Around the PIA Western Alliance States

California — Work Comp Written Premium Totals for 2021:

Written premium for workers’ compensation insurance dropped 2% below the rates of 2020. They are also 14% below 2019’s rates.

That information comes from the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) and its quarterly report. Decreases in employer payroll drove the change.

Here’s more:

** The average rate for 2021 is 7% below 2020

** It is the lowest in decades

** The projected loss ratio is 6 points above 2020

** The projected combined ratio for 2021 will be 7 points higher than 2020

** The projected combined ratio for 2021 will be 33 points higher than 2016’s low

** Indemnity claim frequency is up 8%

** The 2020 indemnity claim frequency saw a 12% drop over 2019

Source link: Insurance Journal — https://www.insurancejournal.com/news/west/2022/05/26/669241.htm

Oregon — Health Insurance Rates: Oregon consumers can get a first look at requested rates for 2023 individual and small group health insurance plans, the Oregon Department of Consumer and Business Services announced today.

In the individual market, six companies submitted rate change requests ranging from an average 2.3 percent to 12.6 percent increase, for a weighted average increase of 6.7 percent. In the small group market, nine companies submitted rate change requests ranging from an average 0 percent to 11.6 percent increase, for a weighted average increase of 6.9 percent. Our initial review has found that insurers have identified inflation, medical trend, and enrollment changes as factors in the proposed increases. See the attached chart for the full list of rate change requests.

Oregonians will also see an uptick in premiums due to the expiration of temporary enhanced subsidies for on exchange individual market plans. The additional premium support has helped to lower monthly premiums by an average of 46 percent since enactment in 2021. Under the enhanced subsidy structure, people between 151 percent and 200 percent of the federal poverty level can get a bronze plan for as low as $1 per month, with other plans varying in costs. The loss of subsidies will equate to an approximate $11.9 million increase every month for Oregonians.

Health insurance companies submitted rate requests to the department’s Division of Financial Regulation on May 16. The requested rates are for plans that comply with the Affordable Care Act for small businesses and individuals who buy their own coverage rather than getting it through an employer. Every county has at least four companies available for people to buy insurance on the individual market.

Over the next two months, the division will analyze the requested rates to ensure they adequately cover Oregonians’ health care costs. The division must review and approve rates before they are charged to policyholders.

“Oregon continues to have a strong and competitive insurance marketplace, with four carriers offering plans statewide and Oregonians in most our counties having five or six companies to choose from, ” said Insurance Commissioner and DCBS Director Andrew Stolfi. “The Oregon Reinsurance Program continues to allow Oregonians to find reasonable rates.”

The Oregon Reinsurance Program continues to help stabilize the market and lower rates. Reinsurance lowered rates by 6 percent for the fifth straight year.

Virtual public hearings about the 2023 health insurance rates will be held July 27-28. A web address to watch the public hearings will be posted at oregonhealthrates.org. At the hearings, each insurance company will provide a brief presentation about its rate requests, answer questions from the division, and hear public comment from Oregonians.

“We look forward to a thorough public review of these filings as we work to establish next year’s health insurance rates.” Stolfi said. “We encourage all Oregonians to join us for the virtual public hearings and provide feedback on their health insurance plans.”

Oregonians are encouraged to comment on rate change requests during the public comment period, which opens later this month and runs through July 7. The public can submit comments at oregonhealthrates.org and during the public rate hearings.

Preliminary decisions are expected to be announced in early July, and final decisions will be made in early August after public hearings and comment periods end.

Washington — Court Upholds a Kreidler Fine Against the Armed Citizens Legal Defense Network: The Superior Court of Lewis County upheld Insurance Commissioner Mike Kreidler’s fine and cease-and-desist order against Armed Citizens Legal Defense Network, Inc., for illegally acting as an insurer in Washington state.

In March 2020, Kreidler ordered Armed Citizens to stop acting as an insurer. Armed Citizens sells memberships that include self-defense insurance to cover bail and legal costs incurred in conjunction with using force against another person. In May 2020, Kreidler fined Armed Citizens $200,000 for law violations. Armed Citizens appealed both actions and an administrative law judge upheld Kreidler’s actions, but amended the fine to $50,000 and ordered Armed Citizens to pay it by Dec. 7, 2020. 

“The bottom line is that this is about illegal insurance activity in Washington state,” said Kreidler. “Armed Citizens and other similar organizations try to cloud the issue by saying it’s about guns, but at the end of the day they are attempting to illegally operate as insurers in Washington state and it’s my job to make sure that doesn’t happen.”

The judge’s ruling reads: “… ACLDN is transacting insurance in Washington. Thus, the Insurance Commissioner has authority to issue a cease and desist order and to issue a fine, under the provisions listed below.”

Armed Citizens has until June 24 to file a notice of appeal.

Armed Citizens, based in Onalaska, Wash., has sold memberships to over 17,000 people nationwide– including 2,559 in Washington state–since 2008. Its original marketing materials promised “when a member uses force in self-defense, the Network immediately sends up to $25,000 to the member’s attorney and can provide up to $25,000 in bail assistance.”

From 2008 to 2019, 25 members nationwide filed claims. Of the 25 claims, two occurred in Washington –Armed Citizens paid $2,000 in one claim and denied the other one.

Kreidler has taken similar enforcement action against four other organizations that sell or underwrite self-defense insurance and fined them $302,000. 

Armed Citizens and other similar organizations can legally sell insurance in Washington state by applying for admission as an insurer and complying with the laws and rules that apply to insurers and insurance producers.

Washington — Extension of Coronavirus and Surprise Billing: Insurance Commissioner Mike Kreidler has extended two emergency orders. His order requiring health insurers to waive copays and deductibles for any consumer requiring testing for the coronavirus (COVID-19) and his order protecting consumers from receiving surprise bills for lab fees related to medically necessary diagnostic testing for COVID-19 are both extended until June 27.

Kreidler’s order waiving cost-sharing applies to all state-regulated health insurance plans and short-term, limited-duration medical plans. The order on surprise billing applies to both in-state and out-of-state laboratories when a provider orders diagnostic testing for COVID-19.

Also, insurers must continue:

    Allowing a one-time early refill for prescription drugs.

    Suspending any prior authorization requirement for treatment or testing of COVID-19.

In addition, if an insurer does not have enough medical providers in its network to provide testing or treatment for COVID-19, it must allow enrollees to be treated by another provider within a reasonable distance at no additional cost.

“Consumers are rightly concerned about prevention, testing and possible treatment,” Kreidler said. “My emergency order provides guidance to health insurers and should help reassure the public that we will take all necessary steps to protect them.”

Kreidler is using powers granted to him following the statewide emergency that Gov. Jay Inslee declared to protect Washington residents against the spread of the coronavirus.

When the governor issues an emergency proclamation, the commissioner can issue an emergency order related to health care coverage to ensure access to care. The order can be extended by the commissioner for 30 days at a time as long as the governor’s emergency proclamation remains in effect.