Around the PIA Western Alliance States – Week of June 30
Published July 1, 2025 at 1:24 PM · News Releases and Bulletins
Oregon — The Oregon Division of Financial Regulation recently announced the following permanent rulemaking: ID 3-2025: NCCI Statistical Plan changes related to the Experience Rating Plan Manual for Workers’ Compensation
Rule: 836-042-0025
Rule Summary: This rule does not allow for scheduled rating plans, which is in conflict with ORS 656.508(3). Therefore, part (b) of this rule was removed.
Rule: 836-042-0045
Rule Summary: Amended for revisions to become effective on or before July 1, 2025, is prescribed as the statistical plan for workers’ compensation and employers' liability insurance.
Filed: June 25, 2025
Effective: July 1, 2025
For more information on this recently adopted rule, please visit the division's website:
Oregon — The Oregon Division of Financial Regulation recently announced the following permanent rulemaking on the silver health benefit plan: ID 4-2025: Amendment to 2026 standard silver health benefit plan
Rule: 836-053-0013
Rule Summary: Update standard silver plans.
Filed: June 25, 2025
Effective: July 1, 2025
For more information on this recently adopted rule, please visit the division's website:
Washington — Kurderer Elected to NAIC Post: Insurance Commissioner Patty Kuderer was elected to serve as Secretary/Treasurer for the Western Zone Committee of the National Association of Insurance Commissioners earlier this week at their Mid-Year Roundtable in Big Sky, MT. Her new role also gives her an official role on the NAIC’s Executive Committee.
“It’s a tremendous honor to be recognized by my fellow commissioners and be tasked with helping lead our priorities,” Kuderer said. “Insurance is regulated by the states and the issues we’re facing are increasingly complex and challenging for all of us, from climate change to the use of artificial intelligence. I’m looking forward to contributing to this important work at such a critical time.”
Washington — Kuderer fines health care sharing ministry, bars illegal service contract provider: Washington state Insurance Commissioner Patty Kuderer’s office issued more than $839,750 in fines for insurance law violations in the second half of May and the first half of June. That included a $275,000 fine for an illegal health care sharing ministry, a $300,000 fine for an illegal service contract provider and $45,000 for an unlicensed surplus lines provider.
Kuderer fines health care sharing ministry $275,000
Kuderer issued a cease-and-desist order and a fine of $275,000 against ClearShare Health and its associated companies Clearwater Benefits Administrators, Clearwater Benefits Holdings, and Clearwater Benefits Aggregator. ClearShare sold insurance plans, calling them “memberships,” without being authorized to do so by the OIC.
ClearShare sold 376 memberships to Washington consumers between August 1, 2022, and March 1, 2024, collecting $524,095 in monthly contributions from members and paying $54,201 towards expenses with $54,535 in denied expenses and $26,370 in pending requests for expenses.
The membership agreements, however, did not cover abortion services and had pre-existing conditions requirements, and ClearShare does not meet the qualifications of a health care sharing ministry as defined by the Affordable Care Act.
ClearShare was also ordered to pay taxes, penalties and interest on the premiums it collected.
Kuderer bars CRAST from doing business in Washington
Kuderer’s office issued a cease-and-desist order and $300,000 fine against CRAST, Inc. (doing business as America’s First Choice Home Club) for operating as a service contract provider in Washington without being registered with the OIC.
The OIC started its investigation after receiving a complaint from a consumer who paid $1,425 for a three-year membership plan in 2022 that claimed to cover up to $2,000 per item. The consumer contacted CRAST in November of 2022 to repair their furnace, but after 10 days and multiple calls, CRAST did not send a technician out to evaluate the furnace.
The consumer purchased a new furnace for approximately $5,000. CRAST said the original furnace, installed in the 1970s, was too old to be of any value, and offered a goodwill payment of $200 that was later increased to $400.
During the ensuing investigation, CRAST reported it sold 2,268 home club memberships to Washington consumers between December 26, 2015, and April 28, 2023, for a total of $1,494,317 in membership fees. CRAST reported it made $321,068 in payments to members, while denying 456 requests for benefits. Despite its claim that it stopped offering memberships in Washington, the company’s website listed Washington as a state it covered as of February 2025.
Kuderer fines unlicensed surplus lines broker $45,000
The OIC took action against BC Environmental Insurance Brokers, Inc. — and producer Marc Robicheau — for selling surplus line insurance products without being licensed as a producer or broker for those specific products.
Surplus lines is a specialized line of insurance that provides coverage for risks not covered in the traditional insurance market.
BC Environmental Insurance Brokers, Inc. was fined $45,000 and agreed to apply for a surplus line broker license for the agency and its employees. The agency was licensed to sell property and casualty insurance — but not surplus lines — as of January 2023 but wrote 31 policies in Washington between 2014 and 2021. BC Environmental Insurance Brokers, Inc. obtained its surplus line broker license in Washington in May 2025.
Additional fines
Amtrust Insurance Company; Milford Casualty Insurance Company; Security National Insurance Company; Wesco Insurance Company; Wilmington, Del.; fined $30,000 (order 25-0035).
The companies used Washington Surveying and Rating Bureau loss costs to calculate premium rates without filing and acquiring approval to do so.
