Health & Life Insurance Actuaries | Lewis & Ellis Inc.

Market Conduct Examinations

Lewis & Ellis understands the complexities of regulating life insurance, health insurance and property & casualty insurance companies. Our team members built their careers observing and facilitating the process of establishing new and maintaining current regulatory laws and regulations. L&E uses a methodical and meticulous approach for market conduct examinations utilizing a diverse range of backgrounds and experience. From conducting examinations for state insurance regulators and policymakers to preparing or mitigating risk for insurers and other regulated insurance entities, L&E is prepared to meet your needs.

State Insurance Departments, Regulators, and Policymakers

L&E has led and assisted market conduct examinations of all sizes related to all lines of business for several state insurance departments with an unbiased approach to improve consumer confidence. Our team’s adherence to regulatory timelines while performing precise, comprehensive, and proficient examinations has repeatedly proven to be a secure model in providing exceptional performance that we are passionate to sustain.

From new entities to well-established, multistate, insurers, no policy, procedure, or form is overlooked during the examination process, ensuring each of the thousands of state-specific requirements for the company has been assessed. Our team is dedicated to maintaining public confidence in the insurance industry by ensuring consumers have access to compliant insurance products and are protected against insurers failing to operate within the legal and regulatory bounds of its jurisdiction, including misleading marketing tactics and bad claims practices. Additionally, L&E has led Mental Health Parity and Addiction Equity Act (MHPAEA) and Pharmacy Benefit Manager (PBM) examinations to protect the rights of consumers. You can rely on L&E to administer market conduct examinations in a professional, competent, and timely manner.

Insurers, Third-Party Administrators, and Other Regulated Insurance Entities

Insurance regulation has proven effective in protecting consumers by guaranteeing insurers uphold their promises. However, market conduct examinations are one of several regulatory functions that is a recurrent, arduous, time-consuming, and costly process for insurers. Market conduct examinations can also identify problems that could be a precursor to financial solvency concerns. L&E will provide you with resourceful, cost-effective, and straightforward results using a blend of technical expertise, industry experience, practical judgment, and effective communication. We will help prepare your company for, and respond to, examinations, maintain compliance with changing market conduct requirements, and identify and prioritize jurisdictional concerns using a targeted and risk-based approach to provide a direct path for internal efforts to effectively manage and mitigate long-term compliance risk.

Our team will fully examine all areas of business subject to market conduct examinations, provide thorough understanding of any violations or red flags, offer a plan to ensure compliance, and specify the necessary tools and practices to avoid costly fines or the higher cost of a diminished reputation in the industry.

The need for consulting for compliance and filing functions is more important than ever before. State and Federal regulatory demands on the insurance and benefit industries are complex and fast paced resulting in a varied and demanding workload. Regulations can be complicated, which makes it hard to put policies in place with confidence. Noncompliance can put your reputation at risk. L&E handles regulatory issues successfully every day for insurers, health plans, and employers by being familiar with the laws and regulations in every state.

L&E Provides the Integrity, Experience, and Solutions Essential to Your Needs

Integrity and credentials provide a strong foundation for the expert judgment, industry experience, and adept insight provided by L&E. As an industry leading consulting firm, we will provide your company with comprehensive assistance across all areas subject to market conduct examinations, and tailor-make our compliance services to meet your specific and specialized needs.

Our commitment to excellence is supported by our diligence in following all working groups and task forces of the NAIC’s Market Regulation and Consumer Affairs (D) Committee and active participation as an associate member of the Society of Financial Examiners (SOFE). The essential industry credentials of our team members include, but are not limited to, the following: CFE, AFE, MCM, CLU, FCA, FLMI, CPA, FIA, FSA, ASA, FCAS, ACAS, and MAAA.

We are prepared to assist with your market conduct examination needs and look forward to the opportunity to resolve your regulatory objectives in a skilled, proficient, and cost-effective manner.


Consultants to Contact