Around the PIA Western Alliance States – Week of September 22, 2025

California — First Wildfires, Now Mudslides & Debris: Homes and roads have already been hit hard as yesterday’s storm swept across California and, with the threat of additional mudslides and debris flows, Insurance Commissioner Ricardo Lara today issued a Notice to insurance companies reminding them of their legal duty to cover damage from any mudslide, debris flow, or similar disaster that is caused by the recent statewide wildfires that may have weakened hillsides.

“The top priority is the safety of residents in these affected areas, and protecting those still vulnerable wildfire survivors in burn areas across California,” said Commissioner Lara. “Beyond immediate safety concerns, survivors should have peace of mind knowing the protections in place for recovery. I am reminding insurance companies of their legal obligation to cover any mudslides, debris flows, or other damage resulting from these fires so that consumers can recover as quickly as possible."

A “burn scar” refers to land left bare after a wildfire, making it prone to flash floods and debris flows. Without vegetation to absorb rain, water runs off quickly, and wildfire heat can create a water-repellent soil layer, worsening the risk. Even light rain can trigger dangerous flooding, especially in steep areas. Homes, roads, and infrastructure near recent burn areas face heightened danger, often with little warning.

Many policyholders may not be aware that homeowners’ and commercial insurance policies typically exclude flood, mudslide, debris flow, and other similar disasters — unless they are directly or indirectly caused by a recent wildfire or another peril covered by the applicable insurance policy. The Department of Insurance has posted a fact sheet for consumers to answer questions about what their policies cover.

The Montecito mudslide in Santa Barbara County in January 2018 that followed the destructive Thomas Fire claimed 23 lives and caused more than $421 million in damage, according to Department of Insurance data. Following that disaster, the Governor enacted a new law to help prevent confusion about insurance coverage following mudslides.

Commissioner Lara is also urging consumers to take the following steps to prepare for upcoming storms and the winter storm season:

Use their smart phone to perform a home inventory to create a record of their belongings and store scans of important documents that they can easily access.

Locate their insurance papers and put in a safe place or upload to an online location.

For renters, consider purchasing renters’ insurance to protect their personal belongings, which typically are not covered by their landlord’s homeowners’ policy.

Consider comprehensive auto insurance, which would protect their vehicle in the event of flood damage.

Visit the Governor’s Office of Emergency Services (CalOES) “winter wise” web page to read more tips to prepare for winter weather.

Consider flood insurance for future disasters in addition to their homeowners’ insurance policy. The National Flood Insurance Program currently provides the majority of flood coverage written in the state, but private flood insurance is also available. Flood insurance takes effect 30 days after it is purchased, except in the case of a home purchase where flood insurance is required by the lender.

The Department of Insurance can help consumers with insurance coverage or claim questions. Contact us at our consumer hotline at 800-927-4357 or through online chat or email at Contact Us, CA Dept of Insurance

Idaho — Medicare Enrollment: Medicare Open Enrollment runs from October 15 through December 7, 2025, and the Idaho Department of Insurance (DOI) is advising Medicare beneficiaries to carefully review their options this year.

Across the country, insurers are making significant changes to Medicare Advantage (MA) plans due to rising costs, reduced federal payments, and new federal regulatory requirements. As a result, some carriers are leaving certain markets, reducing plan benefits, or narrowing provider networks.

Currently, 7 carriers offer county-specific Medicare Advantage plans in Idaho (Blue Cross of Idaho, Regence BlueShield of Idaho, UnitedHealthcare, Humana, Saint Alphonsus Health Plan, PacificSource Medicare, and Select Health). However, plan withdrawals are expected in 2026. Even if carriers remain in the market, many enrollees may see changes to plan benefits or provider networks.

In 2024, approximately 51% of Medicare eligible Idahoans were enrolled in a Medicare Advantage plan. While the DOI does not regulate MA plan pricing, insurers are required to notify consumers in advance of any plan withdrawals. All enrollees will receive an Annual Notice of Change (ANOC) from their carrier explaining upcoming changes by October 1, 2025.

“Consumers should use this annual Open Enrollment Period to compare plans, confirm that their doctors and prescriptions are covered, and seek free, objective help from the Department of Insurance, SHIBA, or a local trusted agent,” said DOI Director Dean Cameron. “Taking action early ensures uninterrupted coverage and continued access to quality care. Most importantly, consumers should know they are not alone – our team is ready to help every step of the way.”

Options for Impacted Consumers

Beneficiaries whose plans are ending will qualify for a Special Enrollment Period, allowing them to:

Switch to another Medicare Advantage plan, or

Return to Original Medicare (with the option to add a standalone Part D prescription drug plan and, in most cases, a Medigap policy without medical underwriting).

