Around the PIA Western Alliance States

Tina Wolter — Congratulations A New CIC Designation in Oregon: Tina Wolter, CIC has earned her designation.

In discussion with us on the designation, Tina said, Earning the CIC designation is a standard of excellence in the insurance industry, showing to my colleagues, clients, and underwriters that I am striving to be the best insurance professional that I can be.”

Her insurance career began with high school graduation and has progressed from there.

“I started at an independent agency fresh out of high school in 1986 and have continued my career since then mainly in commercial property and casualty. I’m currently working remote from Oregon for an agency in Southern California,” she said.

Idaho — Health Insurance Rates: Final 2022 premium rates for individual and small group health insurance plans were published by the Idaho Department of Insurance on the Department website at doi.idaho.gov/idaho-rate-review.

Next year, individual market premium rates will decrease 4% on average, with the greatest decrease at 10%. In addition to overall changes, the Department publishes each insurer’s justification of their preliminary 2023 rate changes and tables of the final rates by plan, available in each county and metal level, for an age 40 individual.

“Idaho’s individual health insurance market premium rates for 2023 are substantially decreasing while all other states are seeing increases,” said Director Dean L. Cameron. “This is thanks to Governor Little’s leadership in funding Idaho’s High Risk Reinsurance Program and the legislature in empowering the Department to seek a state innovation waiver.”

In addition to lower rates for most individual health insurance plans, Idaho consumers will have increased choice when shopping for individual coverage. In 2023 SelectHealth, PacificSource Health Plans, Blue Cross of Idaho, Regence Blue Shield of Idaho, Mountain Health CO-OP, Molina Healthcare, and two new carriers, Moda Health Plan and St. Luke’s Health Plan, will offer health plans on Idaho’s exchange, Your Health Idaho.

Additionally, a new dental carrier will offer dental plans in 2023 on Your Health Idaho. The Guardian Life Insurance Company of America joins the other carriers currently offering individual market dental plans: PacificSource Health Plans, Educators Mutual Insurance Association, Delta Dental of Idaho, Blue Cross of Idaho, and Best Life and Health Insurance Company.

Open enrollment for 2022 begins October 15th and ends December 15th. Those seeking coverage can visit the state’s insurance exchange, Your Health Idaho, at yourhealthidaho.org, where a total of 141 medical plans and 21 dental plans can be compared and purchased. Many consumers are eligible for assistance covering premiums, out-of-pocket costs, and deductibles when purchasing through Your Health Idaho. The Department recommends consumers contact a licensed ins

Idaho — Dean Cameron Warns Consumers: On Friday, October 14, 2022, Idaho Department of Insurance  Director and National Association of Insurance Commissioners (NAIC) President Dean L. Cameron talked to nearly 30 TV and radio stations as he shared important information for consumers nationwide on the COVID-19 Public Health Emergency, surprise billing protections, questions to ask before switching or signing up for a health plan, how to navigate increased plan marketing, and more.

“I encourage viewers to contact their trusted local agent and the Idaho Department of Insurance with any questions they have during open enrollment season,” said Director Cameron. Open enrollment is currently underway through December 7, 2022 for Medicare Advantage plans, and through December 15, 2022 for ACA plans.

A video of Director Cameron’s key points is available to share with consumers: https://vimeo.com/a1broadcast/review/760415266/461caf9ee8

Oregon — The Oregon Division of Financial Regulation recently announced the following permanent rulemaking:

ID 7-2022: In the matter of clarifying notice requirements for midterm cancellations of package policies

Amend Rule:  836-085-0055

Rule summary: Amend in order to clarify notice period requirements for commercial liability insurance policy

cancellations as outlined within the published DFR product standards.

Filed: September 23, 2022  

Effective: October 1, 2022

Washington — Emergency orders on insurance coverage and COVID-19 expire Oct. 31: Three emergency orders issued by Insurance Commissioner Mike Kreidler related to insurance coverage and COVID-19 expire on Oct. 31.  The orders requiring health insurers to waive copays and deductibles for any consumer requiring testing for COVID-19, protecting consumers from receiving surprise bills for lab fees related to medically necessary diagnostic testing and requiring insurers to cover COVID-19 vaccine counseling all expire when Washington state’s state of emergency ends. 

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

    Allow a one-time early refill for prescription drugs.

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

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

“I issued these orders to provide guidance to insurers and reassure the public that we would take all necessary steps to protect them,” Kreidler.

Kreidler issued the first order on March 3, 2020 as the need for flexibility and added protections for consumers became apparent.

Washington — Implementation of E2SHB 1688 (R 2022-02) proposed rule posted: We have released the proposed rule language on R 2022-02. Chap. 263, Laws of 2022 amends state law related to health carrier coverage of emergency services, the Balance Billing Protection Act (BBPA) and network access provisions for services subject to the balance billing prohibition under the BBPA. Rulemaking is necessary to revise the Independent Review Organization rule at chapter 284-43A WAC, Balance Billing Protection Act rules at chapter 284-43B WAC and OIC network access rules at chapter 284-170 WAC to be consistent with the new law. The rules will facilitate implementation of the law changes by ensuring that all affected entities understand their rights and obligations under the new law.

We scheduled a public hearing on the rule:

When: November 29, 2022 at 4:00pm 

Where: Please register for the public hearing via Zoom

Comments on the proposed rule language are due November 28, 2022; please send them to rulescoordinator@oic.wa.gov.