Banking and Insurance Enforces Affordable Care Act
For Immediate Release
July 30, 2014
For More Information Contact:
Shawna K. Richards, Director of Communications
Ph: (340) 773-6459 ext. 3129
Division of Banking and Insurance Enforces Compliance with Affordable Care Act
Lieutenant Governor Gregory R. Francis announced today that the Division of Banking and Insurance has taken steps to ensure that insurance providers writing new health insurance policies throughout the territory are in compliance with the applicable provisions of the Affordable Care Act (ACA). On July 22, 2014, the Division issued a bulletin to all agents, brokers, agencies and insurers transacting health insurance advising them of their responsibility to issue policies that are compliant with the Affordable Care Act.
Issuance of the bulletin resulted from complaints received by the Division about insurers in the territory that have continued to write new individual and small group non-compliant plans. In accordance with ACA, as of January 1, 2014, insurers can no longer issue individual and small group health policies that do not include the ACA requirements of ten essential health benefits. Any request for existing policies to be grandfathered were to be submitted to Department of Health and Human Services for their approval in 2010. Actions taken by President Obama in 2013 allowed for the State Departments of Insurance to waive ACA requirements for renewal of existing policies only, which enabled individuals to keep their old policies if they wanted. The Division allowed for this waiver, which does not apply to any insurer issuing new policies in the Virgin Islands. Accordingly, all new policies issued in the territory must offer the ten essential health benefits, which include coverage for children until age 26, wellness and preventive care and mental health services.
The Division will be auditing the records of health insurers and/or health agents suspected of acting in violation of the ACA and local and federal rules and regulations. Any licensee found to be transacting insurance business in violation of the law will be subject to enforcement actions which may include fines and/or suspension of the insurer and/or agent license. Brokers, agents and insurers are also advised that until further guidance is received from the Department of Health and Human Services regarding their July 16th letter, that they must continue to provide policies consistent with the requirements of ACA.
Bulletins issued by the Division are online at www.ltg.gov.vi. For more information, please contact the Division of Banking and Insurance at (340)774-7166.