Around the PIA Western Alliance States

California — Commissioner Lara protects insurance coverage for over 85,000 Central Coast residents — Helping consumers continue their recovery from wildfires, Insurance Commissioner Ricardo Lara ordered insurance companies to preserve residential insurance coverage for more than 85,000 policyholders affected by fires in Santa Barbara County and Monterey County after Governor Gavin Newsom issued emergency declarations this month. The Commissioner’s Bulletin shields those living within the perimeters or adjoining ZIP Codes of the Alisal Fire and Colorado Fire from insurance non-renewal or cancellation for one year from the date of the Governor’s July 1 declaration regardless of whether they suffered a loss.

“My number one priority in the wake of climate-intensified wildfires is to protect California consumers. My moratorium orders are one of the many tools that I am using to provide relief to homeowners and their families as we address the root causes of these ever-intensifying natural disasters and prevent greater losses,” said Commissioner Lara. “I will continue to enforce this law to protect consumers while working to create long-term solutions.”

The Commissioner’s ability to issue moratoriums is a result of a California law he authored in 2018 while serving as state senator in order to provide temporary relief from insurance non-renewals and cancellations to residents living within or adjacent to a gubernatorial-declared wildfire disaster.

Today’s order protects over 85,000 policyholders, effective July 1, 2022. Consumers who were non-renewed prior to the emergency declaration date and are unable to obtain insurance or are dissatisfied with their current coverage should contact the California Department of Insurance for assistance in shopping for insurance.

Consumers can go to the Department of Insurance website to see if their ZIP Code is included in the moratorium. Consumers should contact the Department of Insurance at 800-927-4357 or via chat or email at insurance.ca.gov if they believe their insurance company is in violation of this law, or have additional claims-related questions.

The Commissioner’s action is part of a larger solution he is pursuing for consumers and wildfire survivors that includes working to increase insurance protections and market competition to help protect consumers. Commissioner Lara’s actions since taking office in 2019 include:

Announced “Safer from Wildfires,” a new insurance framework that incorporates wildfire safety measures to help save lives while making homes and businesses more resilient. Safer from Wildfires was created by a first-ever partnership between the Department of Insurance and the emergency and preparedness agencies in Governor Newsom’s Administration, including CAL FIRE, the Governor’s Office of Emergency Services (CalOES), the Governor’s Office of Planning and Research, and the California Public Utilities Commission.

Proposed new regulations to incorporate Safer from Wildfires in insurance pricing, driving down costs for consumers who have taken actions to protect their communities while increasing transparency about their home’s or business’s “wildfire risk score.”

Sponsored new insurance protections signed into law by Governor Newsom — despite opposition from insurance companies — that will mean larger payouts for some claims, less red tape from insurance companies, and more help for people under evacuation orders.

Ordered the FAIR Plan, the state’s insurer of last resort, to offer a more comprehensive homeowners policy as an option, which a judge recently upheld, as well as expanding residential and commercial coverage limits for the first time in 25 years to keep pace with increased costs.

Following Governor Newsom’s state of emergency declarations, the Department of Insurance partners with CAL FIRE and CalOES, pursuant to existing statute, to identify wildfire perimeters for mandatory moratorium areas. The Department of Insurance will continue to collaborate with CAL FIRE and CalOES to identify additional wildfire perimeters for any fires where there is a declaration of a state of emergency.

California — Insurance Commissioner Lara issues workers’ compensation benchmark rate: Insurance Commissioner Ricardo Lara adopted and issued a rate for workers’ compensation insurance that reflects California’s still-recovering economy. Recognizing that businesses are working hard to return to a nearly pre-pandemic market but still facing economic uncertainty and continued COVID-19 disruptions, the Commissioner’s action maintains the benchmark rate at $1.45 per $100 of payroll for workers’ compensation insurance unchanged from last year and within the reasonable actuarial range proposed by other experts, effective September 1, 2022.

Because of continued uncertainty regarding COVID-19 and its effects on the economy, this year’s pure premium rate remains the same as last year’s rate, and again does not include a COVID-19 factor. Commissioner Lara will continue to review data in future pure premium rate filings to determine the long-term impact of COVID-19 claims as well as other experience data.

“We’re working hard to get California back to business as usual as people return to work,” said Commissioner Lara. “This year’s rate is on par with normal, pre-pandemic levels while still reflecting the long-term benefits of workers’ compensation reform passed by the State Legislature and signed by the Governor to reduce costs.”

