Specialties
Testimonial
At Lewis & Ellis LLC, we offer comprehensive market conduct examination (MCE) services designed to help your insurance company or the company you regulate comply with regulations, protect consumers, and uphold its reputation in the industry by conducting a thorough market analysis that examines core business aspects such as:
- Sales and marketing practices.
- Underwriting practices.
- Claims handling.
- Financial conditions.
- Policy form filing methods and practices.
Our team members have built their careers observing and facilitating processes that involve establishing and maintaining laws and regulations for life insurance, health insurance, and property & casualty insurance.
Our Core Market Conduct Examination Services and Processes
- Market Conduct Examination Planning and Scoping
We conduct preliminary risk assessments to determine the ideal examination scope and develop customized examination plans tailored to the unique operations of each insurance company. This often involves meeting with supervisors and other key stakeholders to better understand operations and establishing clear communication channels early. - Regulatory Compliance Assessments
Our teams then conduct on-site reviews and interviews to determine compliance with state laws and regulations, assessing adherence to the National Association of Insurance Commissioners (NAIC) market conduct standards. - Data Collection and Analysis
Once we’ve developed a compliance baseline, we’ll gather and analyze additional relevant data and documentation, utilizing advanced analytics to identify patterns, trends, and potential areas of concern. - Operational and Financial Examination
Once we’re ready to begin the audit, our experts will audit core aspects of the business, including marketing practices, policyholder service, underwriting, rating, and claims handling. Flipping over to finances, we’ll also look at financial transactions and reporting to ensure integrity and transparency. - Report Preparation and Recommendations
Following the audit, we’ll prepare detailed market conduct examination reports outlining our findings and any potential compliance issues, and provide actionable recommendations for corrective actions and improvements. - Follow-Up and Support
Our service doesn’t stop once we deliver the report. Our experts can assist in implementing their recommended changes, provide ongoing support and guidance to ensure sustained compliance, and deliver insights that can help improve operations.
Why Choose Lewis & Ellis LLC for Your Market Conduct Examination?
Lewis & Ellis offers a unique combination of expertise, tailored solutions, comprehensive services, and a client-centric approach. Our commitment to excellence and integrity ensures that we deliver strategic value.
Comprehensive Examination Process
Our process is thorough and meticulous, focusing on several key aspects of operations including underwriting procedures, policyholder service, claims handling, marketing and sales practices, agent activities, and more. We go beyond just checking compliance — we aim to help operations and service quality.
Diverse Expertise Across Insurance Sectors
We bring a wealth of experience and knowledge across various sectors of the insurance industry, including life, health, and property & casualty insurance. Regardless of the specialty, we have the insight and understanding to carry out a comprehensive and tailored market conduct examination.
An Analytical Approach
Our team of market conduct examiners and other insurance experts utilizes robust analytical tools to conduct a thorough examination. Our techniques include detailed file reviews, intensive data analysis, in-depth interviews with key personnel, and comprehensive compliance checks. We strive to leave no stone unturned in our quest for a complete and accurate assessment.
Regulatory Enterprise
With our deep understanding of insurance laws and regulations, we help insurers and regulators navigate the complex regulatory landscape. We stay updated with the latest changes in legislation and industry standards to ensure our clients remain in compliance.
An Unbiased, Independent Perspective
As an independent consulting firm, we ensure a fair and impartial examination, adhering to the highest professional and ethical standards and providing unbiased findings and recommendations.
Through our market conduct examinations, we aim to provide valuable insights that can help improve business operations and enhance customer satisfaction.
Pharmacy Benefit Manager (PBM) Expertise
Our team is uniquely positioned to provide market conduct examination services for regulators assessing PBMs. We employ our expertise in risk assessment and analysis to identify market conduct regulation violations, such as excessive markups and steering practices, and assess the impact of PBM practices on consumers, including the affordability of prescription drugs and access to necessary medications.
Get One Step Closer to Compliance and Customer Satisfaction
Remaining compliant with constantly evolving regulations can be a lot to handle. At Lewis & Ellis LLC, our experts approach every market conduct exam with an unbiased, transparent, and truthful attitude to help achieve and maintain compliance and to serve customers.
Ready to get started? Contact us today.