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Around the PIA Western Alliance States

Posted By Administration, Monday, June 12, 2017

Arizona — Flood Control
The federal government — via the Army Corps of Engineers — has given Flagstaff $1 million for a Rio de Flag flood control project. It gives the city the resources to acquire the land, do the flood control design and start the project.

City officials say the project is critical to controlling flooding and avoiding damage to 1,500 structures. It will also do away with the need for those owning those structures to purchase flood insurance.

 

California — Insurance Fraud Scheme
Ten lawyers and six other people have been arrested over a multi-million dollar workers’ compensation crime. The Orange County District Attorney’s office did the investigation that it says targeted Latinos.

The scheme involved 30,000 patients and $300 million in billing. The group used flea markets and other places to entice Latinos into participation.

No charges were filed against doctors and hospitals.

 

California — Data Breach Law
A new bill has been floated in the California Legislature to require public agencies to provide data protection for a year if a breach happens. This law already applies to hospitals and health care businesses and retail businesses.

Right now, it is stalled because public agencies don’t really have the cash available to make consumers whole. And some critics say once a person’s ID has been compromised, it is compromised forever.

The stall has not deterred Assemblyman Matt Dababneh — and Democrat from Woodland Hills — who says his point is to force government agencies to make themselves more secure. California agencies — according to authorities — have been victim to many hacking schemes and the records of millions have been compromised.

By the way, these are the six largest California breaches:

  Anthem 2015 — 10.4 million records stolen

  Target 2013 — 7.5 million records stolen

  Living Social 2013 — 7.5 million records stolen

  UCLA Health 2015 — 4.5 million records stolen

  PNI Digital Media (Costco, RiteAid, CVS) 2015 — 2.8 million records stolen

  T-Mobile 2015 — 2.1 million records stolen

Source link: Los Angeles Times

 

Nevada — Electronic Insurance Notice
Nevada Governor Brian Sandoval said yes to a law that gives consumers the option to get their insurance policies and other documents and consumer notices electronically. He signed Assembly Bill 455 into law last week.

Property Casualty Insurers Association of America (PCI) spokesman Mark Sektnan said, “Increasingly consumers want to conduct their personal business online using their smartphone or tablet. They want fast access and user-friendly ways to see their documents. Assembly Bill 455 gives insurance customers more choice, convenience and flexibility in managing their insurance.”

Nevada is now the 23rd state to do allow electronic delivery and Sektnan said it’s also a cost saver that can be passed onto consumers. “These modernized delivery options reduce energy consumption, paper use and other consumables associated with conventional mail. This is a win-win for everyone,” he said.

Source link: Financial Regulation News

 

Washington — Actions from the Insurance Commissioner
Notice of rulemaking on Obsolete citations to domestic insurer investments (R 2017-02)
. We are starting rulemaking (R 2017-02) to consider repealing and/or amending the obsolete statutory citations to the rules regarding domestic insurer investments.

Comments are due July 20, 2017; please send them to rulescoordinator@oic.wa.gov.

Prior authorization rule adopted. We adopted the prior authorization processes and transparency rule (R 2016-19) on June 5, 2017. The rule will take effect July 6, 2017 though some requirements are being phased in over time. The rule is intended to standardize the process of prior authorization and to streamline the prior authorization process to ensure it is more transparent for consumers and providers.

For more information, including the adopted rule (CR-103P) and the concise explanatory statement, please visit the rule's webpage.

Insurance Commissioner’s Emergency Powers rule withdrawn. We have withdrawn the pre-proposal (CR-101) on the Insurance Commissioner’s Powers during a state of emergency rule (R 2015-17). We withdrew the pre-proposal for the rule because we have determined that this rulemaking is not necessary at this time.

For more information, including the withdrawal letter, please visit the rule's webpage.

Notice of rulemaking on Federal model privacy form (R 2017-01). We are starting rulemaking (R 2017-01) to encourage carriers to use the federal model privacy form by providing a safe harbor of compliance. The rule will be identical to the recently revised NAIC Model Privacy of Consumer Financial and Health Information Regulation.

Comments are due July 21, 2017; please send them to rulescoordinator@oic.wa.gov.

For information on any of these changes go to the commissioner’s website: https://www.insurance.wa.gov/obsolete-citations-domestic-insurer-investments-r-2017-02?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=

 

Washington — Kreidler’s Health Insurance Concerns
Eleven health insurers have filed 71 plans for Washington state’s 2018 individual health insurance market:

Six insurers inside the Exchange, Washington Healthplanfinder: Coordinated Care Corporation, Kaiser Foundation Health Plan of Washington, Kaiser Foundation Health Plan of the Northwest, Lifewise Health Plan of Washington, Molina Healthcare of Washington, and Premera Blue Cross.

Seven insurers outside the Exchange: Asuris Northwest Health, BridgeSpan Health Company, Health Alliance Northwest Plan, Inc., Regence BlueCross BlueShield of Oregon, Regence BlueShield, Kaiser Foundation Health Plan of Washington, and Kaiser Foundation Health Plan of the Northwest.

Two insurers selling both inside and outside the Exchange: Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of the Northwest.

Currently, no insurer has filed plans in two counties – Klickitat and Grays Harbor.

Two insurers, Community Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc., announced earlier this year that they will not participate in the 2018 individual health insurance market.

However, Kaiser Foundation Health Plan of Washington and Kaiser Health Plan of the Northwest will remain in both the Exchange and outside Exchange market for 2018.

As of March 2017, 1,119 people in Klickitat County and 2,227 in Grays Harbor County were enrolled in the individual market.

Under current state law, if no health insurer is available in a particular county, the only coverage option is through Washington state’s high-risk pool, WSHIP. However, because WSHIP is not a qualified Exchange insurer, subsidies would not be available.

“I will be reaching out to our health insurers this week to strongly encourage them to reconsider their participation in the two counties that have no options for 2018,” said Insurance Commissioner Mike Kreidler. “After that, I will look for whatever options are available at the state level to protect the stability of our health insurance market. The more than 316,000 consumers who buy their own health insurance are counting on us to do no less.”

All proposed rates for 2018 will be public 10 days from the June 7 filing deadline. No decisions will be made until early fall. Rates as well as coverage areas may change during the review.

Insurers and number of proposed individual market plans by county for 2018 (PDF, 88.90 KB)

“I’m deeply troubled by the changes we’re seeing for next year’s health insurance market,” said Kreidler. “The proposed drop in insurers and coverage areas clearly indicates to me that the uncertainty the Trump administration and the GOP-controlled Congress has sowed for months is sabotaging the progress we’ve made. Their actions, including failing to commit to fund the cost-sharing subsidies, not enforcing the individual mandate, and continuing to push in secret the severely flawed American Health Care Act are eroding confidence health insurers have in the market here and across the nation. These actions only increase premiums and decrease insurer participation.

“The Affordable Care Act has worked in Washington state because we fully embraced the reforms it offered – including expanding Medicaid and creating our own state Exchange. These decisions helped increase competition, provided better coverage and access, and fueled the largest drop in our uninsured in decades. Much more could be done to improve upon our progress, but that would take congressional action focused on shoring up the law, versus taking it down.

“For months, we’ve worked closely with our health insurers and other stakeholders in a concerted effort to try to explain to the Trump administration and congressional leaders what the impact could be to our market and most importantly, to our consumers, if this level of uncertainty and volatility continued. Today, our predictions came true."

Tags:  Around the PIA Western Alliance States  Insurance Content  Insurance Industry  Insurance news  Weekly Industry News 

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