• NQTLs are processes, strategies, evidentiary standards, or other criteria that limit the scope or duration of benefits for services provided under the plan. Certain utilization reviews, prior authorization and plan provisions may only be applied to mental health/substance use disorder benefits if they are comparable to or less restrictive than those for medical surgical services.

    NQTLs include, but are not limited to:

    • Medical management standards limiting or excluding benefits based on medical necessity, medical appropriateness, or based on whether the treatment is experimental or investigative (including standards for concurrent review).
    • Formulary design for prescription drugs.
    • Network tier design.
    • Fail-first policies or step therapy protocols. For example: Refusal to pay for higher-cost therapies until it can be shown that a lower-cost therapy is not effective.
    • Exclusions based on failure to complete a course of treatment.
    • Restrictions based on geographic location, facility type, provider specialty, and other criteria that limit the scope or duration of benefits for services provided under the plan or coverage.
  • QTLs can be measured numerically. Health insurers generally cannot impose a financial requirement (such as copays, coinsurance, deductible) or a QTL (such as the number of outpatient visits or inpatient days covered) on mental health/substance use disorder benefits that are more restrictive than the financial requirement or QTL that apply to most – but not all – medical surgical benefits in the same classification.

  • MHPAEA protections extend to most health plans, including self-insured and fully insured:

    • Individual health plans issued on and off the Health Insurance Marketplace
    • Large group health plans, including private and public-sector employers with more than 50 employees (certain self-insured governmental plans may opt-out).

    The Patient Protection and Affordable Care Act (ACA) requires small group plans to provide mental health/substance use disorder benefits. Any plan that offers mental health/substance use disorder coverage must comply with MHPAEA.

  • If your insurance includes prescription drug coverage, it will include benefits for all drugs that your insurer has included on its formulary. If the drug your doctor prescribed is not covered on your insurance formulary, you may be required to appeal to your insurer to use the uncovered drug, or try an alternative drug first.

  • If your insurance limits non-emergency care to in-network doctors and facilities, then your insurer can require you to go to an in-network facility in order to receive services. There may be some exceptions if you are experiencing an emergency or you have a need that can’t be met by an in-network doctor or facility.

  • Particular benefits must be covered under the terms of your insurance policy in order for your insurer to pay for them. Insurers can also require that the service meet criteria to be considered medically necessary before they issue prior authorization for the service.

  • Yes. A complex formula is used to determine the maximum cost-share that an insurer may charge for mental health or substance used disorder services The copay or coinsurance for some medical services may still be lower than the maximum mental health services cost-share. 

  • Unless it’s an emergency or the patient could be harmed, insurers may require patients to try less involved or intensive treatment first.

  • Some group health insurance policies are not required to provide mental health services at parity with medical services.

  • Individual health insurance policies issued prior to 2014, and some group health insurance, do not have to cover mental health/substance use services. In addition, short term and limited benefit policies do not have to include mental health benefits.

  • Parity means parity within your own plan and not parity between plans.

  • MHPAEA requires that insurers meet mental health parity standards in two areas: quantitative limits and non-quantitative limits.

    • Plans must apply comparable financial requirements (such as copay, coinsurance, & deductible) for mental health/substance use disorder and medical surgical care.
    • The number of outpatient visits or inpatient days covered must be comparable for mental health/substance use disorder and medical surgical care.  
    • Prior authorization requirements for mental health/substance use disorder services must be comparable to or less restrictive than those for medical surgical services.

    These standards are applied according to classifications of benefits:

    • Inpatient / in-network
    • Inpatient / out-of-network
    • Outpatient / in-network
    • Outpatient / out-of-network
    • Emergency care
    • Prescription drugs
  • Parity means that financial cost-sharing requirements for mental health/substance use disorder benefits (such as deductibles, copayments, coinsurance, and out-of-pocket limitations) must be comparable but not identical to those for medical surgical. Parity also applies to rules regarding care management (authorization for treatment) and treatment limitations.

     Although benefits may differ across plans, parity requires that the processes related to plan benefit determinations be comparable. The ACA contributed to parity by eliminating annual and lifetime dollar limits for mental health/substance use disorder benefits.

  • The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law requiring health plans to apply similar financial and treatment limits to mental health/substance use disorder benefits and medical surgical benefits.

  • We can help clarify the difference between the need for an appeal or a complaint and to whom that request should be investigated by.  For more information read Appeal Vs Complaint

  • DIFI regulates insurance companies to comply with requirements to protect consumers and encourage economic development. We work to keep the public informed of any changes, programs, opportunities, and laws that may have an impact here in Arizona.

  • We provide information on the various types of insurance, general shopping tips, rates, and reports that can be used to assist in the decisions making process for researching and purchasing insurance.

  • DIFI is short for the Department of Insurance and Financial Institutions.

  • The law requiring DIFI to regulate Motor Vehicle Dealers expired on August 6, 2016. You may refer to HB1358 and HB2535. DIFI ceased accepting new license applications and renewals for Motor Vehicle Dealers. If you have any questions regarding your Motor Vehicle Dealer license, please contact ADOT Motor Vehicle Division Dealer Services and Licensing at (602) 712-7571 or visiting Dealer License Types on the AZDOT.GOV site. 

  • No, the DIFI will not accept cash payments.

  • Yes, DIFI does accept Visa and/or MasterCard payments through the eLicensing portal. Payments are not accepted at the DIFI office.

  • Once DIFI has reviewed each renewal, if there are items needed to complete the renewal application, the licensee will be contacted via e-mail (mortgage industry will be contacted via NMLS).  Once your renewal has been processed and approved, our website will be updated so that your license will no longer reflect “Renewing”.