“While some carriers are exiting the market, Idaho still offers a competitive selection of plans and strong consumer protections,” Cameron said. “We strongly encourage Medicare beneficiaries to review their options and take advantage of free help from SHIBA or a licensed agent.”

Free Help from SHIBA

The Senior Health Insurance Benefits Advisors (SHIBA) program, part of the DOI, provides free, confidential Medicare guidance to Idahoans. SHIBA counselors can:

Review coverage options

Answer Medicare-related questions

Assist with plan comparisons

Enroll in Medicare Advantage and Part D prescription drug plans

Assist consumers with Medicare complaints

To connect with a SHIBA counselor, call 1-800-247-4422. SHIBA also hosts monthly Medicare webinar workshops. To register, call the Helpline at the same number.

Watch Out for Improper Marketing

Open Enrollment is also a time when misleading marketing can confuse seniors and providers. Idahoans can learn how to protect themselves at: Protect Yourself During 2025 Medicare Open Enrollment | Department of Insurance

Oregon — All entities offering health benefit plans: The Oregon Division of Financial Regulation has issued a bulletin regarding coverage of the COVID-19 vaccination.

Purpose

This bulletin clarifies the division’s expectations around the coverage of COVID-19 vaccination by health benefit plans in Oregon in accordance with Bulletin No. DFR 2021-1.

Guidance for health benefit plans

The division reiterates its expectations that coverage for COVID-19 vaccines must be provided in accordance with Bulletin No. DFR 2021-1 and emphasizes the following:

• All health benefit plans (including grandfathered health benefit plans) in Oregon must provide coverage for FDA-approved COVID-19 vaccines and their administration in accordance with Bulletin No. DFR 2021-1.

• The requirement to cover vaccines and their administration under Bulletin No. DFR 2021-1 is in addition to any coverage requirements that may apply to a health benefit plan under state or federal law.

• A health benefit plan may not impose any cost sharing requirements, such as a copay, coinsurance, or deductible, or restrict coverage to in-network providers in accordance with Bulletin No. DFR 2021-1.

Click here to review this bulletin:  https://bit.ly/46hRCV9

Click here to read our FAQs page on insurance coverage for COVID-19 vaccines: https://bit.ly/4ncNgEz

Washington — Registering and identifying umpires in auto appraisal prepublication rule draft posted: We released a prepublication draft for the registering and identifying umpires in auto appraisals rule (R 2025-04). The Legislature passed Engrossed Senate Bill 5721 relating to consumer protections for automobile insurance coverage. The new law requires the Insurance Commissioner to register competent and disinterested umpires who will be identified to auto appraisers if they are unable to agree on an umpire to resolve their loss dispute.

The comment period for the prepublication draft begins on Friday, September 19 and closes at 11:59 p.m. on September 28, 2025. Please send comments to rulescoordinator@oic.wa.gov.

For more information, including the text of the prepublication draft, please visit the rule's webpage.

Washington — Fire loss reporting proposed rule filed: We have released the proposed rule language on R 2025-03, Fire loss reporting. In 2025, the Legislature passed a fire loss reporting bill, Second Substitute Senate Bill (SSB) 5419 (Chapter 225, Laws of 2025), which requires insurers to report fire losses to the OIC instead of to the Washington State Patrol. This rule will implement SSB 5419 and assist insurance companies with fire loss data reporting requirements. A new subsection is being added to WAC 284-20-010 directing authorized insurers to the OIC website for instructions on reporting fire losses.

We scheduled a public hearing on the rule:

When: October 22, 2025 11:00 AM Pacific Time (US and Canada)

Where: virtual via Zoom, please register in advance.

The comment period for the CR-102 began on September 17, 2025 and is open until October 23, 2025. Please send comments to rulescoordinator@oic.wa.gov.

For more information, including the proposed rule language (CR-102), please visit the rule's webpage.

Washington — Technical Assistance Advisory 2025-02: OIC’s Interpretation of Chapter 48.200 RCW – Health care benefit managers: The Washington state Office of the Insurance Commissioner (OIC) recently published Technical Assistance Advisory 2025-02: OIC’s Interpretation of Chapter 48.200 RCW – Health care benefit managers.

The purpose of this Technical Assistance Advisory (TAA) is to provide guidance to health care benefit managers and health carriers operating in the state of Washington related to the application of Chapter 48.200 RCW to health care benefit managers, including pharmacy benefit managers. The TAA also provides guidance related to provisions enacted by Engrossed Second Substitute Senate Bill 5213 (E2SSB 5213, Chapter 242, Laws of 2024).  

OIC released a preproposal statement of inquiry (CR-101) on July 22, 2025, pertaining to E2SSB 5213 and health care benefit managers (R 2025-11, WSR 25-15-143).

For more information, including other TAAs, please visit OIC’s technical assistance advisories webpage.