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Feedback — No to Oregon Governor’s SAIF Raid Plan

Posted By Staff writer, Tuesday, April 9, 2019

Rich Kingsley was PIA Oregon/Idaho’s president from 2004 to 2005. He was, and still is very savvy politically. He recently sent Portland, Oregon’s daily newspaper, The Oregonian, a letter to the editor.

 

His concern? Governor Kate Brown’s plan to raid the reserves of the State Accident Insurance Fund Corporation (SAIF) to pay for the shortfall in the state’s PERS fund. PERS — as we all know — is not properly funded and the state is desperate to find a way to give the money promised by PERS to retired public employees.

 

The governor — and her SAIF fund-grabbing supporters — say SAIF has $1.4 billion in surplus that can be used to shore up PERS. 

 

Here are parts of Rich Kingsley’s letter to the editor. He asks some great questions. Some of which we will answer after you read what he wrote.

 

I was an Independent Insurance Agent in the insurance business for 37 years, writing mostly commercial policies for clients. I not only feel frustration, but extreme anger with the Democrats who want to raid SAIF.

 

In the late 1980's the legislature did just this same stupid “Raid SAIF” stunt. I think it was in 1996 or 1997 that a lawsuit against the State for ‘robbing’ funds from SAIF was settled, and the State was found culpable for taking money from SAIF. The State had to refund money to SAIF AND refund money to commercial clients that had to pay higher work comp rates thru SAIF, due to the State's robbing of those funds in the 1980's. The State not only had to return the funds, but interest for all the years the lawsuit went on.

 

When the funds were sent to be repaid back to commercial clients who had paid higher premiums, SAIF sent the checks to the agents who had assigned our work comp clients to SAIF, and we hand delivered the checks to our clients, who knew that we and our agent association [PIA Oregon/Idaho] had been highly in favor of penalizing the State for their act of stupidity in 'robbing' SAIF. Those businesses that had bought their work comp directly from SAIF received their checks in the mail.

 

It was a stupid stunt then, and to think of doing it again is still stupid, and reckless.

 

He then praises the newspaper for bringing to light the problems with this blatant theft of money that belongs to the state’s employers.

 

Kingsley is correct that the dollars in the fund that aren’t used for claims belong to employers. Many governor and Legislatures in states around the country are looking at their own versions of SAIF and those surplus funds to balance budgets.

 

The PIA Western Alliance state of Montana is the other state in our association where the Legislature has made a grab. PIA Montana and other groups and employers in the state oppose the taking of those surplus funds and a lawsuit was filed.

 

It will be heard in the Montana Supreme Court later this year or early next. Experts in Montana law believe the taking of the money from the Montana State Fund will be found unconstitutional and it will have to be returned.

 

To answer Rich Kingsley’s question. In the early 1980s, the Oregon Legislature had a budget crisis. It grabbed $80 million of SAIF’s reserves. A lawsuit followed and the Oregon Supreme Court said the state acted illegally and ordered the money returned.

 

With interest, $225 million was returned to SAIF and its policyholders. The attorneys fees and the cost of the litigation totaled a staggering $20 million.

 

The group opposing the Oregon governor’s SAIF funds plan includes PIA Oregon/Idaho. In their response to Brown’s plan the group said, “Doing so is nothing more than a Ponzi scheme. They [the governor and the Legislature] are literally stealing from one pot to cover liabilities in another and hoping that you can pay it back before something bad happens. That’s a dangerous game.”

 

In its response document, the group pointed out that those reserve funds are good for Oregon’s employers and Oregon’s economy.

 

“The premiums paid by Oregon employers are some of the lowest in the nation thanks to SAIF. It’s one of Oregon’s few competitive advantages. SAIF’s board and leadership are 100% local,” the group wrote. “They don’t operate like big corporate insurers and that’s proven to be a good thing for Oregon workers and employers alike.”

 

In addition to PIA Oregon/Idaho, these are the groups opposing Governor Brown’s plan.

