2011-2012 DOI Rulemaking Activity
The following Department of Insurance pending rules became final and effective upon adjournment of the legislature, March 29, 2012:
IDAPA 18.01.05 - Health Carrier External Review. This rulemaking implements HB 131 & HB299 enacted in 2011 to conform Idaho’s external review law to the NAIC model law. The changes expand the types of claims eligible for external review to include denials based on appropriateness, health care setting, level of care and effectiveness. The changes also clarify the definition of an “urgent care request,” and permit a person to simultaneously file for internal and external review of an urgent care request in certain circumstances. In addition, self-funded ERISA health plans may opt into the state external review process if they do not wish to use the federal external review process. The rulemaking also includes changes to notices to be given by health carriers to covered persons. (This rulemaking was also a temporary rule that became effective June 1, 2011.)
IDAPA 18.01.46 - Recognition of New Mortality Tables for Use in Determining the Minimum Standard of Valuation for Annuities & Pure Endowment Contracts. The purpose of this rule is to supplement permitted mortality tables for use in determining the minimum standard of valuation for annuity and pure endowment contracts by life and annuity insurance companies operating in Idaho with the addition of two new tables: the 1994 Group Annuity Reserving (1994 GAR) Table and the Annuity 2000 Mortality Table.
IDAPA 18.01.50 - Adoption of International Fire Code. This rulemaking: 1) eliminates the potential of the adopted fire code to interfere with a government's ability to establish conditions of employment; 2) restores an exemption for placement of fire extinguishers for certain types of building uses; and 3) clarifies when fire sprinklers are required in a building selling upholstered furniture.