Alaska — Notice of Public Scoping: The Alaska Division of Insurance (division) is holding a public hearing to seek input about what changes are needed in 3 AAC, the regulations of the Division of Insurance, and what regulations can be repealed altogether.
The division is in the information gathering stage and seeks comments and recommendations from members of the public for proposed changes before a decision is made on what changes to make to 3 AAC. The division is not proposing any changes to the regulations for the hearing. There are no draft regulations to review. Please note that this is for all of 3AAC, and not specifically focused on the 80th Percentile Regulation. The division has held multiple hearings on that particular regulation, and will not be discussing it during this hearing.
The division invites you to attend the public hearing to be held on November 6, 2019, from 1:00 p.m. to 3:00 p.m. to share your oral or written comments on proposed changes to the regulations of the Division of Insurance. The hearing will be held in Conference Room 1560, at the Atwood Building, 550 West Seventh Avenue, Anchorage, Alaska and in Conference Room C on the ninth floor of the State Office Building, located at 333 Willoughby Ave., Juneau, Alaska.
The hearings may be extended to accommodate those present before 3:00 p.m. who did not have an opportunity to comment. If you are unable to attend a hearing in person and would like to participate by teleconference, please call 1 (800) 315-6338 and enter access code 42070 followed by the # (pound sign).
To submit a comment or proposal through the mail, via email, or the Alaska Online Public Notice System, parties submitting suggestions for rule changes should send a clear and concise statement with the following information:
The citation for the specific rule on which you are commenting.
• Why the rule should be reviewed, revised, or repealed.
• The issue the rule causes and why changing it should be a priority for the division.
• A brief description of your idea for improving the rule.
You are also invited to submit written comments to the Alaska Division of Insurance, Attention Jackson Willard; P.O. Box l 10805, Juneau, AK 99811-0805 or by e-mail to firstname.lastname@example.org or by fax to (907) 465-3422. All comments must be received no later than 5:00 p.m., November 6, 2019.
If you are a person with a disability who needs a special accommodation in order to participate in this process, please contact Sian Ng-Ashcraft at email@example.com or (907) 269-7892 not later than November 1, 2019, to ensure that any necessary accommodations can be provided.
Notice of Public Scoping: https://www.commerce.alaska.gov/web/Portals/11/Pub/INS_Notice_09.2019.pdf
Alaska — Bulletin B19-13: Liability for Assisting in the Transaction of Unauthorized Insurance
The Alaska Division of Insurance (division) reminds all insurance licensees and third-party administrators (TPAs) assisting a company engaged in the unauthorized transaction of insurance may put their licenses or registrations at risk and that they may be held responsible pursuant to Alaska Statutes AS 21.27.410(a)(13) and AS 21.33.037 (a), (c), and (d).
The division has noted new types of health insurance or insurance products are being marketed to Alaska consumers. While some of these products, including self-funded single employer health plans under ERISA and recognized health care sharing ministries are exempt from state regulation and do not need a license, certificate, or authorization from the division, other products are subject to the provisions of Title 21. Specifically, companies may claim to be a health care sharing ministry or other innovative organization without complying with the requirements of the claimed exemption. The division advises licensees and TPAs to carefully evaluate all new products and organizations. You may check the National Association of Insurance Commissioners or Alaska Division of Insurance websites to verify a company’s license or certificate of authority. If you have questions about a company or product, call the division at 907-269-7900.
Insurers and consumers may review the division’s bulletin B02-14 available at https://www.commerce.alaska.gov/web/portals/11/pub/Bulletins/B02-14.pdf for additional information regarding ERISA plans, multiple employer welfare arrangements (MEWAs), and the characteristics of unauthorized and unlicensed health insurance plans.
If you believe an organization may be engaged in the unauthorized transaction of insurance, please notify the division at (907)-269-7900 or firstname.lastname@example.org.
If you have questions relating to this bulletin, please contact Chris Murray at (907) 465-2545 or chris.Murray@alaska.gov.
Bulletin B19-13: https://www.commerce.alaska.gov/web/Portals/11/Pub/INS_B19-13.pdf
Arizona — From the Arizona Department of Insurance: The State of Arizona’s Department of Insurance (AzDOI) technology team is advising insurance agents and company personnel of a phishing scam. It is based on information gathered from National Association of Insurance Commissioners (NAIC) and Arizona Department of Administration Security Operations Center (AZSOC) and Security Privacy and Risk groups.