Professional Land Surveyors of Oregon

Oregon Columbia Chapter of the Associated General Contractors

Oregon Economic Development Association

National Federation of Independent Businesses

Oregon Business & Industry

Economic Development for Central Oregon

Oregon Farm Bureau

Plumbing-Heating-Cooling Contractors Association

Oregon School Boards Association

Oregon Trucking Association

Oregon Home Building Association

Oregon Vehicle Dealer Association

Northwest Grocery Association

Oregon Metals Industry Council

Oregon State Chamber of Commerce

Oregon Wheat Growers

Oregon Seed Council

Columbia Gorge Fruit Growers

Oregon Power Sports Association

Northwest Automotive Trades Association

Oregon Manufacturers and Commerce

Far West Agribusiness Association

Oregon Association of Nurseries

Oregon Concrete & Aggregate Producers Association

Associated Oregon Loggers

Tags:  insurance content  insurance industry  insurance news  PERS  Raid the reserves of SAIF  SAIF 

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Oregon’s PERS Puzzle — In Search of a Solution

Posted By Staff writer, Tuesday, April 9, 2019

Oregon Governor Kate Brown and the Oregon Legislature are desperately looking for ways to beef up the state’s PERS system. It appears to be running out of money. As a fix, Brown is suggesting taking the State Accident Insurance Fund’s (SAIF) $1.4 billion surplus.

 

Of course, that money belongs to the businesses that buy work comp from SAIF but apparently Brown and some in the Legislature aren’t aware of how SAIF is constructed, nor have they looked deeply into the last time a Legislature grabbed those funds.

 

It cost the state over $225 million.

 

Oregon’s business community is looking at two ballot measures that may go a long way toward solving the PERS problem by fixing the future. The first gives new hires the option of a 401(k)-type retirement plan that is financed by a 6% salary contribution of the employee and an equal amount by the employer.

 

These new hires could pick this or the pension system as it exists now. They cannot — however — do both as today’s employees can. If enough signatures are gathered to put it on the ballot, and if it passes, then starting in July of 2021, employees would give 6% of each paycheck toward their choice.

 

Ballot idea two requires the Oregon Legislature to study a new 401(k) style retirement plan — like that just discussed — and then submit recommendations to implement the plan by 2022. At the same time, the idea will require current employees and new employees to pay a third of the cost of their pension benefits going forward.

 

The costs range between 2.8% and 6% depending on job classification.

 

The two petitioners are former governor Ted Kulongoski and former Republican legislator Chris Telfer. “This is not a short-term issue,” Kulongoski said. “For the next 20 years, this will eat at state government finances unless this issue is dealt with. If nothing else, I’m hoping the legislature starts looking at this much more seriously than they have.”

 

Kulongoski and Telfer got interested in pushing these ideas from interaction with the Oregon Business Council and the business council’s group, PERS Solutions for Public Services. For years both have — and with no success — pushed the Oregon Legislature to solve the PERS issue.

 

Tim Nesbitt is a labor leader. He has been the Oregon Business Council’s PERS consultant for years. Nesbitt thinks it’s going to take more than just a business community push to get PERS reforms passed.

 

“If the legislature doesn’t act this year, it would be on the ballot for the 2020 general election,” Nesbitt said. “By then, schools and other employers will be staring at another big PERS cost increase. This only gets worse. It intensifies to crisis proportions, whether we’re there already or will be” in the next few years.”

 

Nesbitt said the two groups, and Kulongoski and Telfer are taking both ideas to various places to get some sort of consensus. He doubts both will end up on the ballot. More than likely it will be something that combines both ideas.

 

Each will take 112,020 signatures to get on the ballot to be seen by Oregon voters in 2020.

 

Nesbitt says neither measure will do much to help with the $27 billion unfunded liability of the Oregon Public Employees Retirement Fund. They would — if passed — ease the future impact to schools and public agencies.

 

Lou Ogden is the former mayor of Tualatin, Oregon. Former state representative Julie Parrish has joined Ogden and others to form Unified Business Oregon. Ogden says they like the two ballot measures. “Our organization applauds Governor Kulongoski and Senator Telfer for stepping up to lead on PERS reforms,” Ogden said. “They too have set aside party differences to come together to do what's right for all Oregonians, and we'll be there to help.”

 

Parrish is also working as a co-sponsor for another ballot measure that prohibits the state — or any government — from borrowing money to pay PERS obligations.

 

Source link: OregonLive.com

Tags:  California’s Superstorm: Did it end the drought?  insurance content  insurance industry  Oregon 

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Social Media — A Love-Hate Relationship

Posted By Staff writer, Tuesday, April 9, 2019

We don’t like social media big shots like Twitter and Facebook. Or so says an NBC News/Wall Street Journal poll. It found a high percentage of us say these sites do nothing positive. In fact, they do more to divide us than they do to unite us. Respondents say the sites spread falsehoods that some try to pass off as legitimate news.

 

The poll also found six in 10 of us — or 60% — don’t trust Facebook to protect vital personal information.

