ALASKA STATE LEGISLATURE  SENATE LABOR AND COMMERCE STANDING COMMITTEE  April 14, 2016 1:35 p.m. MEMBERS PRESENT Senator Mia Costello, Chair Senator Cathy Giessel, Vice Chair Senator Kevin Meyer Senator Gary Stevens MEMBERS ABSENT  Senator Johnny Ellis COMMITTEE CALENDAR  HOUSE BILL NO. 290 "An Act extending the termination date of the Real Estate Commission; and providing for an effective date." - MOVED HB 290 OUT OF COMMITTEE COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 234(L&C) "An Act relating to insurance coverage for mental health benefits provided through telemedicine." - HEARD & HELD COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 372(L&C) AM "An Act relating to insurance; relating to the annual report by the director of policies and variable annuities; establishing limitations on issuance of long-term care insurance; relating to expenses for insurance examinations; relating to regulations for insurance; relating to requirements for group health insurance policies; amending the insurance utilization review, benefits determination, health care insurance grievance definition of 'group health insurance'; relating to motor vehicle service contracts; resolution procedures, independent review of adverse determinations or final adverse relating to notice requirements for meetings of stockholders or members of a domestic determinations, independent review organizations, and continuing education providers; insurer; establishing a definition of 'bona fide association'; relating to requirements and relating to required provisions for health care insurance contracts and policies, penalties for committing a fraudulent or criminal insurance act; updating criteria for including health care provider choice; establishing civil penalties for insurers for failure examinations; relating to rate filing deviations; establishing civil penalties for certain to provide requested records; amending the definition of 'wet marine and wilful violations; and providing for an effective date." transportation' insurance; amending provisions on limited licenses to include crop insurance; relating to third-party administrator notification requirements; relating to certification filing by reinsurance intermediary brokers; relating to rate filings, delivery of insurance policies or endorsements; relating to refunds of variable life insurance - HEARD & HELD HOUSE BILL NO. 125 "An Act relating to the sale of products containing dextromethorphan; relating to the regulation of dextromethorphan by municipalities; and providing for an effective date." - SCHEDULED BUT NOT HEARD COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 305(EDC) "An Act relating to the sale of products containing dextromethorphan; relating to the regulation of dextromethorphan by municipalities; and providing for an effective date." - SCHEDULED BUT NOT HEARD PREVIOUS COMMITTEE ACTION  BILL: HB 290 SHORT TITLE: EXTENDING THE REAL ESTATE COMMISSION SPONSOR(s): LABOR & COMMERCE 02/01/16 (H) READ THE FIRST TIME - REFERRALS 02/01/16 (H) L&C, FIN 03/30/16 (H) L&C AT 3:15 PM BARNES 124 03/30/16 (H) Moved HB 290 Out of Committee 03/30/16 (H) MINUTE(L&C) 03/31/16 (H) L&C RPT 2DP 5NR 03/31/16 (H) DP: HUGHES, OLSON 03/31/16 (H) NR: LEDOUX, TILTON, KITO, JOSEPHSON, COLVER 04/11/16 (H) FIN AT 8:30 AM HOUSE FINANCE 519 04/11/16 (H) -- MEETING CANCELED -- 04/11/16 (H) FIN AT 1:30 PM HOUSE FINANCE 519 04/11/16 (H) Moved HB 290 Out of Committee 04/11/16 (H) MINUTE(FIN) 04/12/16 (H) FIN RPT 3DP 5NR 1AM 04/12/16 (H) DP: SADDLER, MUNOZ, THOMPSON 04/12/16 (H) NR: PRUITT, WILSON, GUTTENBERG, GATTIS, EDGMON 04/12/16 (H) AM: KAWASAKI 04/12/16 (H) TRANSMITTED TO (S) 04/12/16 (H) VERSION: HB 290 04/13/16 (S) READ THE FIRST TIME - REFERRALS 04/13/16 (S) L&C, FIN 04/14/16 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) BILL: HB 234 SHORT TITLE: INSURANCE COVERAGE FOR TELEMEDICINE SPONSOR(s): REPRESENTATIVE(s) VAZQUEZ 01/19/16 (H) PREFILE RELEASED 1/8/16 01/19/16 (H) READ THE FIRST TIME - REFERRALS 01/19/16 (H) HSS, L&C 03/15/16 (H) HSS AT 3:00 PM CAPITOL 106 03/15/16 (H) Heard & Held 03/15/16 (H) MINUTE(HSS) 03/17/16 (H) HSS AT 3:00 PM CAPITOL 106 03/17/16 (H) Moved HB 234 Out of Committee 03/17/16 (H) MINUTE(HSS) 03/18/16 (H) HSS RPT 3DP 1NR 1AM 03/18/16 (H) DP: TARR, VAZQUEZ, WOOL 03/18/16 (H) NR: TALERICO 03/18/16 (H) AM: SEATON 04/06/16 (H) L&C AT 3:15 PM BARNES 124 04/06/16 (H) Heard & Held 04/06/16 (H) MINUTE(L&C) 04/11/16 (H) L&C AT 3:15 PM BARNES 124 04/11/16 (H) Moved CSHB 234(L&C) Out of Committee 04/11/16 (H) MINUTE(L&C) 04/12/16 (H) L&C RPT CS(L&C) 3DP 3NR 04/12/16 (H) DP: TILTON, HUGHES, OLSON 04/12/16 (H) NR: LEDOUX, KITO, JOSEPHSON 04/13/16 (H) TRANSMITTED TO (S) 04/13/16 (H) VERSION: CSHB 234(L&C) 04/14/16 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) BILL: