NOTICE - Filing Guidance for Changes to MIB, Inc. Authorization Forms

To: All Sickness and Accident Insurance Carriers

The Medical Information Bureau (MIB, Inc) has issued a requirement for its member companies to amend their authorization forms to add the following language:

“I authorize [Company Name] or its reinsurer to make a brief report of my personal [protected] health information to MIB, Inc. [or MIB, or Medical Information Bureau]” This language must be added to all authorization forms beginning January 1, 2013.

The Nebraska Department of Insurance (NDOI) has determined that any form revised solely to comply with the language in the MIB, Inc. requirement is not required to be submitted to the Department for review and approval. NDOI will review the notices on a going forward basis upon each new revision to the forms to ensure that the required language has been incorporated accordingly.

Any questions regarding this notice should be directed to the Life and Health Administrator at (402) 471-2201.