 

Going a step farther, when it comes to the economy, the poll things technology has more positives and benefits than drawbacks. However, half of us want to see the largest technology companies — Apple, Google, Amazon and Facebook — broken up.

 

Micah Roberts is a spokesman for the Republican-leaning Public Opinion Strategies. He said, “Social media — and Facebook, in particular — have some serious issues in this poll.” And then he added, “If America was giving social media a Yelp review, a majority would give it zero stars.”

 

When asked if the federal government should break up the largest tech companies like Apple, Amazon, Facebook and Google:

 

  47% said yes

  50% said no

 

Here is how the poll says we view social media:

 

  82% — wastes our time

  15% — say they help us use our time well

  61% — spreads unfair attacks and rumors

  32% — say it holds public figures and corporations accountable

  57% — it divides us

  55% — spreads lies and falsehoods

  Just 35% say these sites do more to bring us together

  Younger respondents to the poll are less likely to say social media divides us than older respondents

 

Here’s how we perceive the technology giants in terms of trust and when it comes to our personal information:

 

  28% don’t trust Amazon

  37% don’t trust Google

  36% view Facebook positively

  33% see it as a negative

  Twitter is 24% positive, 27% negative

  35% don’t trust the federal government

 

When it comes to personal information, and the collecting of personal information, most of us say giving these companies our personal information to pass onto advertisers is not an adequate trade-off for free or for lower priced social media services:

 

  74% say it is not an acceptable trade off

  23% are good with the trade off

 

Jeff Horwitt of Hart Research Associates is a pollster for Democrats. He said “If these were political candidates, it would be one thing. But for companies, you’d think these ratings would be [more] on the positive side.”

 

Here’s more:

 

  69% use social media once a day or more often

  63% pay bills online

  In the last couple of years, 48% have made an effort to limit how often they use their smartphone

  42% have made an effort to limit or stop using social media in the last couple of years

  42% have applied for a job using an online job search site

  33% listen to podcasts to get news and information

  26% have blocked or unfriended someone on Facebook or another social media site because of their political opinions

  26% use a personal assistant device like Alexa or Google Home

  24% have used a ride-sharing app like Uber of Lyft in the last month

  18% have used an online dating app or website

  14% play an online multi-player video game

 

Last question — how old is a child under age of 18 old enough to have their own smartphone:

 

  42% said 15 or older

  40% said 12 to 14

  11% say 11 and younger

 

Source link: NBC News

Tags:  Around the PIA Western Alliance States  insurance content  insurance industry  social media 

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Around the PIA Western Alliance States

Posted By Staff writer, Tuesday, April 9, 2019
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Idaho

Health Plans: Non-grandfathered transitional health plans, also known as “grandmothered” plans, will be extended through December 31, 2020, the Idaho Department of Insurance announced.  The announcement follows the latest guidance released March 25, 2019 by the Centers for Medicare & Medicaid Services (CMS) that allows states the option of extending such plans.

 

Most Affordable Care Act (ACA) market reforms took effect January 1, 2014.  Non-grandfathered health policies in existence prior to that date are considered “transitional policies.”  Director Dean Cameron says these types of health policies continue to serve many consumers well.

 

“Numerous individuals and families have held onto these transitional policies since before 2014,” said Cameron.  “We are pleased they will have the option to retain them for another year.”

 

Transitional policies are not fully ACA-compliant; however, they must comply with state law and only specific ACA provisions regarding annual dollar limitations, pre-existing condition exclusions, waiting periods and mental health parity rules.  Carriers are to provide notice at renewal informing individuals or small employers of renewal options, including the opportunity to enroll in ACA-compliant plans.  CMS is permitting states to continue the extension of transitional plans through the “substantially enforcing” provision of the ACA.

 

For further information, click Bulletin 19-02, visit the Department website at doi.idaho.gov or call 208-334-4250.

 

Source link: Idaho Department of Insurance

 

 

Montana

Recreational Marijuana Goes Down: The House Taxation Committee has voted down a bill that would have made Montana the latest state in the union to allow recreational marijuana to be smoked legally.

 

The bill was tabled by a 12 to six vote.

 

Supporters argue the legalized pot would be a good profit center tax wise. The 32% tax could bring in $35 to $55 million a year in revenue.

 

Source link: Insurance Journal

Tags:  Insurance Content  insurance industry  Weekly Industry News 

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Washington House & 9.9% Capital Gains Tax

Posted By Administration, Tuesday, March 26, 2019

Former PIA Washington Alaska President Dick Fournier.