Commissioner Lara’s decision results in an average advisory pure premium rate that is below the $1.56 average rate proposed by the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) in its filing with the Department of Insurance. Commissioner Lara issued today’s advisory rate after a virtual public hearing that he convened on June 14, 2022 and careful review of the testimony and evidence submitted by stakeholders.

The recommended rate is based on insurance companies’ cost data. The pure premium rate is only advisory, as the State Legislature has not given the Commissioner rate setting authority over workers’ compensation rates. The average advisory pure premium rate level of $1.45 approved by the Commissioner is about 18 percent lower than the industry-filed average pure premium rate of $1.77 as of January 1, 2022.

Commissioner Lara issued emergency rules in June 2020 allowing businesses to reduce costs for workers whose duties changed to lower-risk classifications or were furloughed due to the pandemic. Late last month, Commissioner Lara issued an Order directing the WCIRB to continue implementing the rule he adopted in 2020 which excludes COVID-19 claims from being used in calculating experience modification rates from December 1, 2019 forward.

Nevada — Work Comp 5.5% Benefit Jump: The Nevada Workers’ Compensation Section says it is increasing the maximum monthly benefit by 5.5% because of an increase in the average weekly wage. Last year it rose to $1,125.45 from $1,066.64.

The average monthly wage is up, too. It jumped from $6,927.83 to $7,309.80.

Source link: Business Insurance — https://bit.ly/3B2PcdN

Oregon — Updated Product Standards: Following were updated on our website today as we discussed on meeting we had on Wednesday:

440-3604  Crop – Hail – Aircraft

440-3610  Liability for Personal/commercial lines

440-3617  Boiler – Mechanical Breakdown

440-3618  Monoline – Package property

440-3627  Inland Marine

440-4868  Service contracts or Obligors

440-4869  Vehicle Protection Products or Warrantors

You can find a list of Current Filing Forms here: https://dfr.oregon.gov/rates-forms/Documents/current-filing-forms.pdf

This e-notify was distributed to the following groups:

● Product Standards updates

Washington — New protections for people seeking emergency behavioral health services: A new law expanding consumers’ protections from surprise medical bills also adds new protections for patients seeking care for a behavioral health or substance use disorder emergency. Insurance Commissioner Mike Kreidler recently urged other state regulators to take similar actions.

“We have a behavioral health crisis in our country, and even with strong mental health parity laws, we know that people may not get the coverage they’re entitled to,” said Kreidler. “We know that critical behavioral health emergency care is being delivered by providers and crisis teams outside a hospital setting. These patients deserve the same level of protections as patients experiencing a medical emergency.”

In Washington state and nationally, health insurers must cover emergency services even if the provider or facility is out-of-network, and they cannot require a prior approval if a patient reasonably believes they have a medical emergency.

Previously, emergency services were only covered if delivered in a hospital setting. Hospital emergency rooms often lack the staff and capacity to address behavioral health emergencies, but there are providers designed and licensed for this purpose. The new law expands the definition of emergency providers and facilities to include behavioral health emergency providers, such as crisis stabilization units, evaluation and treatment facilities, and mobile rapid response crisis teams.

Before the federal No Surprises Act, emergency care included just screening, examination and services needed to stabilize a person’s emergency condition. The new federal law adds post-stabilization services such as outpatient observation to the definition of emergency services. The new law in Washington state extends coverage of post-stabilization services to people receiving care from a behavioral health emergency services provider as well.

“I applaud Washington state for taking the steps necessary to hold health insurers accountable for equal coverage of mental health and addiction treatment services,” said former U.S. Rep. and founder of The Kennedy Forum, Patrick J. Kennedy. “People everywhere are in desperate need of better access to care — other states and the federal government must now follow suit to ensure parity in emergency services.”

Washington state’s Balance Billing Protection Act protects patients from getting a surprise medical bill when they seek emergency services from any emergency provider or facility or if get care from an out-of-network provider at an in-network hospital or ambulatory surgery center. This law was updated earlier this year to add the benefits included in the recent federal No Surprises Act and to include surprise billing protections for a wider scope of emergency care providers and facilities, as well as air ambulance services.

“The expansion of surprise billing to include all the facilities who respond to behavioral health emergencies is critical in addressing behavioral health parity and is a significant step towards racial and socio-economic equity in coverage,” said Lauren Simonds, Executive Director of NAMIWA.org.

“Every Washingtonian owes these legislators thanks for their leadership in helping pass these reforms: Rep. Eileen Cody,D-Seattle and Rep. Joe Schmick, R-Colfax and Sen. Annette Cleveland, D-Vancouver,” added Kreidler. “We could not have accomplished these changes without their bipartisan leadership and support.”