Licensing and State Admissions

Insurance Regulatory & Compliance Consultants, LLC has the experience and specialized knowledge to help navigate the complexities of securing state licenses or certificates of authority.  Such requirements often extend to include the coordination of multi-agency standards and can involve Uniform Certificate of Authority Application (UCAA) process for multi-state admissions.

IRCC will provide you with a checklist of state requirements, deadlines, and minimum standards applicable to your licensing needs as well as suggest best practice for securing timely approvals.  Whether filing for the first time or expanding your current business model, you can rely on our knowledge and expertise to assist your company.

Policy Drafting and Compliance

We can provide suggested product design elements meeting state specific regulatory requirements, providing content flexibility and reducing repeat compliance filings.  Depending on your specific needs, we will support your product portfolio whether in the development of new products, the modification of existing plan design or in the design of required language needed to meet regulatory compliance  standards. 

IRCC’s regulatory experience includes the following product areas:

• Accident and Health Products
• Managed care plans including HMO, Single Service HMO, and PPO products
• Property and Casualty products
• Association group products
• Discretionary group products
• Group trust products
• Individual and aggregate stop loss plans
• Supplemental products

Whether you need a new product developed, a compliance update on an existing line of business, or a general product review prior to filing, we can provide you with assurance that a state’s regulatory review standards have been met.

We can also assist in managing the ever-changing federal compliance landscape brought with the passage of the Patient Protection and Affordable Care Act (PPACA). Let us assist in designing specific solutions to your federal compliance needs.

specialized services

We provide your organization with research services needed to meet your compliance requirements, including:

• Extraterritoriality issues
• Discretionary group and association group research
•  Specific benefit and or state research

Provider Network and Contracting Services

Whether an individual provider, IPA, PHO or hospital health care system, we will help you with network licensure, administrative and provider services contract design, establishing concierge care programs or the development of direct contract self-funded benefit designs. 

We also provide solutions for providers experiencing non-contractual discount taking by intermediaries that attempt to tie health care services reimbursement to arbitrary discounted fee schedules or methodology.

We are committed to providing you with contract and network support to which you are entitled, both under contract and under law.