HB 372 SHORT TITLE: OMNIBUS INSURANCE SPONSOR(s): LABOR & COMMERCE 03/21/16 (H) READ THE FIRST TIME - REFERRALS 03/21/16 (H) L&C 03/28/16 (H) L&C AT 3:15 PM BARNES 124 03/28/16 (H) Heard & Held 03/28/16 (H) MINUTE(L&C) 03/30/16 (H) L&C AT 3:15 PM BARNES 124 03/30/16 (H) Heard & Held 03/30/16 (H) MINUTE(L&C) 04/04/16 (H) L&C AT 3:15 PM BARNES 124 04/04/16 (H) Heard & Held 04/04/16 (H) MINUTE(L&C) 04/06/16 (H) L&C AT 3:15 PM BARNES 124 04/06/16 (H) Moved CSHB 372(L&C) Out of Committee 04/06/16 (H) MINUTE(L&C) 04/07/16 (H) L&C RPT CS(L&C) 1DP 6NR 04/07/16 (H) DP: OLSON 04/07/16 (H) NR: LEDOUX, TILTON, HUGHES, KITO, JOSEPHSON, COLVER 04/13/16 (H) TRANSMITTED TO (S) 04/13/16 (H) VERSION: CSHB 372(L&C) AM 04/14/16 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) WITNESS REGISTER LAURA STIDOLPH, Staff Representative Kurt Olson and House Labor and Commerce Committee Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Introduced the legislation on behalf of the sponsor speaking to the following sponsor statement: KRIS CURTIS, Legislative Auditor Division of Legislative Audit Legislative Affairs Agency Alaska State Legislature Juneau, Alaska POSITION STATEMENT: During the hearing on HB 290, reviewed the sunset audit findings for the Real Estate Commission. SARAH CHAMBERS, Operations Manager Division of Corporations, Business and Professional Licensing Department of Commerce, Community and Economic Development Juneau, Alaska POSITION STATEMENT: Provided information related to HB 290. ED MARTIN, representing himself Cooper Landing, Alaska POSITION STATEMENT: Testified on HB 290. TRACI BARICKMAN Alaska Real Estate Commission Mat-Su, Alaska POSITION STATEMENT: Testified in support of HB 290. ANITA HALTERMAN, Staff Representative Liz Vazquez Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Introduced HB 234 on behalf of the sponsor. REPRESENTATIVE LIZ VAZQUEZ Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Sponsor of HB 234. LORI WING-HEIER Director Division of Insurance Department of Commerce, Community and Economic Development Anchorage, Alaska POSITION STATEMENT: Provided information related to HB 234. STACY TONER, Deputy Director Division of Behavioral health Juneau, Alaska POSITION STATEMENT: Testified in support of HB 234. LYN FREEMAN MIND MATTERS RESEARCH Anchorage, Alaska POSITION STATEMENT: Testified in support of HB 234. KELLY PUFF, representing herself Anchorage, Alaska POSITION STATEMENT: Testified in support of HB 234. DR. AROM EVANS, Medical Director Orion Behavioral Eagle River, Alaska POSITION STATEMENT: Testified in support of HB 234. KONRAD JACKSON, Staff Senator Kurt Olson Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Introduced HB 372 on behalf of the sponsor. LORI WING-HEIER, Director Division of Insurance Department of Commerce, Community and Economic Development Anchorage, Alaska  POSITION STATEMENT: Provided information on HB 372. DAVE DONLEY, representing himself Anchorage, Alaska POSITION STATEMENT: Requested the committee amend HB 372. ACTION NARRATIVE  1:35:01 PM CHAIR MIA COSTELLO called the Senate Labor and Commerce Standing Committee meeting to order at 1:35 p.m. Present at the call to order were Senators Giessel, Stevens, and Chair Costello. Senator Meyer arrived soon thereafter. She reviewed the agenda. HB 290-EXTENDING THE REAL ESTATE COMMISSION  1:35:49 PM CHAIR COSTELLO announced the consideration of HB 290. 1:36:42 PM LAURA STIDOLPH, Staff, Representative Kurt Olson, House Labor and Commerce Committee, sponsor of HB 290, introduced the legislation on behalf of the sponsor speaking to the following sponsor statement: HB 290 extends the sunset date for the Real Estate Commission to June 30, 2018. I encourage all the members to review the Legislative Audit summary and the full audit report. You will see that in the opinion of our auditors, the Real Estate Commission is serving the public's interest by effectively licensing real estate brokers, associate brokers, and salespersons. Additionally, it was found that the board worked to improve operations and industry practices by modifying and adopting regulations. MS. STIDOLPH said the audit made two recommendations: 1) the chair of the Real Estate Commission and the director of Administrative Services for the Department of Commerce, Community and Economic Development (DCCED) should work together to procure a master errors and omissions insurance policy and 2) the Division of Corporations, Business and Professional Licensing should take action to ensure that cases are actively investigated. She concluded that the Real Estate Commission serves an important role by improving operations and industry practices by modifying and adopting regulations. 