OIC opened two new jobs this week, both working in our Tumwater headquarters.
The first job will help us ensure that health insurance plans have adequate networks of medical providers across the state. The position is a Functional Program Analyst 3 in our Rates and Forms Division. The person in this position will review network access reports and provider agreements that health insurance companies submit to us. The position reports to our Healthcare Consumer Access Manager and plays a crucial role in our state's implementation of the Affordable Care Act.
The position is open until filled. Read more about the position or apply at careers.wa.gov.
The second job is an Office Support Supervisor 2 in our Consumer Protection Division. We have a robust consumer protection program, working directly with Washington consumers and insurance companies. This position will supervise our consumer hotline staff, oversee consumer hotline operations, serve as the public records coordinator for the division and report on the division's performance.
This opening closes on Sept. 25. Read more about the position or apply at careers.wa.gov.
Thursday, September 11, 2014
Wednesday, September 10, 2014
Can my age be used as a rating factor in auto insurance?
While it may sound like age discrimination, the answer to this question is "yes." A person’s age can be and usually is used as a factor in determining auto insurance rates. Age is connected to risk and is linked to accident frequency, accident severity, and claim costs, so insurers are allowed to factor it into rates.
There are other rating factors typically used by insurers, which you may review on our website.
If you find yourself experiencing a little sticker shock when you see your auto insurance premium, it’s always a good idea to shop for competitive auto rates every now and then. We recommend people do that in order to determine if they can find lower rates for the same coverage. Young drivers can sometimes get discounts for good grades and senior drivers can sometimes get discounts for taking driving classes for people aged 55 or older. Ask your agent or insurer about possible discounts.
Questions? You can contact our consumer advocates online or at 1-800-562-6900.
There are other rating factors typically used by insurers, which you may review on our website.
If you find yourself experiencing a little sticker shock when you see your auto insurance premium, it’s always a good idea to shop for competitive auto rates every now and then. We recommend people do that in order to determine if they can find lower rates for the same coverage. Young drivers can sometimes get discounts for good grades and senior drivers can sometimes get discounts for taking driving classes for people aged 55 or older. Ask your agent or insurer about possible discounts.
Questions? You can contact our consumer advocates online or at 1-800-562-6900.
Monday, September 8, 2014
Seattle Children’s Hospital officially withdraws legal complaint
Seattle Children’s Hospital officially withdrew its legal challenge with the OIC on Sept. 5 after it reached an agreement with Regence Blue Shield to include some services in Regence’s health provider networks for 2014 plans.
Seattle Children’s Hospital initiated legal proceedings about a year ago when Premera, Regence Blue Shield and Coordinated Care decided against including the hospital and research facility in their medical networks because of cost concerns. Seattle Children’s argued the OIC shouldn’t have approved 2014 plans from the three carriers because they excluded the facility from their networks for routine pediatric medical care. The plans argued Seattle Children’s charges for routine pediatric medical care would drive up their costs; Insurance Commissioner Mike Kreidler sided with the plans in favor of “narrow networks” to be able to provide cost-effective services for consumers. No families who needed specialty pediatric care were turned away from Seattle Children’s or had to pay out of pocket for those services.
Seattle Children’s and Premera Blue Cross last month reached an agreement to include the hospital in its medical networks, effective Sept. 1. Coordinated Care earlier this year made a deal to include the hospital in its network and was removed from the case.
OIC is in the process of reviewing 2015 plans that are sold outside of the Washington health benefit exchange. At the end of August, OIC approved 90 health plans for sale inside the Exchange, called Washington Healthplanfinder, with a record low 1.9 percent average rate change.
Seattle Children’s Hospital initiated legal proceedings about a year ago when Premera, Regence Blue Shield and Coordinated Care decided against including the hospital and research facility in their medical networks because of cost concerns. Seattle Children’s argued the OIC shouldn’t have approved 2014 plans from the three carriers because they excluded the facility from their networks for routine pediatric medical care. The plans argued Seattle Children’s charges for routine pediatric medical care would drive up their costs; Insurance Commissioner Mike Kreidler sided with the plans in favor of “narrow networks” to be able to provide cost-effective services for consumers. No families who needed specialty pediatric care were turned away from Seattle Children’s or had to pay out of pocket for those services.
Seattle Children’s and Premera Blue Cross last month reached an agreement to include the hospital in its medical networks, effective Sept. 1. Coordinated Care earlier this year made a deal to include the hospital in its network and was removed from the case.
OIC is in the process of reviewing 2015 plans that are sold outside of the Washington health benefit exchange. At the end of August, OIC approved 90 health plans for sale inside the Exchange, called Washington Healthplanfinder, with a record low 1.9 percent average rate change.
Friday, September 5, 2014
Pierce County woman ordered to repay insurance company for fraudulent car claim
A Pierce County woman was sentenced to 60 days of electronic home monitoring and ordered to repay $17,426 to Travelers Insurance for attempting to collect insurance money for a car she claimed was stolen and destroyed in a fire. Donica Santos, 40, pleaded guilty to one count of first-degree theft and one count of insurance fraud in Pierce County Superior Court last month.