This phishing scam targets insurance professionals claiming that the National Association of Insurance Commissioners received a complaint against the professional for submitting a falsified claim. This fraudulent email displays the NAIC and CIPR logos, can originate from what appears to be an naic.org or gmail.com email account, and instructs the recipient to click on a link to download the complaint notification.
Certain antivirus products will detect this as a malicious email. If you receive a similar email and have any concerns, contact the NAIC Service Desk at (816) 783-8500 or email@example.com.
• The email subject line reads “National Association of Insurance Commissioners” and the email contains a link.
• The email displays the NAIC and CIPR logos.
• The email presents itself as from a gmail account or firstname.lastname@example.org. The latter is not a valid NAIC address.
• The audience originally included producers in Wisconsin, and has been expanded to include Illinois, Minnesota, and Washington.
This has been identified as phishing attempt because the obvious characteristics (e.g., use of NAIC/CIPR logo and naic.org email address). Clicking on the link would have downloaded a malicious payload that has now been identified as a Remote Access Trojan (Lime RAT). Lime RAT can be used to perform various nefarious functions, one of those being ransomware.
Idaho — Medicare Plan Finder Gets an Upgrade: The Centers for Medicare & Medicaid Services (CMS) launched a modernized and redesigned Medicare Plan Finder, making it easier to compare coverage options and shop for Medicare health and drug plans.
Medicare Open Enrollment is the time for people with Medicare to review their health coverage, which runs from October 15, 2019 to December 7, 2019. There are more than 60 million people with Medicare coverage
What’s new about the Medicare Plan Finder?
The updated Medicare Plan Finder provides a personalized experience through a mobile friendly and easy-to-read design that will help customers learn about different options and select coverage that best meets their health needs. However, the online tools do not replace Medicare’s traditional customer service options.
Benefits of the new Medicare Plan Finder helps customers with the following:
Compare pricing In Medicare Advantage Plans, Medicare Prescription Drug Plans, Medicare Advantage plans, and Medicare Supplement Insurance (Medigap) policies side-by-side
Provides tech savvy support to compare options on smartphones and tablets
Get plan costs and benefits, including which Medicare Advantage plans offer extra benefits
Build a personal drug list and find Medicare Part D prescription drug coverage
For more information, visit Medicare.gov or call 1-800-MEDICARE. In addition, staff with Idaho’s Senior Health Insurance Benefits Advisors (SHIBA) Program, a unit of the Idaho Department of Insurance, is available to answer questions at 1-800-247-4422.
Idaho — Medicare enrollment events to be offered statewide: The Medicare Annual Enrollment period begins October 15th and ends December 7th.
Medicare health and prescription drug plan costs and coverage can change every year. SHIBA (Senior Health Insurance Benefits Advisors) highly recommends people with Medicare review their coverage before the enrollment period ends. Failing to compare and review coverage plan options increases the risk of spending more money on unnecessary health care costs down the road. In addition, with coverage changes, medications and services may no longer be covered by a previous year’s health plan.
Beginning the first week of October, Certified Medicare Counselors from The Department of Insurance’s SHIBA Program will be available across the state. Medicare beneficiaries will have the opportunity to meet one-on-one with a trained Medicare counselor to compare and review their current Medicare Advantage plans, prescription drug plans, and new options available in 2020. In short, SHIBA counselors help people make informed decisions about their specific health insurance needs.
SHIBA counselors will be available in these Idaho cities: Boise, Jerome, Mountain Home, Nampa, Parma, Fairfield, Cambridge, McCall, Gooding, Blackfoot, Idaho Falls, Pocatello, Preston, Coeur d’Alene, Moscow, Kellogg, St. Maries, Lewiston, Sand Point, and Post Falls.
To make an appointment with a SHIBA Medicare Counselor near you, call 1-800-247-4422.
Montana — Work Comp Dividend: The Montana State Fund will pay out a $30 million dividend to workers’ compensation policyholders. They will go out by mid-November.
The $30 million is a return of 22% of the premiums paid by Montana businesses this year. The Montana State Fund — as the largest work comp company in the state — insures 25,000 businesses. The $30 million — however — is down from 2017 and 2018 when the dividend hit $40 million each year.
Source link: Business Insurance
Oregon — Work Comp Cost Drop: Oregon’s long-running success in managing the workers’ compensation system continues as businesses will see yet another drop in costs in 2020 as the key factor behind annual cost changes dips yet again. The numbers are indicative of a long-term trend:
• Employers, next year, on average, will pay $1.02 per $100 of payroll for workers’ compensation insurance, down from $1.11 in 2019, under a proposal by the Oregon Department of Consumer and Business Services (DCBS). That figure covers workers’ compensation claims costs, assessments, and insurer profit and expenses.