1:38:25 PM CHAIR COSTELLO asked how many members serve on the commission. MS. STIDOLPH replied there are five members: two sales persons, two brokers and one public member. 1:39:12 PM KRIS CURTIS, Legislative Auditor, Division of Legislative Audit, reviewed the audit findings for the Real Estate Commission. She emphasized that the audit recommended a six-year extension on the condition that the board demonstrate by January 2016 that it was able to secure a master errors and omissions insurance policy. Otherwise, the recommendation was for a four-year extension. She noted the bill calls for a two-year extension. The audit made two recommendations. First was that the commission work with DCCED to secure a master errors and omissions policy for real estate licensees. The law requiring this insurance became effective in 2010. The department established the terms and conditions of the insurance in December 2011 but the board delayed establishing regulations for the insurance until October 2014. The Division of Corporations, Business and Professional Licensing and the Division of Administrative Services cited the reason for the delay was the overall complexity of the project, the lack of insurance expertise, and the length of time the commission involved the Department of Law in drafting the regulations. She advised that not securing the policy essentially removes the requirement from all licensees thereby exposing the public to error and omission risks in real estate transactions. The second recommendation was for the chief investigator to take action to ensure that all cases are actively investigated and completed timely. Of the 235 investigations that were open during the time period that was audited, significant inactivity was found in 29 of the 36 cases that were tested. During the audit, 11 of those inactive cases were closed because of the age of the matter. The reasons for the excessive time lags were inadequate monitoring and insufficient oversight to ensure that investigations were completed timely. The consequence is that consumers may not have been adequately protected from incompetent or unlawful licensees. MS. CURTIS said the department and the commission generally concurred with the audit recommendations. 1:42:21 PM CHAIR COSTELLO asked how the audit findings were communicated to the commission, and the commission's response. MS. CURTIS explained that there is communication with management and the board chair during the audit and a formal exit meeting that describes the findings. A draft of the report is subsequently sent to both the board chair and the department, which provides an opportunity for each to provide additional information. The preliminary report then is provided to the Legislative Budget and Audit (LB&A) Committee and the board and department are allowed to formally comment on the report. Those comments are found at the back of the report. 1:43:13 PM SENATOR MEYER joined the committee. SENATOR STEVENS asked what the current recommendation is for an extension. MS. CURTIS said she favors four years. The two years proposed in the bill is acceptable but it means they would begin that audit work next year. SENATOR STEVENS asked what it would mean to the audit division if the bill was amended to four years. MS. CURTIS said it depends on the year, but next year they will be very busy with 10 sunset audits. CHAIR COSTELLO asked if the bill passed several years ago requiring audits for the departments weighs into the workload. MS. CURTIS replied it affects her workload but not the audit staff, and that has been deleted for FY2017 going forward. 1:45:45 PM SARAH CHAMBERS, Operations Manager, Division of Corporations, Business and Professional Licensing, Department of Commerce, Community and Economic Development (DCCED), Juneau, Alaska, introduced herself. CHAIR COSTELLO asked her to discuss the financial status of the Real Estate Commission and comment on the findings in the audit. MS. CHAMBERS said the Real Estate Commission is in a strong fiscal condition and has a healthy surplus. With regard to the recommendations, timely investigations has been a recurring theme for all boards and commissions, not just the Real Estate Commission. To address this problem, a new chief investigator has made structural changes to improve caseload management. There is also improved engagement and professionalism between the investigative unit and the Real Estate Commission in an effort to reduce the number of investigations and the time lag identified in the audit. In 2015 there were 116 total cases and only 36 were investigations. She described the errors and omissions insurance as a sticky wicket. The initial delay was a result of spending about a year to get guidance from the Department of Law, followed by a delay to try to understand how the pieces work together. Once the commission and the division adopted regulations, a public invitation for insurers to bid went out in November 2015 and there was no response. Two comments were that the structure of providing E&O insurance was not attractive because the insurers couldn't assess their risk. Insurers had no information on the risk pool being presented and the $300 cap the division set in regulation for an annual premium (the cap that sales people and brokers would pay) was not attractive in the current market. The division is actively working with the commission to discern the next step, including an analysis of whether or not new regulations need to be adopted to raise the premium. 