Legislatures are always seeking ways to raise income to support state governments. Name the state and business is almost always a target. In this case the state is Washington and its governor, Jay Inslee — now a candidate for U.S. President — wants a 9% capital gains tax.

Inslee needs it to support his budget — a budget that includes $52.8 billion in state spending.

Democrats in the Washington Legislature are in agreement with most of the governor’s budget raising proposals including the capital gains tax. For weeks, that has been one of the centers of discussion as Democrats in the House and Senate worked on their own versions of a budget.

Earlier this week one was finally submitted in the Washington House. It calls for $1.4 billion in new revenue. Much of that money will come from 9.9% capital gains tax on the earnings from the sale of stocks, bonds and other assets.

House Democrats have added 0.9% to the governor’s request. The 9.9% comes into play for individuals with taxable incomes of $100,000 or more, and it sits at $200,000 for couples. Members of the House Finance Committee say the tax will only impact 14,000 households.

Among the 14,000 impacted are the independent insurance agents and agencies of PIA Washington/Alaska. The “other assets” part of the equation is the sale of their businesses.

Former PIA Washington/Alaska President Dick Fournier — the head of the Fournier Group — said the independent insurance agents of the PIA, “are among the hardest working people in the state. This is a top-heavy tax that is not fair and that will reduce the value of the business built by hard-working entrepreneurs.”

That comment came earlier this year when he testified at a Senate Ways and Means Committee hearing on a 9% capital gains tax. Fourier told the committee that hundreds of small businesses will be hurt if the capital gains tax passes.

“For many of us decades of work began small. We worked nights and on weekends, and sometimes seven days a week,” he told committee members. “Our client lists often came from a phone book and we reached them via telephone. As the business grew the plan was to eventually sell and use the profit of that sale for retirement.”

He said a 9% capital gains tax wasn’t factored into his business plan.

PIA Washington Lobbyist Mel Sorensen agrees the 9% tax is oppressive and said it will adversely affect PIA members, many of whom have spent their entire business careers building their business. He pointed out that this tax is “very, very unfair and — in a way — punitive. For many, they have spent their entire professional careers building their businesses. The value in their business is frequently what they plan to rely on for their retirements. It’s simply damaging to expose them to a new 9% capital gains tax.”

It is for those reasons — and others — that the PIA Washington/Alaska opposed the 9% proposal in the Senate and this proposal.

Our opposition faces stiff opposition. Rep. Gael Tarleton is a Democrat and chairs the House Finance Committee. She said the 9.9% capital gains tax is an attempt to bring “tax fairness” to Washington, one of the few states without a personal income tax.

“Wealth continues to concentrate in the hands of fewer and fewer individuals who pay less and less into critical public investments as a proportion of their accumulated wealth,” she said. “This wealth is not generating the revenue we need to serve the interests and needs of 7 1/2 million Washingtonians.”

In an interview earlier this year with Weekly Industry News, Sorensen noted the comments about tax fairness leads to another problem with a capital gains tax. It is based on an income tax system and Washington State’s constitution does not allow one.

“Federal law defines the measure of tax on NET capital gain income,” he said. “Although the Governor's capital gains tax plan may call it an ‘excise tax and ‘for the privilege of selling or exchanging long-term capital assets, or receiving Washington capital gains,’ the departments of revenue for every state with a capital gains tax classify it as an income tax.”

Experts say the tax — if passed and signed by the governor — will undoubtedly end up on court.

Republican Rep. Drew Stokesbary serves on the House Finance Committee. He opposes the idea and says even if the courts make it legal, passing this kind of tax is irresponsible. “If we have a recession coming up, it will be difficult to balance the budget if we're dependent on capital gains as part of state revenues,” he said. “The fact of the matter is we can fund all of our priorities without raising taxes.”

By the way, the House budget exempts retirement accounts, primary residencies and the sale of agricultural and timberlands, cattle, horses and other breeding stock.

The target date for passing the budget and sending it to the Senate is this Friday and if a Senate budget has not been submitted by the time you read this story, you can expect one very soon.

Source links: Weekly Industry News — link 1, link 2, The Tri-City Herald

Tags:  Insurance Content  Insurance Industry  Insurance News  Weekly Industry News 

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Workplace Injuries — Assaults and Women

Posted By Administration, Tuesday, March 26, 2019

The National Safety Council regularly puts out information on workplace safety. As part of National Women’s History Month, the council put out information on women and safety in the workplace.