• The pure premium rate – the base rate insurers use to determine how much employers must pay for medical claims and lost wages – will drop by an average 8.4 percent, under the proposal. In fact, the pure premium – filed by a national rate-setting organization and approved by DCBS – will have declined by 45 percent during the 2013 to 2020 period.
This will mark the seventh year in a row that businesses will experience an average decrease in their workers’ compensation costs. Those costs have steadily declined over the years, even as workers continue to receive good benefits. The ongoing decline in costs reflects Oregon’s comprehensive approach to managing the system, including efforts by the Workers’ Compensation Division (WCD) and Oregon OSHA. For example, WCD enforces requirements that employers carry insurance for their workers, keeps medical costs under control, and helps injured workers return to work sooner and earn their pre-injury wages. At the same time, Oregon OSHA enforces on-the-job safety and health rules, identifies hazards so they can be corrected, and advises employers about how to boost worker safety and health.
“The steady decline in workers’ compensation costs is about more than just the numbers,” said Cameron Smith, DCBS director. “It demonstrates the hard work of employers, workers, insurers, and government to maintain essential worker protection programs and robust benefits for injured workers while keeping business costs low.”
Although average workers’ compensation costs have experienced upticks from one year to the next, the overall trend line is one of continuing cost decreases. Average wage replacement and medical costs for injured workers “are showing a long-term downward trend,” according to the National Council on Compensation Insurance (NCCI), the U.S. rate-setting organization whose recommendation DCBS reviews. Meanwhile, “Oregon’s lost-time claim frequency has generally been decreasing moderately over the past few policy years,” according to NCCI.
Employers’ cost for workers’ compensation insurance covers the pure premium and insurer profit and expenses, plus the premium assessment. Employers also pay the Workers’ Benefit Fund assessment, which is a cents-per-hour-worked rate.
The decrease in the pure premium of 8.4 percent is an average, so an individual employer may see a larger or smaller decrease, no change, or even an increase depending on the employer’s own industry, claims experience, and payroll. Also, pure premium does not take into account the varying expenses and profit of insurers.
The average decrease in the pure premium reflects a long-term trend of lower medical care costs and less severe claims. Helping sustain the trend is the stability of Oregon’s workers’ compensation system. The system includes the Workers’ Compensation Division, Oregon OSHA, the Workers’ Compensation Board, which resolves disputes over the state’s workers’ compensation and workplace safety laws, and injured worker and small business advocacy services.
Those successful programs are funded by the premium assessment.
The premium assessment is a percentage of the workers’ compensation insurance premium employers pay. It is added to the premium. It would increase from 7.8 percent this year to 8.4 percent in 2020. The increase is needed to partially offset the decline in pure premium and to keep pace with a growing economy. This modest increase maintains stable funding for state workers’ compensation regulation and worker protection programs that preserve historically low costs.
The Workers’ Benefit Fund assessment provides benefit increases to permanently disabled workers and to families of workers who died from a workplace injury or disease. It also supports Oregon’s efforts to help injured workers return to work sooner – through incentive programs to employers – and earn their pre-injury wages.
The fund’s revenue comes from a cents-per-hour-worked assessment. It would decrease from 2.4 cents per hour worked in 2019 to 2.2 cents per hour worked in 2020. The fund is healthy, made so by a growing economy, which allows the rate to be reduced.
The decrease in the pure premium is effective Jan. 1, 2020, but employers will see the changes when they renew their policies in 2020. The assessment changes are effective Jan. 1, 2020.
Oregon’s workers’ compensation premium rates have ranked low nationally for many years. Oregon had the sixth least expensive rates in 2018, according to a nationally recognized biennial study conducted by DCBS. That was an improvement from Oregon’s ranking as the seventh least expensive state the last time the study was done in 2016. Oregon’s experience of declines in workers’ compensation costs is part of a national trend.
The following chart summarizes all of the changes and includes the date, time, and place of the assessment public hearings: https://www.oregon.gov/DCBS/cost/Documents/wc-summary.pdf
Annual Oregon average pure premium rate changes and average changes by industry: https://www.oregon.gov/DCBS/cost/Documents/pure-premium-rate.pdf
More information about Oregon workers’ compensation costs: http://www.oregon.gov/DCBS/cost/Pages/index.aspx
Washington — Health Insurer Plans: Eight health insurers have been approved to sell health plans in Washington state’s 2020 Exchange, Washington Healthplanfinder, with a record low average rate decrease of -3.27%.