1:51:47 PM SENATOR STEVENS asked how long it will be before the commission has E&) insurance. MS. CHAMBERS replied the hope is to have a plan within the next year. She pointed out that the E&O policy isn't required in statute, but a clause within the statute says that if the commission doesn't have an E&O policy, none of the brokers and licensees would be required to carry E&O insurance. SENATOR STEVENS asked what length extension she supports. MS. CHAMBERS replied the division would work with the timeframe stated in the bill but having longer might be more efficient and effective. 1:54:49 PM SENATOR STEVENS expressed hesitation to extend the sunset to four years. MS. CHAMBERS clarified that the commission has seven members, the majority of which are licensees. 1:55:37 PM ED MARTIN, representing himself, Cooper Landing, Alaska, stated the commission ought to be extended a minimum. He expressed appreciation that the legislature is trying to keep costs down. 1:57:24 PM TRACI BARICKMAN, Member, Alaska Real Estate Commission, testified in support of HB 290. She related her personal experience as a professional realtor. She said the board operates within its budget and does not burden the state. She related that most complaints that are filed have a legitimate foundation and often licensees are disciplined through education, fines and sometimes suspension or revocation of their license. She said the commission works to keep regulations up to date with the constantly changing real estate industry. The sunset audit last year concluded the commission is serving the public interest and recommended an extension with the condition of obtaining a master insurance policy. They are working through that process and a shorter extension will make it more difficult. She stressed that to terminate or not extend the commission would take away an important guardian for consumer protection. CHAIR COSTELLO asked if she is saying it would be challenging to meet the condition of obtaining an E&O policy if the commission is extended just two years. MS. BARICKMAN replied she believes it will take at least two years. She noted that most realtors already carry E&O insurance and during a recent commission meeting she recommended removing subsection (e) of the E&O insurance statute. That voids the requirement for brokers and licensees to carry E&O insurance if the commission is unable to obtain a master policy. It's not possible to get a master policy until there is some historical data and apparently that is lacking. 2:02:34 PM SENATOR STEVENS asked if she is saying that most licensees carry E&O insurance regardless of whether the commission does. MS. BARICKMAN answered yes. SENATOR STEVENS asked what the exposure is to the public if a licensee doesn't have this insurance. MS. BARICKMAN replied the brokers are most at risk. 2:04:23 PM CHAIR COSTELLO closed public testimony on HB 290. She asked if there were any questions. SENATOR STEVENS asked to hear from the department about whether the public and brokers would be protected if there wasn't a requirement for the commission to carry a master E&O policy. 2:05:23 PM MS. CHAMBERS related that the statute says brokers and salespersons must carry errors and omissions insurance, but they are exempt from that requirement as long as the Real Estate Commission doesn't have a master E&O policy. Once the commission has a policy, everyone under their governance must also carry a policy either privately or through the master policy. She noted that a bill that removes the exemption is moving through the process, but it hasn't passed. 2:06:59 PM CHAIR COSTELLO found no further questions and solicited a motion. 2:07:05 PM SENATOR GIESSEL moved to report HB 290, labeled 29-LS1345\W, from committee with individual recommendations and attached fiscal note(s). 2:07:17 PM At ease 2:07:26 PM CHAIR COSTELLO announced that without objection, HB 290 passed from the Senate Labor and Commerce Standing Committee. 