Around the PIA Western Alliance States

California — Consumer Protection Board: Insurance Commissioner Ricardo Lara announced several new appointments to multiple statewide boards to advance the Commissioner’s and the Department of Insurance’s mission to protect California policyholders.

These appointments include one new member to the California Insurance Guarantee Association (CIGA) Board of Governors as well as three new members and one reappointed member to the Insurance Diversity Task Force.

“The leaders and entrepreneurs joining these boards are lending their unique experiences and knowledge to protect consumers and I thank them for serving their fellow Californians,” said Commissioner Lara. “I have no doubt their contributions will help ensure consumers’ claims are honored, push for more diversity in the insurance industry’s boardrooms, and expand contracting opportunities for our state’s small businesses.”

The CIGA Board of Governors oversees the guarantee association’s general operations and management in order to protect policyholders in the event of an insurance company insolvency. Established in 1969 by the Governor and California State Legislature, CIGA comprises all insurance companies admitted to sell homeowners, workers’ compensation, automobile, and other specified property and casualty lines of insurance in California.

The Insurance Diversity Task Force oversees the Department’s nationally-recognized Insurance Diversity Initiative, which encourages insurers to increase procurement contracts with diverse business owners, such as a woman-owned, veteran-/disabled veteran-owned, historically disadvantaged community-owned, and LGBTQ+-owned businesses, as well as advance diversity of insurance company corporate boards. The Task Force makes recommendations to the Insurance Commissioner regarding innovative ways to increase diversity within the insurance industry.

The next CIGA Board of Governors meeting will be held on Tuesday, May 3, 2022 and the next meeting of the Insurance Diversity Task Force will be held on Thursday, June 9, 2022.

More details are available at: www.insurance.ca.gov/boards. These positions are uncompensated.

Oregon — Work Comp Notice: The Oregon Workers’ Compensation Division has published the following industry notice: Coverage requirements for drivers who lease their trucks.

https://wcd.oregon.gov/IndustryNotices/04-18-22-IN-Trucking.pdf

Washington — Notice of Fixed Payment Benefits Plans Report posted: Under RCW 48.43.650, The Office of the Insurance Commissioner (OIC) must collect and report information regarding fixed payment insurance. These products are exempt from complying with many mandated benefit requirements that apply to comprehensive medical insurance.

Fixed-payment insurance policies pay a specific amount to enrollees who receive certain types of medical care or services. Group fixed-payment policies allow employees to buy fixed-payment coverage through their employers.

Proponents of this type of coverage stated that employers wanted to provide this limited coverage to their low-wage and seasonal employees to provide employees an option for some coverage. Opponents expressed concern that some employers would replace comprehensive medical coverage with these very limited plans, resulting in enrollees incurring uncovered medical costs or deferring treatment.

To view the fixed payment benefits plans report, please visit the website.

Washington — Updated Surprise Billing All Payer Claims Database data set: We posted the 2022 update to the Surprise Billing APCD data set per the direction in RCW 43.371.100 adjust the data set each year by the CPI-medical component.

For more information, including the updated data set, please visit the Arbitration and using the Balance Billing Protection Act data set webpage.

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Washington — Kreidler extends orders on COVID testing and surprise billing to May 28: 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 May 28.

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.