Pennsylvania Lumbermens Mutual Insurance Company, Philadelphia, Penn.; fined $50,000 (order 25-0014).
The company failed to apply correct rating factors to commercial policies, resulting in $184,633 in overcharged premiums and $43,964 in undercharged premiums across 53 policies. The company refunded the policyholders who were overcharged.
Safeco Insurance Company of America, Portsmouth, N.H.; fined $3,000 (order 25-0029).
Safeco failed to timely refund a cancelled home insurance policy and failed to keep adequate records of its transactions.
Allstate Fire & Casualty Insurance Company, Northbrook, Ill.; fined $1,250 (order 25-0025).
Allstate failed to timely cancel a consumer’s policy.
UnitedHealthcare of Washington, Inc.; Seattle, Wash.; fined $40,000 (order 25-0050).
UnitedHealthcare failed to ensure its Association Health Plans enrolled employer groups on the same effective date as their associated Association Health Plan’s Master Contract, resulting in 83 employer groups being offered rolling renewals.
Axis Insurance Company, Chicago, Ill.; fined $2,500 (order 25-0056).
Axis used rates that were not in accordance with its effective filings.
Standard Fire Insurance Company, Hartford, Conn.; fined $40,000 (order 25-0046).
In 93 instances, Standard applied a higher uninsured/underinsured property damage deductible than is allowed under Washington law. The investigation was prompted by a complaint in which a consumer was charged a $200 deductible for uninsured/underinsured motorist property damage, when only $100 is permitted in Washington for that specific coverage.
American International Group, fined $50,000 (order 25-0036).
American International Group and its subsidiaries (Commerce and Industry Insurance Company, Granite State Insurance Company, Insurance Company of the State of Pennsylvania, National Union Fire Insurance Company of Pittsburgh, and New Hampshire Insurance Company) used incorrect rates for admiralty coverage, impacting 74 policies. Fifty-five policies’ premiums were overcharged by a total of $148,039, which was credited back to the policyholders.
Brotherhood Mutual Insurance Company, Ft. Wayne, Ind.; fined $3,000 (order 25-0077).
The company applied incorrect classification codes to commercial package policies.
Washington — Kuderer suspends Quick Health-adjacent licensee: Washington state Insurance Commissioner Patty Kuderer’s office issued an emergency order suspending the license of a producer involved in Quick Health’s fraudulent health insurance business, the latest development in a case that prompted federal wire fraud charges from the U.S. Attorney’s Office.
Kuderer’s office suspended the producer licenses for Benefits Now and its sole licensee, Tylor Trego, on June 17, 2025.
Washington — New federal rule creates unnecessary health coverage hurdles for nearly 300,000 Washingtonians: The federal Centers for Medicare and Medicaid Services (CMS) released its final 2025 Marketplace Integrity and Affordability rule on June 20, making it harder for consumers who buy health plans through our Exchange, Washington Healthplanfinder, to get and keep affordable health coverage.
“It’s clear to me that the Trump administration does not care about helping people find and keep affordable, meaningful health insurance,” said Washington state Insurance Commissioner Patty Kuderer. “It wants to restrict both who gets covered and the medically necessary services they can receive. The administration claims it’s needed to combat fraud and abuse, but that is simply not the case in Washington state. Our Exchange has robust safeguards in place to prevent improper enrollments. All this rule does is create widespread consumer confusion, impose complex administrative requirements for states and consumers, and increase premiums and out-of-pocket costs for thousands of people in our state.”
Washington is one of 19 states that runs its own state-based Exchange. Numerous organizations and individuals submitted approximately 26,000 comments on the federal rule that were largely ignored and not reflected in the final language.
The new rule’s changes take effect 60 days after publication, with certain changes scheduled for implementation later in 2026 and 2027. For health plans sold through Washington Healthplanfinder, the rule shortens the open enrollment period, creates unnecessary administrative burdens for states and consumers seeking coverage, and limits who is eligible for premium tax credits. In addition, it restricts states’ ability to select their own benchmark health plans — which is allowed under the Affordable Care Act, — by prohibiting Exchange plans from covering gender-affirming care.
“During his previous administration, Trump said, ‘No one knew health care could be so complicated.’ This rule adds unnecessary and cruel complications and will make it harder for people to get enrolled and stay insured. Every day we hear from people who are struggling to pay for their health insurance. As a result of this action, combined with the expiration of enhanced federal premium subsidies at the end of this year, I’m worried the burden will be even harder to overcome for far too many people.”
Washington — CSR Silver Loading Emergency Rule – Extension: On March 10, 2025, the Commissioner adopted an emergency rule (WSR 25-07-021) related to cost-sharing reduction (CSR) silver loading that is applicable to Plan Year 2026 rate filings. This emergency rule adjusts health insurer rate development components to preserve consumer affordability and stability in Washington state’s individual health insurance market by applying a uniform CSR silver load adjustment factor to rates for silver level qualified health plans sold on the Washington state Health Benefit Exchange.
Per RCW 34.05.350, the Commissioner is extending the emergency rule filed under WSR 25-07-021. OIC has initiated notice and comment rulemaking on this issue in WSR 25-13-098, to provide insurers rate development instructions beginning in Plan Year 2027.
Please contact rulescoordinator@oic.wa.gov with any questions regarding this GovDelivery communication.