2:07:40 PM At ease HB 234-INSURANCE COVERAGE FOR TELEMEDICINE  2:09:03 PM CHAIR COSTELLO announced the consideration of HB 234. She stated that the intent is to hear from the sponsor and the administration, take questions from members, hear public testimony and hold the bill for further review. 2:09:34 PM ANITA HALTERMAN, Staff, Representative Liz Vazquez, Alaska State Legislature, stated that HB 234 seeks to require health care insurers that offer, issue, or renew health insurance plans in Alaska to reimburse mental health professionals for medically necessary services delivered using telemedicine via secure phone or internet video applications. This legislation would not require an initial face-to-face visit but requires providers be licensed in Alaska. HB 234 is a parity bill. Currently, 32 states and the District of Columbia have telehealth parity laws that require the option of telemedicine. Only Arizona requires a face-to-face visit before mental health services can be delivered via telehealth. 2:11:20 PM CHAIR COSTELLO asked if the lack of face-to-face interactions has been an issue in other states. MS. HALTERMAN replied it is appropriate for a mental health professional to require a face-to-face encounter if they deem it appropriate. This legislation seeks to prohibit the insurance industry from imposing that requirement. CHAIR COSTELLO summarized that the insurance would not check to see if there was a face to face interaction. The claim would be handled absent that information. MS. HALTERMAN agreed. 2:13:21 PM REPRESENTATIVE LIZ VAZQUEZ, Alaska State Legislature, sponsor of HB 234, stated that this legislation provides access to medical care that is often difficult for people living in rural areas to access. Even in a city as large as Fairbanks there can be access issues. Some people are also limited by age, mobility, stamina, and transportation from making a trip to a health care provider. CHAIR COSTELLO asked if this would cover Medicaid recipients. She shared that a constituent's son came home from the Alaska Psychiatric Institute (API) and wasn't willing to visit the doctor to renew a prescription. The doctor wasn't willing to make a home visit because transportation wasn't reimbursed. MS. VAZQUEZ answered yes; Medicaid has the gold standard regulations for telehealth delivery. CHAIR COSTELLO asked if she was saying that a phone call to the doctor would have sufficed. REPRESENTATIVE VAZQUEZ replied "it could be in that situation." SENATOR STEVENS asked if the Alaska Native Tribal Health Consortium delivers mental health services via telemedicine. MS. HALTEMAN offered her understanding that tribal entities have federal exemptions that allow flexibility in the use of telemedicine. She said many of those beneficiaries have dual eligibility through Medicaid so there is a parity issue and the private sector is falling behind. She directed attention to the 50-state analysis that gives Alaska an A+ for telehealth for Medicaid policies and an F for the private sector. She said this bill is the first of many to come to help improve for people who currently don't have access. SENATOR STEVENS commented that parity is crucial and it shouldn't matter what race you are. 2:18:40 PM SENATOR GIESSEL added that the Alaska Native Tribal Health Consortium has been very successful in providing mental health services through telemedicine for many years. It leads the nation in this area. 2:19:05 PM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community and Economic Development (DCCED), stated that, as the sponsor said, HB 234 provides for telemedicine. Currently, MODA provides for telemedicine in its policies but Premera does not in the majority of its plans. The division worked with the sponsor in the drafting and has no comments. 2:20:12 PM STACY TONER, Deputy Director, Division of Behavioral health, Department of Health and Social Services (DHSS), stated support for HB 234. She stressed the importance of having mental health services delivered via telehealth. She said tribal organizations that use the division's services use telehealth to give village residents access to psychiatrists and mental health professionals. She noted that telemedicine has been available in the Medicaid service array for years. The only recommendation is to use the term "telehealth" rather than telemedicine. 2:21:32 PM CHAIR COSTELLO opened public testimony. 