Around the PIA Western Alliance States

California — Work Comp Premiums Up 27% in the First Six Months of 2022: California’s Workers’ Compensation Insurance Rating Bureau (WCIRB) said written premium in the first six months of 2022 is up 27% over 2021. Written premiums hit $8.9 billion through the period ending June 30th.

The projected loss ratio is 68% and that’s up from 62% is 2020 and 56% in 2019.

California — Contractor Work Comp Coverage: California Governor Gavin Newsom signed a bill last week that will require some contractors to carry work comp coverage even though they don’t have employees. The bill applies to all contractors in the heating and air conditioning, tree service and concrete businesses unless they are organized as a joint venture under the Business and Professions Code Section 7029 and have no employees.

Idaho — Medicare Scams: The Idaho Department of Insurance is warning consumers shopping for Medicare health insurance to be wary of improper marketing by telemarketers and television commercials during Medicare’s Open Enrollment Period, which begins on October 15 and ends December 7. During that period, Medicare beneficiaries can choose the plans that are best for them for 2023. The DOI offers these reminders to Idahoans:

If anyone calls you who you did not have a scheduled appointment with, and requests personal or private information (Medicare number, Social Security number, bank or credit card information), hang up! CMS will not directly call you about Medicare coverage, and it is illegal for companies to market Medicare Advantage over the phone.

Be cautious of changing your insurance plan based on advertisements. Any extra benefits in Medicare insurance advertisements on television or in mailings might not be available where you live. Get all the details in writing before you sign up.

Ensure the plan is right for you. Before you sign up, reach out to your doctors to verify they are in that plan’s network, and check if your prescription drugs are covered.

You can’t have both a Medigap plan and a Medicare Advantage plan. Even if someone promises that you can keep your Medigap plan (supplemental plan) and have a Medicare Advantage plan, it is against the rules and is not beneficial to have both.

Before making a change, contact your trusted insurance agent or call Senior Health Insurance Benefits Advisors (SHIBA) at 1-800-247-4422. Licensed agents can be found at the Department of Insurance’s website.

“We highly recommend consumers work with a licensed, local agent, or someone they know and trust to carefully evaluate plan options,” says Dean L. Cameron, Director of the Idaho Department of Insurance. “We hope Idahoans will utilize our department and SHIBA if they have any concerns about manipulative or deceptive sales and enrollment tactics. Our role is to protect consumers.”

For more information, visit the DOI’s Medicare Improper Marketing web page at  https://doi.idaho.gov/shiba/medicare-improper-marketing/.

Idaho — Work Comp Rate Revision: The National Council on Compensation Insurance (NCCI) recently submitted their annual rate recommendation to the Department of Insurance for review. NCCI’s recommendation is based on claims volume, claims utilization, workforce, and wages, as well as any changes in rules or legislation. After review and discussion, the Idaho Department of Insurance accepted a 11.5% reduction in rates, effective January 1, 2023.  Workers’ compensation insurers can now either adopt the NCCI rates without modification or propose to the Department’s review an adjustment from NCCI’s rates.

“The Department is pleased to announce another significant decrease to workers’ compensation rates,” said Director Dean Cameron. “With inflation and other economic concerns hurting many Idaho businesses, this is good news.”

Employers purchase workers’ compensation insurance, which is designed to cover their employee’s medical costs associated with any workplace injuries. It also provides wage replacement benefits to injured workers for lost work time. In exchange, employers are protected from litigation should an employee be hurt on the job.

NCCI annually collects information about the workers’ compensation system and submits proposed rates to the Department of Insurance for review and approval. The Department continues working with the NCCI to keep rates low for Idaho businesses and Idahoans.

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

Oregon — Clarifying questions sought on the Paid Leave Oregon Equivalent Plan Product Standards: The Oregon Division of Financial Regulation will be conducting a 1-hour virtual meeting on Monday, October 10 (1:00-2:00 p.m. PDT) to answer clarifying questions regarding the information in the drafted Paid Leave Oregon Equivalent Plan Product Standards. The link for the drafted Product Standards can be found here: https://dfr.oregon.gov/rates-forms/Documents/5809.pdf. The information for the Microsoft Teams meeting can be found below.

Please note this is not a deadline to submit comments. After further discussion internally, we have decided to not set a specific deadline for accepting comments at this time. Reason being, we will likely have some periodic changes to the Paid Leave Oregon Equivalent Plan Product Standards as The Oregon Employment Department finalizes more and more administrative rules throughout this program. Thus, we believe it makes the most sense to address questions as they come in and to not set a specific deadline at this time. So please know this meeting will not be your only opportunity to ask us questions. We will address questions as they come in.

Please note the purpose of this meeting is to answer clarifying questions about the information in the drafted product standards. It is not a meeting intended to reconsider substantive material presented in the drafted Paid Leave Oregon Equivalent Plan Product standards. Reason being, the Oregon Employment Department is ultimately administering this program, and a lot of the information presented in the drafted Product Standards references the Oregon statutory chapter and administrative rules designated for this program. We understand there will likely be some questions regarding the information in the Rate/Rule portion at the end of the drafted Product Standards, on pages 16 and 17. Our intention is to clarify uncertainties insurers have regarding that information, and the information in the rest of the drafted Product Standards.

Washington — Insurance Department Website Improvements: Take this survey to help us improve the OIC’s website (and maybe win $500). Over the next two weeks, we are conducting a user experience survey of our website. We’d appreciate a few minutes of your time and, as a thank-you, we’re entering everyone who takes the survey into a drawing for a chance to win $500.

This survey will help us understand any issues you experience with the current site and how it could be improved. Whether you’re a regular visitor or you’ve only used it once or twice, we would be glad to have your input.

The survey should only take a few minutes. You can take it here — https://survey.alchemer.com/s3/7041916/OIC-User-Survey?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=

Contact the OIC Public Affairs team with any questions or concerns about the survey, and thanks for your help.

Washington — Statement requirement for consumer adverse benefit determination notices rulemaking (R 2022-04): We adopted the Statement Requirement for Consumer Adverse Benefit Determination Notices rule (R 2022-04) on October 4, 2022. The rule takes effect on November 4, 2022. This rule amends existing rules so a required statement for consumer adverse benefit determination notices will be at a lower, more accessible reading level.

For more information, including the adopted rule (CR-103) and the concise explanatory statement, please visit the rule’s webpage.