The information says women are the targets of 70% of all of the non-fatal workplace assaults. This conclusion comes from 2017 totals:

  12,820 assaults upon women

  That’s a 60% increase since 2011

  5,530 men were assaulted

Other work-related — and non-assault — injuries and illnesses also disproportionately impact women:

  59% are accidentally caused by another person

  57% are from falls

  61% are from ergonomic causes like repetitive motion

The National Safety Council’s statistics also say some sectors have disproportionate numbers as well:

  80% of non-fatal injuries to women happen in the healthcare sector

  61% come from education

  60% from management, business and financial companies

National Safety Council President and CEO Nick Smith said, “Our workplaces should be safe havens for everyone, and these data show us we can do more to protect women in the workplaces. As employers examine the biggest risks facing their workforce, we urge them to consider these trends and make sure safety is extending to all employees.”

Source link: Insurance Journal

Tags:  Insurance Content  Insurance Industry  Insurance News  Weekly Industry News 

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Around the PIA Western Alliance States

Posted By Administration, Tuesday, March 26, 2019

Arizona — Department Consolidation: Arizona Governor Doug Ducey wants Department of Insurance head Keith Schraad to lead the Arizona Department of Financial Institutions on a temporary basis.

Actually, it’s not all that temporary. The two agencies are being consolidated into one.

Bob Charlton — who has led that agency for 32 years — is retiring.

Source link: Insurance Journal

Idaho — Medicare Workshops: A pair of Medicare Workshops for individuals turning 65 and those approaching Medicare eligibility will take place in Coeur d’Alene the final week of March. The first session will be held Tuesday March 26 from 1 to 3 p.m., with a second session scheduled for Thursday, March 28 from 5:30 p.m. to 7 p.m.  Both workshops will be held at the Salvation Army Kroc Center, 1765 W. Golf Course Road.

Caregivers and all those interested in learning how Medicare works are encouraged to attend.

The workshops will be led by Senior Health Insurance Benefits Advisors (SHIBA), a unit of the Idaho Department of Insurance.  SHIBA presenters will introduce the various parts of Medicare and explain some of the vocabulary associated with the program. 

Topics to be covered include:

 

  Timeframes for enrolling in Medicare

  Enrollment periods for Medigap, Medicare Advantage and Prescription Drug Plans

  How the different parts of Medicare work together — and when they don’t

To register for either workshop, please contact the SHIBA Helpline at 1-800-247-4422.

Oregon — From the Department of Insurance: The Oregon Division of Financial Regulation recently adopted the following temporary rule:

ID 04-2019: Amendment to 2020 standard bronze and silver health benefit plans (Temporary)

Rules affected: OAR 836-053-0013

Rule Summary:

Refiled to remove the word "Draft" on Exhibits.

Need for the Rule:

ORS 743B.130 requires the Department of Consumer and Business Services (DCBS) to prescribe by rule the form, level of coverage, and benefit design for bronze and silver health benefit plans that must be offered by insurance carriers. These plans must meet federal requirements issued by the Department of Health and Human Services (HHS). Each year, HHS updates the actuarial value (AV) calculator used for determining coverage levels. Changes may include costs, plan designs, populations, developments in the function and operation of the AV calculator and other actuarially relevant factors.

As a result of changes made to the federal AV calculator for 2020, the AV for the standard bronze and silver plans prescribed in OAR 836-053-0013 exceeded federal requirements. Failure to update the rule would result in DCBS requiring carriers to submit plans that are illegal with respect to federal law.

This year, HHS released the AV calculator later than in previous years. As a result, rulemaking would not be able to be completed in time for carriers to submit plans in May for review.

Filed: March 21, 2019

Effective: March 21, 2019 through September 13, 2019

Tags:  Around the PIA Western Alliance States  insurance content  Insurance Industry  Insurance News  Weekly Industry News 

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Around the PIA Western Alliance States

Posted By Administration, Tuesday, March 12, 2019

Arizona — Uber Not Criminally Liable for Crash: Yavapai County prosecutors are not going to go after Uber for the March 2018 crash in Tempe that killed a pedestrian. However, it is recommended that the vehicle’s “driver,” Rafaela Vasquez be referred to Tempe’s police department for another look.

He was looking at a TV show when the crash occurred and could end up being prosecuted for vehicular manslaughter.

California — Russian River Flood Information: In the wake of record rains and recent flooding Insurance Commissioner Ricardo Lara dispatched Department of Insurance staff to Sonoma County to assist with recovery efforts. With many Californians not aware that traditional homeowners insurance does not cover flood damage, he urged homeowners to consider purchasing flood insurance.