2:21:44 PM LYN FREEMAN, Mind Matters Research, testified in support of HB 234. She described her professional experience and education. She described the mental health intervention she designed and tested specifically for Alaskans. When she published the outcomes, the National Institute of Health (NIH) directed her to make the intervention available to people across Alaska. She was specifically directed to utilize telemedicine as much as possible to overcome the barriers to access to care. The NIH wrote letters of support and asked insurance providers for assurance that the intervention would be available for patients in the office setting and through telemedicine. She said she approached the insurance providers in the state asking for their support and was stonewalled at every point. She was told that her patients would not be covered unless she became part of one of their programs or joined their Teladoc program. She decided not to treat patients via telemedicine until legislation passed that would protect both her patients and herself. She urged the committee to pass the bill. 2:26:33 PM KELLY PUFF, representing herself, testified in support of HB 234. She related her experience as a parent of a son with autism and said the family wouldn't be intact if it weren't for home telehealth. It's made all the difference to their family. 2:28:24 PM DR. AROM EVANS, Medical Director, Orion Behavioral Health Network, testified in support of HB 234. He described the services the company provides throughout the state for children and adolescents with mental health conditions. This is a vulnerable population, many of which would not have access to these services if it weren't for telehealth. Medicaid beneficiaries are able to receive telehealth services in their home, but individuals with private insurance don't have access to these service because their insurance company won't pay. Oftentimes the option is to pay for an expensive flight to Anchorage or forego the care. He urged the committee to pass the bill. 2:32:45 PM CHAIR COSTELLO closed public testimony on HB 234 and held the bill in committee for further review. 2:33:08 PM At ease HB 372-OMNIBUS INSURANCE  2:36:40 PM CHAIR COSTELLO reconvened the meeting and announced the consideration of HB 372. [CSHB 372(L&C) am is before the committee.] 2:37:31 PM KONRAD JACKSON, Staff, Senator Kurt Olson, Alaska State Legislature, introduced HB 372 the legislation on behalf of the House Labor and Commerce Committee, speaking to the following sponsor statement: House Bill 372 is an insurance statute clean-up bill, similar to ones introduced every few years. The bill makes conforming changes to Alaska Statutes which bring us into compliance with the ever changing Federal insurance laws. The modernization of several provisions to Title 21 also include consumer protection and insurer licensing restrictions. Your support for this important Title 21 update is appreciated. 2:38:39 PM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community and Economic Development (DCCED), Anchorage, Alaska provided the following sectional analysis for HB 372: Sec. 1 AS 21.06.110 Director's annual report  that the director include in the annual report the total number of public comments received and the director's efforts, to the extent allowable by law, to improve or maintain public access to information on the individual health care insurance rate filings before they become effective. This has been added to provide the consumer with as notice of the impending rate filing and the impact it will have on their healthcare insurance plan. Sec. 2 AS 21.06.120(a) Examination of insurers  references to the handbooks used throughout the country for financial and market conduct examinations. Both publications are published by the National Association of Insurance Commissioners. Formerly, the term "Examiners' Handbook" was a sufficient description as both the financial examination and market conduct examination handbooks used the term in their title. Now, however, the "Market Conduct Examiners Handbook" is no longer published and is part of the "Market Regulation Handbook". Sec. 3 AS 21.06.140(f) Conduct of examination  references to the handbooks used throughout the country for financial and market conduct examinations. Both publications are published by the National Association of Insurance Commissioners. Formerly, the term "Examiners' Handbook" was a sufficient description as both the financial examination and market conduct examination handbooks used the term in their title. Now, however, the "Market Conduct Examiners Handbook" is no longer published and is part of the "Market Regulation Handbook". Sec. 4 AS 21.06.160(a) Examination expense  general agents, third-party administrators, reinsurance intermediary managers, motor vehicle service contract providers, and surplus lines brokers from the requirements of paying for division personnel and overhead costs relating to an examination; such entities would still be required to pay for the division's "out-of-pocket" expenses including travel expenses and for compensation of a contract examiner, however, the entities could apply for a waiver from the director based on financial hardship. Sec. 5 AS 21.07.005 Regulations relating to health  care insurance policies