“I’m pleased to see the average rate change go down and that many will see lower premiums next year,” said Insurance Commissioner Mike Kreidler. “This comes in the face of continuing efforts by the Trump administration to dismantle the Affordable Care Act with no replacement plan. We still have work to do to lower the underlying cost of health care and to help lower out-of-pocket costs, but these new rates are welcome news.”
One additional Exchange insurer — Providence Health Plan — is still under review. Four insurers — Regence BlueShield, Regence BlueCross BlueShield of Oregon, Asuris Northwest Health and Health Alliance Northwest Health Plan — intend to sell only outside of the Exchange and are also still under review.
How much someone will pay depends on the plan they choose, if they qualify for any financial help, where they live, their age, whether or not they smoke and how many family members are covered, and their family members' age.
Approximately 241,000 people who don’t get coverage from their employer must buy their own health insurance through the individual market, with most shopping through the Exchange. In Washington, 65% of people who buy Exchange plans qualify for subsidies that help lower their monthly premiums.
Source link: Washington Department of Insurance
Washington — Surprise Billing: Section 23 of the Balance Billing Protection Act (Chapter 427, Laws of 2019) gives self-funded group health plans the opportunity to participate in the Act, and protect their enrollees from balance billing for the services included in the Act.
We are seeking stakeholder input on the forms and process that self-funded group health plans would use to elect to participate in the Act.
Please submit comments by October 4, 2019 to the OIC Rules Coordinator — Balance Billing Protection Act Implementation - Self-funded group health plan plans
Section 23 of the Balance Billing Protection Act (Chapter 427, Laws of 2019) gives self-funded group health plans the opportunity to participate in the Act, and protect their enrollees from balance billing for the services included in the Act.
We are seeking stakeholder input on the forms and process that self-funded group health plans would use to elect to participate in the Act.
Please submit comments by October 4, 2019 to the OIC Rules Coordinator.
Learn more about our work on surprise or 'balance' billing — https://www.insurance.wa.gov/surprise-medical-billing?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=
Washington — Surprise Billing: The Washington Department of Insurance posted a stakeholder letter on the Surprise Billing webpage: https://www.insurance.wa.gov/surprise-medical-billing?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=
Washington — Work Comp Rates: The price of workers’ compensation insurance in Washington would drop for the third year in a row under a proposal by the Washington Department of Labor & Industries.
The L&I on Wednesday proposed a 0.8% decrease in the average premium employers would pay for the coverage in 2020.
“Workplace injury rates in Washington are declining, and we’ve had great success in recent years helping injured workers heal and return to work,” L&I Director Joel Sacks said in a statement. “That’s good for everyone and is helping us keep the price of workers’ compensation insurance down.”
In 2018, the average workers’ comp premium rate dropped by 2.5%. L&I lowered the 2019 rate by another 5%, the largest decline in more than 10 years.
The proposed decrease would mean Washington employers, as a group, pay a total of $21 million less in premiums. According to L&I, the price drop would result in employers paying an average of about $15 less a year per employee for workers’ comp.
Employees would see a very small increase in the amount they pay because of a rise in costs related to the supplemental pension fund, due to an increase in the average wage in Washington. The supplemental pension fund supports cost-of-living adjustments for long-term time-loss and pension benefits.
The public will get an opportunity to provide input about the rate proposal before a final decision is made in late November.
Three public hearings are scheduled:
• Tukwila, Oct. 29, 10 a.m., Deptartment of Labor & Industries Tukwila office
• Spokane Valley, Oct. 30, 9 a.m., Spokane CenterPlace
• Tumwater, Nov. 1, 10 a.m., Tumwater Labor & Industries office
People can also comment in writing to Jo Anne Attwood, administrative regulations analyst, at P.O. Box 41448, Olympia, WA, 98504-4148; or email joanne.attwood@Lni.wa.gov. All comments must be received by 5 p.m. on Nov. 5.
More information about the proposal is available at www.Lni.wa.gov/Rates. Final rates will be adopted by early December and go into effect Jan. 1, 2020.
L&I workers’ compensation insurance covers about 3 million workers and nearly 180,000 employers in Washington.
Source link: The Washington Department of Labor & Industries