Department staff are available to answer questions through Saturday, March 9 at the Local Assistance Center in Guerneville or by phone at 800-927-4357 following the winter storms and Russian River flooding that inundated 2,600 homes and businesses and damaged or destroyed many automobiles.

“Climate change is driving more extreme weather events than ever, including floods,” said Insurance Commissioner Ricardo Lara. “We want to make sure people have the coverage they need before the next storm puts their home at risk. Having flood insurance may be the difference between recovering quickly from a catastrophic event or suffering devastating financial losses.”

Flood insurance is available through the Federal Flood Insurance Program and must be in force for 30 days prior to a flood, in most cases.

February was the sixth wettest month on record, and it is not too late for homeowners to assess their risk for flooding and ensure they have the coverage they need to protect their home which is typically a family’s most valuable financial asset.

The department has a number of resources to help consumers with insurance coverage or claim questions. Consumers with questions or needing assistance should call the consumer hotline at 800-927-4357.

Source link: The California Department of Insurance

 

Idaho — Medicare Workshop to be Offered in Genesee: A free Medicare Workshop for individuals turning 65 and those approaching Medicare eligibility will be held Wednesday, March 13, from 5:15 p.m. to 6:30 p.m. at the Genesee Community Library, 140 E. Walnut, Genesee.  Caregivers and all those interested in learning how Medicare works are encouraged to attend.

The workshop will be led by Senior Health Insurance Benefits Advisors (SHIBA), a unit of the Idaho Department of Insurance.  SHIBA presenters will introduce the various parts of Medicare and explain some of the vocabulary associated with the program. 

Topics to be covered include:

  Timeframes for enrolling in Medicare

  Enrollment periods for Medigap, Medicare Advantage and Prescription Drug Plans

  How the different parts of Medicare work together – and when they don’t

To register for the workshop, please contact the SHIBA Helpline at 1-800-247-4422.

 

Montana — Tester & Asbestos Ban: Montana Senator Jon Tester and eight other U.S. Senators have sponsored a bill to ban the mining, importation, use and sale of asbestos. A companion bill was introduced in the House. The number of co-sponsors there totals 21.

Experts say this one has a much better chance of success than previous bills.

In his support of the bill, Tester said, “Montanans know all too well the lasting damage of asbestos exposure — just ask folks in Libby and Troy. Banning this harmful substance will protect our families and prevent future suffering and loss of life.”

More than 200 deaths in Troy and Libby have been linked to asbestos.

He’s joined by Oregon Senator Jeff Merkley who added, “It's outrageous that in the year 2019 asbestos is still allowed in the United States. While the EPA fiddles, Americans are dying.”

While asbestos is illegal in 60-some countries, it is still legal in the U.S.

Source link: Independent Record

 

Oregon — Prescription Transparency: The Department of Consumer and Business Services is ready to hear about prescription drug price increases from consumers, health insurance companies, and drug manufacturers.

The Prescription Drug Price Transparency Act (HB 4005), from the 2018 Legislative Session, established Oregon’s drug price transparency program. The new law requires prescription drug manufacturers and health insurance companies to report specific drug price increases to the department’s Division of Financial Regulation.

The program staff are ready to hear from consumers as well.

All Oregonians are encouraged to report an increase in the cost of their prescription drugs to the division one of three ways:

Email rx.prices@oregon.gov

Call 888-877-4894 (toll free)

Visit dfr.oregon.gov/drugtransparency (online reporting form available later this month)

We are excited to bring one of the nation’s first prescription drug price transparency programs to Oregonians,” said Andrew Stolfi, insurance commissioner. “It will help people better understand why drug prices increase, and help legislators make informed decisions on how to control rising costs.”

Consumer reports and the pricing of new prescription drugs will be made available as soon as information is received and reviewed. Insurer and drug manufacturer price increase reports will be available later this fall.

The division will provide annual reports to Oregon State Legislature based on the information provided by consumers, and the data reported by health insurers and prescription drug manufacturers.

This program is designed to report drug price increases only. If a consumer has a problem with their health insurance or prescription drug coverage they should contact our consumer advocates at 888-877-4894 (toll-free). To learn more about Oregon’s Prescription Drug Price Transparency Program, visit dfr.oregon.gov/drugtransparency.

 

Washington — From the Department of Insurance: Surprise billing occurs when you're treated for an emergency or scheduled procedure at an in-network hospital or surgery facility and are seen by an out-of-network provider. In addition to your expected out-of-pocket costs, you also get a bill for the difference between what your insurer has agreed to pay that provider and what they believe the service was worth.

