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| Montana Administrative Register Notice 24-29-339 | No. 24 12/21/2018 | |
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BEFORE THE DEPARTMENT OF LABOR AND INDUSTRY OF THE STATE OF MONTANA
TO: All Concerned Persons
1. On August 10, 2018, the Department of Labor and Industry (department) published MAR Notice No. 24-29-339 pertaining to the public hearing on the proposed adoption, amendment, and repeal of the above-stated rules at page 1506 of the 2018 Montana Administrative Register, Issue Number 15.
2. The department held a public hearing in Helena on August 31, 2018, at which members of the public commented on the proposed rule actions. Written comments were also submitted to the department during the public comment period.
3. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:
Comment 1: A commenter asked for clarification on ARM 24.29.956, the administrative fund and safety assessment rule, as to whether the premium surcharge rate calculation is reported as "direct written premium," "net written premium," or some other premium amount.
Response 1: The department will use "direct premium earned" to calculate the surcharge for assessment purposes and has amended the rule accordingly. The department reserves the right to reconcile data submitted to it by insurers with data submitted by insurers to the Insurance Commissioner.
Comment 2: One commenter stated with respect to the medical benefits reopening rules, ARM 24.29.3103(3), ARM 24.29.3107(5)(a), ARM 24.29.3117(3), and ARM 24.29.3124(4), the references to the reopening period as inevitably being two years are not consistent with the provisions of 39-71-717(8), MCA, and exceed the department's statutory rulemaking authority.
Response 2: The department agrees with the point made that reopening is not inevitably for a two-year period, and therefore has amended the rules accordingly.
4. The department has adopted New Rule I (24.29.963) and New Rule II (24.29.221) as proposed.
5. The department has amended ARM 24.29.609, 24.29.616, 24.29.703, 24.29.902, 24.29.929, 24.29.971, 24.29.1801, 24.29.1821, and 24.29.2614 as proposed.
6. The department has amended the following rules as proposed, but with the following changes from the original proposal, new matter underlined, deleted matter interlined:
24.29.956 COMPUTATION AND COLLECTION OF THE ADMINISTRATION FUND AND SAFETY FUND ASSESSMENT PREMIUM SURCHARGE RATE FOR PLAN NO. 2 AND NO. 3 (1) remains as proposed. (a) In calculating the total administration fund and safety fund assessment premium surcharge rate, the department will use previous calendar year direct premium earned data reported to the department by plan No. 2 insurers and the plan No. 3 insurer. (b) through (6) remain as proposed.
AUTH: 39-71-203, 50-71-114, MCA IMP: 39-71-201, 39-71-203, 39-71-2352, 50-71-128, MCA
24.29.3103 DEFINITIONS Terms defined in 39-71-116, MCA, are used in subchapter 31 as they are defined by statute. As used in subchapter 31, the following definitions apply unless the context clearly indicates otherwise: (1) and (2) remain as proposed. (3) "Approved" means that after the medical review has been performed, medical benefits are reopened for not more than two years before being subject to a biennial review. (4) through (22) remain as proposed.
AUTH: 39-71-203, MCA IMP: 39-71-116, 39-71-717, MCA
24.29.3107 TIMELINES AND EXPLANATION OF STATUS CLASSIFICATIONS OF A PETITION (1) through (4) remain as proposed. (5) Once filed, the parties have 14 days to submit medical records and additional information to be considered during the medical review. Once the medical review is completed and the report is issued by the medical director, the petition will have one of the two following status conditions: (a) the petition is approved, with a recommendation in the report that medical benefits should be provided by the insurer for not more than two years before being subject to a biennial review; or (b) through (7) remain as proposed.
AUTH: 39-71-203, MCA IMP: 39-71-717, MCA
24.29.3117 JOINT PETITION FOR REOPENING (1) and (2) remain as proposed. (3) Because the parties agree on the need for reopening medical benefits, the department's medical director will summarily review and approve the petition, reopening medical benefits for not more than two years before being subject to a biennial review. (4) remains as proposed.
AUTH: 39-71-203, MCA IMP: 39-71-717, MCA
24.29.3124 REVIEW BY MEDICAL REVIEW PANEL - REPORT AND RECOMMENDATIONS (1) through (3) remain as proposed. (4) If a panel member concludes that additional medical benefits are necessary, the medical benefits should be provided for not more than two years before being subject to a biennial review. The analysis must include the reasons and rationale that explain: (a) through (6) remain as proposed.
AUTH: 39-71-203, MCA IMP: 39-71-717, MCA
7. The department has repealed ARM 24.29.966, 24.29.1425, 24.29.1426, 24.29.1427, 24.29.1428, 24.29.1430, 24.29.1431, 24.29.1511, 24.29.1519, 24.29.1521, 24.29.1531, 24.29.1532, 24.29.1536, 24.29.1537, 24.29.1541, 24.29.1551, 24.29.1561, 24.29.1566, 24.29.1571, 24.29.1572, 24.29.1573, 24.29.1574, 24.29.1575, 24.29.1581, 24.29.1582, 24.29.1583, 24.29.1584, 24.29.1585, 24.29.1586, 24.29.1702, 24.29.1721, 24.29.1722, 24.29.1727, 24.29.1731, 24.29.1733, 24.29.1735, and 24.29.1737 as proposed.
8. The department advises all interested persons that the adoption notice for MAR Notice No. 24-29-340 appears elsewhere in this issue of the Montana Administrative Register. MAR Notice No. 24-29-340 proposed to amend ARM 24.29.1401A, Definitions, which was also proposed for amendment in this present rule action. Because some of the proposed changes in ARM 24.29.1401A are inconsistently proposed as between the two MAR Notices, the department has decided not to amend ARM 24.29.1401A, Definitions, as proposed in MAR Notice No. 24-29-339. ARM 24.29.1401A is being amended as shown in the adoption notice for MAR Notice. No. 24-29-340.
9. The department advises all interested persons the above rule changes are effective January 1, 2019.
Certified to the Secretary of State December 11, 2018.
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