Our experience covers each phase of our clients’ business, as demonstrated by these representative examples:

Market Conduct Examinations and Self-Audits

• Assisted multiple insurance companies with respect to market conduct examinations across the United States, including a national long-term care insurer with respect to several market conduct examinations by various states. Represented a health insurer during a national multi-state examination. Engaged to conduct attorney/client privileged audits for clients, including reviewing a health insurer’s sales and marketing materials on a national basis.

Application of Insurance Laws

• Analyzed the possible application of state insurance laws for various entities such as warranty companies, pharmacy benefit managers (PBMs), preferred provider organizations (PPOs), and health care organizations forming clinically integrated networks (CINs) or accountable care organizations (ACOs).

Entity Formation and Licensure

• Filed formation and licensure applications for insurers and HMOs and UCAA licensure expansion applications, including the formation and licensure of a Delaware Series LLC captive insurance program and a Kansas domestic P&C insurer. Licensed numerous third party administrators (TPAs), adjusters, insurance agencies, discount medical plan organizations (DMPOs), and preferred provider organizations (PPO) on a national basis.

Acquisitions

• Represented many entities acquiring insurers and insurance-regulated entities, including numerous agencies; represented a United Kingdom-based company on entering the American insurance market that purchased a life and health company and a property and casualty company, involving the drafting of definitive documents, obtaining the necessary approvals through Form A filings, and electronically filing the UCAA and licensure expansions.

National Legal Analysis

• Researched and analyzed critical compliance issues on a national basis, such as electronic transaction of insurance laws, payment of premiums by automatic credit card debits, ACA issues, and referral fee requirements. Updated a national health insurer’s database to include all state health insurance mandated benefits laws and considered extraterritorial jurisdiction.

Financial Analysis

• Our Financial Analysis practice worked with various entities with respect to financial examinations and insolvency issues. Utilized our knowledge of statutory accounting principles to assist an HMO with weak FAST ratios under aggressive surveillance by its domestic insurance department.

Loss Portfolio Transfer; Sale of Company; Exit from Market

• Assisted clients with exiting the insurance market through the reinsurance of all business, the sale of a regulated entity and the nonrenewal of a block of business. Drafted and filed amendatory endorsements and conducted national nonrenewal for a health insurance company.