Some types of providers, including anesthesiologists, radiologists, pathologists, and labs may not be contracted with your insurer even though they provide services at an in-network hospital or facility. This practice is also called “balance billing,” however, some balance billing is not a surprise. For example, if you're treated by a provider that you know is not in your plan's network, you shouldn't be surprised to receive a bill for their services, on top of what your plan covers.

Kreidler's proposed legislation - 2SHB 1065/SB 5031 (www.leg.wa.gov) passes the House of Representatives

Commissioner Mike Kreidler has proposed legislation that would prevent people from getting a surprise medical bill when they seek medical services from an in-network facility, but are treated by an out-of-network provider. If an insurer and provider cannot agree on a price for the covered services, they can go to binding arbitration but cannot bill the consumer for the amount in dispute.

His bill passed the House on March 4 with a strong bipartisan vote of 84-13. It's now in the Senate and must be voted out of the Senate Health and Long Term Care Committee by April 3.

Tell us about your surprise bill

If you or someone you know has received a surprise bill, we’d like to hear from you. Email us your story. We may also follow-up with you to see if you'd like to file a complaint about your surprise billing issue.

See what happened to Jamie Hansen of La Center, WA when she sought emergency care for her son, Ryan.

Source link: Washington Department of Insurance

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

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Around the PIA Western Alliance States

Posted By staff reporter, Tuesday, February 19, 2019

 

 

California

Mudslides: Heavy rains last week in California caused floods and mudslides around the state. The effect is called the Pineapple Express. Homes have been swept away and motorists got stranded in their vehicles.

 

More rain is predicted and with that — more flooding is expected.

 

Source link: Insurance Journal

 

 

Wildfire Starter Sentence to Prison

Brandon McGlover has pleaded guilty to starting nine fires in July of 2018. Those fires destroyed 13,000 acres, destroyed seven homes and caused 7,000 people to flee for their lives in Idyllwild, Anza and Sage, California.

 

He used a can of WD-40 and a lighter to set the fires.

 

McGlover was sentenced to 12-years and four-months in prison. He will be required to register as an arsonist for the rest of his life and will be required to pay restitution to his victims.

 

His victims were allowed to comment at his sentencing. One woman — whose husband died of a heart attack while they were fleeing — made an impassioned plea for a harsh sentence. Her statement was written since she was too upset to make it herself.

 

Others who lost everything in the fires made similar statements.

 

Source link: MSN

 

 

Cease and Desist Order

 The California Department of Insurance (CDI) issued a Cease and Desist Order effective immediately upon NexGen Insurance Services, Inc., Riverstone Capital, LLC dba Riverstone Capital Insurance Services, LLC and its owner/operators Travis O. Bugli, James C. Kelly and Robert M. Clarke.

 

A joint investigation by CDI and the U.S. Department of Labor (DOL) revealed that NexGen and Riverstone have been operating as an unauthorized MEWA (Multiple Employer Welfare Association), an arrangement that offers or provides health and welfare benefits to employers and their employees.

 

The Cease and Desist Order alleges that NexGen and Riverstone were marketing, soliciting, and selling purported “self-insured” health plan arrangements to employers, not health insurance, in violation of California law. NexGen and Riverstone failed to pay medical provider claims totaling approximately $24 million dollars, exposing employers and their employees to risks and significant financial liabilities. The investigation revealed NexGen’s and Riverstone’s business practice of pooling and commingling contributions received from its employer clientele into its own corporate accounts.

 

“This company and its owners misrepresented their ability to pay medical claims, putting employers and their employees in immediate danger,” said Insurance Commissioner Ricardo Lara. “We took action to stop these illegal practices and ensure the safety of California workers and employers.”

 

Under CDI’s Cease and Desist Order, NexGen and Riverstone are to immediately stop operating any MEWA directly or indirectly or acting as an insurance agent, producer, insurer, or any other capacity in the State of California for which they do not hold a valid license, permit, or Certificate of Authority to do so. The companies are to immediately cease and desist from receiving any money, commission, fee, rebate, payment, remuneration, or any other valuable consideration whatsoever, directly or indirectly, in connection with any MEWA transactions.

 

Source link: California Department of Insurance

Tags:  9 state alliance  Around the PIA Western Alliance States  insurance content  insurance industry  weekly industry news 

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Around the PIA Western Alliance States

Posted By staff reporter, Tuesday, February 12, 2019

Around the PIA Western Alliance 

Arizona


Uber Crash Lawsuit: Last year Elaine Herzberg was hit and killed by an autonomous vehicle owned by Uber. The suit isn’t against Uber, but against the city of Tempe.