In March 2012, a driver reported Santos’ vehicle was on fire on the side of Reservation Road in north Thurston County at about 1:40 a.m. on March 16, 2012. Santos reported to Travelers’ Insurance Co. later that day that her car had been stolen from her Tacoma home and was a total loss. Santos told investigators that she had last seen her vehicle the previous night and had not left her house or used her cell phone between 10:30 p.m. and 2:50 a.m., when police arrived at her house to investigate.
However, Santos’ cell phone records showed she used her phone repeatedly late the evening of March 15 and the early morning hours of March 16; several of the calls were made in Thurston County, near where her 2006 Chrysler 300C was found on fire.
Travelers denied the claim, but was required by state law pay off the car loan balance of $17,426.
Santos was charged in December 2013 after she was investigated by Insurance Commissioner Mike Kreidler’s Special Investigations Unit.
In March 2012, a driver reported Santos’ vehicle was on fire on the side of Reservation Road in north Thurston County at about 1:40 a.m. on March 16, 2012. Santos reported to Travelers’ Insurance Co. later that day that her car had been stolen from her Tacoma home and was a total loss. Santos told investigators that she had last seen her vehicle the previous night and had not left her house or used her cell phone between 10:30 p.m. and 2:50 a.m., when police arrived at her house to investigate.
However, Santos’ cell phone records showed she used her phone repeatedly late the evening of March 15 and the early morning hours of March 16; several of the calls were made in Thurston County, near where her 2006 Chrysler 300C was found on fire.
Travelers denied the claim, but was required by state law pay off the car loan balance of $17,426.
Santos was charged in December 2013 after she was investigated by Insurance Commissioner Mike Kreidler’s Special Investigations Unit.
Thursday, August 28, 2014
90 health plans approved for next year's Exchange - find one in your area
Health plans and their rates for next year's Exchange, Washington Healthplanfinder were approved by our office and certified by the Exchange board this week.
Consumers shopping inside the Exchange will have 10 companies and 90 plans to choose from, depending on where they live. Not all plans are available in every county, but most people will have more choices and minimal rate changes.
Additional insurers and plans for sale outside of the Exchange are still under review. There may be more plans for sale outside of the Exchange, but premium subsidies are not available.
Open enrollment for inside and outside of the Exchange starts Nov. 15 and runs through Feb. 15, 2015.
Check out the map below to see the 2015 plans and rates available in your county.
Consumers shopping inside the Exchange will have 10 companies and 90 plans to choose from, depending on where they live. Not all plans are available in every county, but most people will have more choices and minimal rate changes.
Additional insurers and plans for sale outside of the Exchange are still under review. There may be more plans for sale outside of the Exchange, but premium subsidies are not available.
Open enrollment for inside and outside of the Exchange starts Nov. 15 and runs through Feb. 15, 2015.
Check out the map below to see the 2015 plans and rates available in your county.
ACA’s 80/20 rule saves consumers money
Created through the Affordable Care Act law, the 80/20 rule, also known as the Medical Loss Ratio (MLR) rule, requires health insurers to spend at least 80 percent of premium money on patient care and quality improvement activities or pay a rebate back to consumers.
This month, the U.S. Department of Health and Human Services reported that since the rule took effect, more insurers year over year are meeting the 80/20 standard by spending more of the premium dollars they collect on patient care and quality, and not red tape and bonuses. If an insurer did not spend enough premium dollars on patient care and quality improvement, they must pay refunds to consumers in one of the following ways:
- A refund check in the mail.
- A lump-sum reimbursement to the same account that was used to pay the premium.
- A reduction in future premiums.
If the consumer bought insurance through their employer, their employer must provide one of the above options, or apply the refund in another manner that benefits its employees, such as more generous benefits.
In 2013, 9,605 Washington consumers received refunds totaling $792,846, an average of $122 per family.
Read more about health care reform on our website. Questions? Contact our consumer advocates online or at 1-800-562-6900.
Wednesday, August 27, 2014
Temporary special enrollment for those stuck in Exchange plans begins today
A temporary special enrollment period begins today for those consumers who have experienced difficulties with enrollment in health plans on the Washington Healthplanfinder.
Insurance Commissioner Mike Kreidler authorized the special enrollment period this week as another option to those who feel they might need more help. This voluntary special enrollment period starts Aug. 27 and runs through Nov. 14, 2014. Only people who attest to having enrollment, billing, or payment issues with an Exchange plan may change plans during this time.
If you’re considering this option, you should be aware of all of the details involved, including the fact that you could lose a current premium subsidy. Special enrollment may not be the best choice for everyone. But as the commissioner notes, “Hopefully, it will bring relief to some.”
A list of answers to questions about this temporary special enrollment is available on our website.
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