  • Arizona Statutes prohibit the use of the terms “bank” “credit union” or “trust” in a business name unless the business holds a bank, credit union or trust permit issued by DIFI, another state or federal regulator.  Exceptions may be granted when the business does not hold itself out to be a bank, credit union, trust company or savings and loan association.
    Send a letter to DIFI, attention to the Financial Institutions division requesting permission for use of the name; include the name of the business and the type of business you plan on conducting in Arizona.  See the following Arizona Revised Statutes for reference: §6-391, §6-509 (B), §6-867. §10-401(3), and §10-1506(A)(3).  

  • Yes, you can buy a bond for any amount you want as long it is over the statutorily required amount.  You do not need permission from DIFI in this situation.

  • For the mortgage industry, mortgage brokers, mortgage bankers, commercial mortgage brokers, commercial mortgage bankers, registered exempt persons and loan originators, you will need to submit your application for a license via the Nationwide Mortgage Licensing System (“NMLS”), telephone number (855) 665-7123.

    *** For all other license types, please visit our Licensing page, click on Financial Institution or Finacial Enterprise and the license type you are applying for.  The “Forms and Fee” section will provide you with the information you need to apply for a license.  You may also call 602-771-2800, if you have additional questions. Collection Agencies may apply through NMLS.

  • All of the financial institutions and enterprises you see listed at the top of this page,  who are transacting business in Arizona and are not exempt by statute must be licensed by DIFI.

  • Checks should be made payable to the Arizona Department of Insurance and Financial Institutions or DIFI.

  • Rates are limited on title loans only.  Please see A.R.S. §44-291 for cap information.

  • You can find the statutes under A.R.S. Title 44, Chapter 2.1.

  • Licensing Timeframes associated with Sales Finance Companies can be found under the Arizona Administrative Code, Article 1. Section R20-4-107.

  • DIFI shall make a final decision on a COMPLETED application within 120 days.    Once DIFI has reviewed your application, you will be contacted via e-mail.   See Arizona Administrative Code R20-4-107 licensing time frames.

  • At this time, there are no associations in Arizona that have applied for and have been issued a permit to transact business as a state-chartered Savings and Loan Association.   Please call 602-771-2800  if you have any questions.

  • Arizona Statutes prohibit use of the terms “bank” “credit union” or “trust” in a business name unless the business holds a bank, credit union or trust permit issued by the DIFI, another state or federal regulator.  Exceptions may be granted when the business does not hold itself out to be a bank, credit union, trust company or savings and loan association.
    See the instructions and application on the Financial Institutions Division webpage  to request permission for use of the name; include the name of the business and the type of business you plan on conducting in Arizona.  See the following Arizona Revised Statutes for reference: §6-391,§ 10-401(3), and §10-1506(A)(3). 

  • A non-cash sale is when a dealer sells a motor vehicle with one or more deferred payments or when a dealer assists in finding financing for the buyer

  • Once your application has been reviewed, you will get notices from NMLS to go to your account/records which you must review for any deficiencies and comply with the requirements made by DIFI.

  • Please refer to the applicable Amendment Checklist for guidelines on making changes.  (The Amendment Checklists are for those who already hold a license, they are not to be used while still in the application process.)  All changes should be reflected on NMLS.  The Amendment Checklist must be printed, completed, and submitted to DIFI along with applicable documents and fees.  The Amendment Checklist is found on the NMLS website under Arizona Requirements page.  

  • DIFI shall make a final decision on a COMPLETED application within 45 days.    Once DIFI has reviewed your application, you will be contacted via e-mail.  See Arizona Administrative Code R20-4-107 licensing time frames.

  • Go to the DIFI home page, click on “Financial Enterprises”, click on "Sales Finance Companies”  and under “Forms and Fees” find the change you want to make.  The license change instructions and application will be on the right-hand side of that page.  Follow the instructions, print, complete and return all appropriate forms, documents, and fees to DIFI.

  • Anyone in the business of buying loan contracts against a motor vehicle, from a retail seller, or anyone who creates or holds loans against a motor vehicle with an outstanding balance that exceeds $50,000.00.

  • No

  • In a cash sale there is no financing taking place, meaning it is cash only with a clear title.  There is no lien against the title.

  • A Title loan is a personal loan against the title of a motor vehicle. There are caps for the loan amount.  Please see A.R.S. §44-291 for cap information.

  • DIFI shall make a final decision on a COMPLETED application within 120 days.    Once DIFI has reviewed your application, you will be contacted via e-mail. See Arizona Administrative Code R20-4-107 licensing time frames.

  • Go to the DIFI home page, click on “Financial Enterprises”, click on ”Escrow Agents”  and under “Forms and Fees” find the change you want to make.  The license change instructions and application will be on the right hand side of that page.  Follow the instructions, print, complete and return all appropriate forms, documents and fees to DIFI.

  • Here is a link to help you make amendments: click HERE 

  • Our state specific requirements are available through NMLS

  • Both the Federal S.A.F.E. Act and our own statutes are very clear, there can be no felony conviction within the last 7 years of the date of the application for licensing or at any time preceding such date of application, if such felony involved an act of fraud, dishonesty, or a breach of trust, or money laundering.  There are no exceptions.

  • DIFI shall make a final decision on a COMPLETED application within 120 days.    Once DIFI has reviewed your application, you will be contacted via e-mail.  See Arizona Administrative Code R20-4-107 licensing time frames.

Faq