Keeping up with Compliance Just Got Easier

The information provided here in no way constitutes legal advice. It is provided solely for informational purposes. You should consult your own legal counsel to determine the extent to which individual state laws apply to your activities.

• The DOI has interpreted the law to require DMPOs to have direct contracts with participating providers. This means that DMPOs cannot utilize provider networks in Alaska; rather, DMPOs must directly manage any panel that offers services in the product configuration.

• No unique statutes or interpretations. Please refer to Compliance Universals.

• The DOI has interpreted the law to require private label marketers and co-branding marketers to be licensed as MDPs.
• Bundled products must be sold by a CT licensed, insurance appointed producer.
• Marketers performing telephonic sales (outbound) must attain an actual signed member application before receiving any monies
• Careington will electronically block enrollment in this state until all requirements have been met by the marketer (i.e., proof of license).

• Prior to marketing, must file and get OIR approval of rates and materials used in enrollment (applications, websites, phone scripts, etc.). Must also file a description of the marketing process.
• OIR approval process can take sixty days
• All bundled products will be reviewed on a case by case basis. Bundled products must have the insurance piece and the discount piece filed and approved separately before they can be offered to consumers.
• Charges for discount healthcare products over $30.00 per month and or $360 per year require OIR prior approval, except that prior approval is not required for a discount plan that (i) costs no more than $50 per month, (ii) includes physician, dental, vision, chiropractic and podiatric discounts and (iii) does not offer hospital discounts.
• Any processing fee that exceeds $30 must be refunded if a membership is canceled within the first 30 days.
• Careington will electronically block enrollment in this state until all requirements have been met by the marketer (i.e., approval of filings).

• No unique statutes or interpretations. Please refer to Compliance Universals.

• No unique statutes or interpretations. Please refer to Compliance Universals.

• The DOI has interpreted the law to require marketers not selling Careington labeled products to register as PPAs (form can be supplied by Careington). This includes Private label or Co-Branded materials.
• Careington will electronically block enrollment in this state until all requirements have been met by the marketer (i.e., proof of registration).

• The DOI has interpreted the law to require marketers not selling Careington labeled products to register. This includes Private label or Co-Branded materials.

• Suppliers of discount programs must maintain a surety bond of $50,000.
  • Careington’s interpretation is that it is supplying the program to private label marketers.
  • The Attorney General has enforced the surety bond requirement in some cases against private label marketers.
• Marketers performing telephonic sales (outbound) must attain an actual signed member application before receiving any monies.
• Must provide members within seven calendar days after purchase with a list of their closest 25 providers for each service.

• No unique statutes or interpretations. Please refer to Compliance Universals.

• Hospital discounts are not permitted in this state. As such, members will not have access to hospital products in Maryland.
• As of October 1, 2007, all marketers must be added to a list of authorized marketers maintained and supplied to the DOI by Careington.
• If the plan has a prescription drug benefit, it must include the disclaimer THIS IS NOT A MEDICARE PRESCRIPTION DRUG PLAN along with THIS IS NOT INSURANCE.
• If an advertisement or brochure refers to hospital services, it must state that hospital discounts are not offered in Maryland.

• No unique statutes or interpretations. Please refer to Compliance Universals.

• Prescription discounts cannot be offered in the state unless the DMPO pays a portion of the discount given by the pharmacy.

• All advertisements must include website address where prospective members can access a current list of participating providers.

• At this time, Careington is not actively marketing in this state.

• Marketers not selling Careington labeled products must register with the state (form is available from Careington).
• Bundling is not allowed unless discount product is free to consumer.
• Careington will electronically block enrollment in this state until all requirements have been met by the marketer (i.e., proof of registration).

• Marketers selling a prescription discount program that is not a Careington labeled product must register with the state (form is available from Careington).
• Careington will electronically block enrollment in this state until all requirements have been met by the marketer (i.e., proof of registration if marketing a plan with prescription discounts).

• No unique statutes or interpretations. Please refer to Compliance Universals.

• The State regulates discount buying clubs (i.e. Sam’s or Costco).
• Statute requires a $50,000 surety bond for an entity to sell in the state.
  • Careington’s interpretation is that DMPOs and their marketers are not subject to discount buying club regulations.
  • The Attorney General has sought to enforce the discount buying club statute in some cases against discount programs.

• Any processing fee that exceeds $50 must be refunded if a membership is canceled within the first 30 days.

• Any processing fee that exceeds $30 must be refunded if a membership is canceled within the first 30 days.
• If a discount program is bundled with any other product, must either send the member a written list of charges for the discount program, or reimburse all periodic charges (including charges for the non-bundled product) if a member cancels within the first 30 days.

• All marketers must be added to a quarterly list of marketers maintained and supplied to the State by Careington.
• Forms cannot contain any condition requiring construction according to the laws of another state.
• CHA has asked the DOI whether the Oklahoma rule prohibiting DMPOs from offering insurance policies as "inducements" works to prohibit bundling in the State.

• All private label marketers must be added to the list of marketers maintained and supplied to the State by Careington.

• All marketers must be added to the list of marketers maintained and supplied to the State by Careington.
• One-time or short-term promotions may be offered only if limiting terms are as prominent as the special offer.

• Any processing fee that exceeds $25.00 must be refunded if a membership is canceled within the first 30 days.
• Must receive signed member contracts prior to receiving any payment, unless the consumer pays by credit card or enrolls over the telephone.

• Plans with prescription drug discounts must provide prospective members, prior to enrollment, a complete description of all fees that could be assessed, including any enrollment or processing fees, as well as the estimated average savings.
• Plans with prescription drug discounts must refund all fees, including processing fees, if a member cancels in the first thirty days.

• All marketers must be added to a list of marketers maintained and supplied to the State by Careington.
• If the plan includes a prescription drug benefit, the discount card must include the name or logo of the entity administering that benefit, the entity’s ANSI identification number, the group number applicable to the member, and a telephone number applicable to the discount prescription benefit.
• Cannot offer a "free" trial membership unless you disclose, in close proximity to the offer, (i) any obligation to purchase the program; (ii) any obligation to cancel the membership or take another affirmative action to avoid incurring payment obligations, (iii) the manner in which a cancellation request can be submitted; (iv) the number and amount of payments that may be required and the circumstances under which additional payments may be required; and (v) any conditions, limitations, or restrictions on the ability of the member to use or cancel the trial membership.
• One-time enrollment fee cannot exceed $60.
• Cannot advertise price ranges where the uppermost part of the range can only be achieved by a few members.

• A new rule requires private label marketers that sell discount products from more than one DMPO (a discount aggregator) to be licensed as their own DMPO. However, the DOI has indicated that it plans to reopen that rulemaking. It is unclear whether discount aggregators must be licensed at this time.
• Bundled products must be sold by a UT appointed, licensed, insurance producer.
• If the discount plan is bundled with another product (e.g., insurance) that can be purchased separately, the member must be provided with a written itemization of the fees.
• All marketing materials and advertisements must be filed with the DOI prior to use.

• At this time, Careington is not marketing in this state.

• Members will not have access to hospital products in West Virginia as hospital discounts are not allowed in the state.

If you have any questions about compliance, please contact
Erin Tillery at (800) 441-0380 ext. 2831.

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Careington International Corporation
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