3, and this guidance. Carriers may establish requirements
        for such telemedicine and/or telehealth services, in accordance with P.L. 2020, c.3, and
        guidance issued by the Department, including documentation and recordkeeping, but such
        requirements may not be more restrictive than those for in-person services. Carriers are
        not permitted to impose any specific requirements on the technologies used to deliver
        telemedicine and/or telehealth services (including any limitations on audio-only or live
        video technologies) during the state of emergency and public health emergency declared
        pursuant to EO 103;

    •   ensure that the rates of payment to in-network providers for services delivered via
        telemedicine or telehealth are not lower than the rates of payment established by the carrier
        for services delivered via traditional (i.e., in-person) methods, and carriers must notify
        providers of any instructions that are necessary to facilitate billing for such telehealth
        services.

    •   may not impose any restriction on the reimbursement for telehealth or telemedicine that
        requires that the provider who is delivering the services be licensed in a particular state, so
        long as the provider is in compliance with P.L. 2020, c.3 and c.4 and this guidance; and

    •   may not impose prior authorization requirements on medically-necessary treatment that is
        delivered via telemedicine or telehealth.
        If you have any questions, please contact the Department’s Office of Life and Health at
lifehealth@dobi.nj.gov.

        3/22/20
Date                                                           Marlene Caride
                                                               Commissioner

AV COVID-19 Telemedicine and Telehealth Bulletin

                                                   2