Around the PIA Western Alliance States – June 12, 2023

Arizona — DIFI Receives Accreditation From National Credit Union Organization: On June 7, 2023, the Arizona Department of Insurance and Financial Institutions (DIFI) was approved for Accreditation by the Performance Standards Committee (PSC) of the National Association of State Credit Union Supervisors (NASCUS).

DIFI’s Financial Institutions Division participates in a voluntary, in-depth examination every five years to ensure the division’s processes, procedures and training meet the highest level of regulatory proficiency and industry standards set forth by the PSC. The PSC employs a strategy of utilizing the expertise of professional peer reviewers from other accredited states, to examine other states’ credit union regulatory practices.

“Successful completion of the Accreditation process confirms the DIFI Financial Institutions Division staff are effectively implementing financial surveillance controls so consumers can have confidence in our oversight responsibilities of Arizona credit unions,” said DIFI Director Barbara Richardson. “I am proud of this achievement and applaud the division staff for their continuing effort.”

As noted in the Re-accreditation Status Letter to DIFI, the NASCUS Accreditation Program acknowledges credit union regulatory agencies that serve the citizens of their State through operation of an effective, skilled, and professional program with credit union safety and soundness at the forefront of supervision.

Washington — Kreidler issues $398,500 in fines for violations in April and May: Insurance Commissioner Mike Kreidler issued fines in April and May totaling $398,500 against insurance companies that violated state insurance laws and regulations.

Insurance companies

LifeWise Health Plan of Washington, Mountlake Terrace, Wash.; fined $250,000 (order 23-0068).

    During the COVID-19 pandemic, LifeWise incorrectly processed 4,133 virtual mental health claims for 871 consumers, which resulted in $75,366 in overpayments to providers.

    LifeWise also incorrectly coded 6,591 COVID-19 testing claims in 2020 and 2021. Of those claims, 4,357 were underpaid (totaling $560,354) and 1,341 were overpaid (totaling $618,714).

    Additionally, LifeWise incorrectly processed 314 COVID-19 claims in 2022. Configuration updates and human error caused the processing issues.

    LifeWise also posted incorrect information about appeals on its website.

Premera Blue Cross, Mountlake Terrace, Wash.; fined $50,000 (order 23-0067).

    Premera’s third-party vendor incorrectly configured benefits in its claims system, which resulted in 1,420 mental health office visits being charged a deductible and a total of $89,737 in claim underpayments.

    Premera also denied 893 COVID-19 testing claims between January 1 and February 7, 2021. After reprocessing the claims, Premera issued $91,056 to providers.

    Due to human error, Premera incorrectly processed 77 claims on COVID-19 testing cost-shares between March 5, 2020, and December 14, 2021, totaling $17,207. All claims were reprocessed.

    A processing issue, due to a system configuration, prevented cost shares for COVID-19 exposure billing from being waived. The 3,964 affected claims were underpaid by $394,235 and were reprocessed.

    Additionally, two Premera publications featured incorrect information on appeal rights.

Regence BlueShield, Seattle, Wash.; fined $10,000 (order 23-0082).

    Regence was the victim of a data security breach that exposed 570 Washington consumers’ private information in 2021. Regence failed to timely notify the OIC of the breach and oversee its subcontractor.

American Digital Title Insurance Company, Denver, Co.; fined $30,000 (order 23-0081).

    American Digital Title Insurance accepted new business and paid commissions to its sole producer without appointing them as title agent. The company also failed to respond to the OIC’s inquiry in a timely manner.

New Hampshire Insurance Company, Chicago, Ill.; fined $8,000 with $4,000 suspended (order 23-0047).

    The company was fined $8,000 for sending out storage unit burglary claim denial letters with language that doesn’t appear on the Washington Certificate of Storage Insurance. Half of the fine was suspended on the condition the company doesn’t violate any statutes or regulations for the next two years.

Unauthorized insurers or companies

Airbnb, San Francisco, Calif.; fined $20,000 (order 23-0108).

    Airbnb acted as an unauthorized insurer through its Host Damage Protection program. The company was ordered to obtain a surplus lines policy through a broker authorized in Washington state.

Mack Camera & Video Service, Springfield, N.J.; fined $20,000 (order 22-0294).

    Mack Camera & Video acted as an unauthorized insurer. The company was also ordered to stop engaging in unauthorized insurance business in Washington state.

Producers, agents & brokers

Golden State Claims Adjusters, Carlsbad, Calif.; fined $5,000 (order 23-0072).

    The company used an adjuster who was not licensed in Washington state to process a claim.

Railroad Insurance Services; fined $500 (order 23-0069).

    Railroad Insurance Services acted as a surplus line broker and insurance producer without being licensed in Washington state.

Sandra Sherman, Renton, Wash.; fined $7,000 (order 23-0022).

    Sherman misrepresented life insurance policies, leading consumers to believe the policies included long-term care coverage that would exempt them from paying into the WA Cares Fund.

William H. Steenis, Snohomish, Wash.; fined $500 (order 23-0064).

Perla’s Insurance Services, Mount Vernon, Wash.; fined $500 (order 23-0078).

Tanika Stewart, Fishers, Ind.; fined $250 (order 23-0054).

Lori Ann Veccia, Sharon, Penn.; fined $250 (order 23-0100).

Shane Van Dalen, Lynden, Wash.; fined $500 (order 23-0059).

Washington — Wildfire smoke forecasted to impact Washington again this season: As our climate changes, the threat of wildfires looms larger every year. The Washington State Department of Health (DOH) is urging the public to prepare now for smoke that can make air unhealthy to breathe. Smoke Ready Week, observed June 12-16, is an opportunity to take proactive steps to protect yourself and your family.

“We are expecting to have above normal fire activity in Washington by July,” said Kaitlyn Kelly, MPH, Air Quality Policy Specialist, DOH. “We have an outlook for below normal precipitation and that’s going to last into fall, so conditions are trending to a long fire season.”

When smoke arrives it’s important to reduce exposure by staying up to date on the forecast and air quality index, limiting time outside, and keeping indoor air as clean as possible. After several days smoke can enter homes and buildings through leaky gaps in windows and doors. Having a way to filter indoor air will benefit your health. It’s key to buy supplies in advance because they often sell out quickly when it’s smoky out.

Filter indoor air by using a:

HVAC system with MERV 13 filter.

HEPA portable air cleaner.

DIY box fan filter.

“We no longer have smoke-free summers in Washington,” said Kelly. “It’s important to know what is in wildfire smoke and why it can be bad for your health.”

Smoke from wildfires contains fine particles and gases including carbon monoxide. Exposure to smoke can cause a number of health problems ranging from minor to severe. Those with pre-existing conditions, infants and children, pregnant individuals, adults 65 and older, and people with heart and lung disease can be most sensitive to wildfire smoke. Minor symptoms can include headaches, stinging eyes, runny nose, and trouble breathing. 

You can stay updated on wildfires, air quality, the forecast, and health information on the WA Smoke Blog. For more information on how to protect yourself from wildfire smoke, visit the DOH’s Smoke from Fires webpage.

About PIA Western Alliance

The Professional Insurance Agents Western Alliance is a membership organization promoting and enhancing the success of independent agencies seeking to grow, learn and be heard within the industry.


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