Herzberg’s husband and daughter each want $5 million in damages and say the city of Tempe created a dangerous situation when it installed a brick pathway across the median where people aren’t supposed to be crossing.

 

Source link: Insurance Journal

 

Idaho

From the Idaho Department of Insurance

A tip from a social media post helped lead to an insurance fraud conviction for a Bingham County resident.  Danielle Collins was sentenced in Bingham County District Court last week after pleading guilty to one count of insurance fraud following an investigation conducted by the Idaho Department of Insurance.

In court proceedings, Collins admitted to purchasing car insurance after damaging her vehicle.  She was placed on three years of supervised probation by Judge Darren B. Simpson and ordered to pay $800 in fines, $245 in court costs, $500 to the Public Defender’s office, and $536 in restitution to the DOI.  She also must complete 100 hours of community service.

Court records show Collins purchased an auto policy through Progressive Insurance on August 25, 2017.  Three days later she submitted a claim for an accident in which her vehicle sustained damage to its front end and both driver’s side tires.  However, Progressive officials discovered a Facebook post dated days prior to the reported date of the accident and claim submission in which Collins asked her friends and followers, “Who gets not one but two flat tires?? Meeee!!  The social media gaffe helped DOI investigators close the case against Collins.

“This is an example of how insurance fraud comes in all shapes and sizes,” said Director Dean Cameron.  “I’m proud of the work of our investigators because every case of fraud, no matter how big or small, adds up and becomes costly for all Idaho consumers.”

 

Medicare Workshop to be Offered in Idaho Falls

A free Medicare Workshop for individuals turning 65 and those approaching Medicare eligibility will be held Thursday, February 14, from 2 to 4 p.m. at the Idaho Falls Senior Center, 535 W. 21st St., Idaho Falls.  Caregivers and all those interested in learning how Medicare works are encouraged to attend.

The workshop will be led by Senior Health Insurance Benefits Advisors (SHIBA), a unit of the Idaho Department of Insurance.  SHIBA presenters will introduce the various parts of Medicare and explain some of the vocabulary associated with the program. 

Topics to be covered include:

 

  Timeframes for enrolling in Medicare

  Enrollment periods for Medigap, Medicare Advantage and Prescription Drug Plans

  How the different parts of Medicare work together – and when they don’t

 

To register for the workshop, please contact the SHIBA Helpline at 1-800-247-4422.

 

Montana

Minimum Wage

Montana Democrat Rep. Mary Ann Dunwell of Helena wants the state’s minimum wage to go up from $8.50 an hour to $15. If her bill — HB 345 — gets passed, the wage will go to $12 an hour on July 1st of this year, and rise to $15 on July 1st in 2020.

The AFL-CIO and the Montana Federation of Public Employees and the Montana Department of Labor and Industry are supporting the bill.

Opposing the bill is the Montana Retail Association and the Montana Restaurant Association.

Source link: Independent Record

 

Oregon

Marijuana Audit

An audit done by the secretary of state’s office has found the inspections conducted in Oregon’s marijuana industry and not up to speed. The state says the testing system is weak and threatens consumers with contaminants.

Just 3% of the retailers have been inspected and just one-third of the state’s marijuana growers. Also — the report said — marijuana regulators are not doing much to address the black market sales.

However, so far, the legal pot market has generated $207 million in taxes for the state coffers.

 

Oregon’s Innovation Hub

The Department of Consumer and Business Services’ Division of Financial Regulation has opened its Innovation Hub to help insurance, financial, and technology companies bring innovative products, services, and tools to Oregonians.

Experts, thought leaders, and businesses are encouraged to visit dfr.oregon.gov/innovation to connect with the division’s Innovation Liaison and learn more about Oregon’s Innovation Hub.

“We want to engage and collaborate with businesses that are poised to leverage technology in a way that will benefit Oregonians.” said Andrew Stolfi, division administrator. “The Innovation Hub is here to help the businesses we regulate deliver emerging products, and services to Oregon consumers.”

The Innovation Liaison helps companies navigate regulatory guidelines in a way that enables new technology flourish within the state. The liaison helps the division develop and maintain a structure that that can adapt to innovation both now and in the future.

For more information or to connect with the Innovation Liaison visit dfr.oregon.gov/innovation

 

 

Tags:  Around the PIA Western Alliance States  insurance content  insurance industry  pia western alliance 

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