AZ| The Arizona Department of Insurance Regulatory Bulletin 2025-05 summarizes major legislative changes affecting Arizona’s insurance and financial institutions for laws effective in 2025. Below is a summary highlighting each main law change category. These highlights capture the principal regulatory changes introduced by Arizona’s legislative session impacting insurers, financial institutions, healthcare providers, and related stakeholders in 2025:
- Insurance & Pharmacy Benefits
- Pharmacy benefits managers (PBMs) are restricted from limiting or changing coverage for patients on ongoing prescriptions within a plan year and must provide advance notification for formulary changes. There are provisions for formulary exception requests and detailed denial requirements, effective for contracts renewed after December 31, 2025.
- Surprise billing requirements are refined to clarify when dispute resolution rights notices are needed.
- Health insurers adopting NAIC Life Insurance Illustrations Model Regulation will no longer be required to provide standard policy summaries for those policies.
- Organ transplant coverage may be restricted if organs are sourced from China or Hong Kong.
- Annual reporting for homeowners insurance policies in fire-risk areas; creation of a Fire Insurance Review Task Force.
- Autism behavioral therapy annual maximums eliminated for children 16 and younger; redefinition of autism spectrum disorder.
- Financial Institutions & Escrow
- Escrow agents may only use funds according to explicit loan or settlement terms.
- The Uniform Special Deposits Act (S.B. 1206) establishes requirements for special bank deposits, including termination, payment, and amendment guidelines.
- Office of the Auditor General is granted access to financial institution records for official duties and these institutions are not liable for disclosures made to the OAG.
- Workers’ Compensation
- Dependent allowance for temporary total disability increased from $25 to $100 monthly for certain claims.
- New rules for schedule of provider fees and definitions related to service and interested parties.
- Provider & Insurance Administration
- Health insurers must speed up provider credentialing (60 days for processing, 30 days for billing system integration) and outline new claim submission/payment rules, effective April 1, 2026.
- Medical directors must personally review and exercise medical judgment on prior authorization denials, effective July 1, 2026.
- Clarifies rules for administrative hearings, including peremptory changes of judge and conflict of interest motions.
- Cryptocurrency and Fraud
- Cryptocurrency kiosk operators must provide clear disclosures, physical receipts, use blockchain analytics for fraud prevention, set transaction caps, offer live customer support, and promptly refund fraud-induced transactions. Attorney General is assigned enforcement.
- Consumer Protection and Reporting
- Public records requests require affirmation of noncommercial use or disclosure if for commercial use.
- Insurers must accept electronic communications and submissions for motor vehicle insurance claims and respond within 10 business days.
- Licensing and Compliance
- Adjusts licensing renewal dates and late fee rules for lenders, escrow agents, and sales finance companies.
- Continues the Department of Insurance and Financial Institutions until July 1, 2033.
- Captive Insurers
- Dormant captive insurers can apply for dormancy certification, maintain requirements for minimum capital, and surrender under specific conditions. Cell captive minimum capital is reduced.
- Other Categories
- Prohibition on insurance, title, or escrow agents’ liability for certain real property transfers involving foreign adversary ownership.
- Establishment of Arizona Rare Disease Advisory Council and a state committee for maternal mental health in rural communities, requiring distribution of educational materials.
- New procedures for life care contract refunds, electronic vehicle title documentation, and several miscellaneous regulatory and administrative clarifications.