Around the PIA Western Alliance States – Week of March 18, 2024

Hawaii — Maui Mayor Looks at the Island’s Future: Maui, Hawaii Mayor Richard Bissen talked about steps he is taking to rebuild the island. His priority is housing, evaluating evacuation routes and hiring more firefighters.

His remakes came after the deadliest fire in U.S. history killed 101 people in Lahaina on August 8th of last year. Bissen’s voice broke several times in his 45-minute speech in which he talked of the heroism and the sacrifices of the people of Lahaina.

“It will take strength, courage and faith to keep moving forward. But the foundations of that will be in how we care for one another, always leading with aloha,” Bissen said.

Even before the fire, Maui had a housing shortage. Not only that, but some of the country’s most expensive properties to rent are on Maui. The fire — which destroyed 2,000 buildings and made 4,500 residents homeless — intensified the problem as 87% of those living on the island are renters.

Today, thousands of people are still staying in motels and hotels waiting to find a place to rent.

Bissen wants to review a county law to set up an exemption that would allow condo owners to rent them to vacationers for 30 days. He also wants to fortify the island’s fire departments and hire more firefighters.

Source link: Associated Press — https://apnews.com/article/hawaii-maui-wildfire-mayor-state-of-county-11ecb46f43f729066780abe4d5758220

Idaho — Change Healthcare Cyber Attack: The Idaho Department of Insurance (DOI) is monitoring the effects of the recent cybersecurity attack on Change Healthcare that occurred on February 21, 2024. Change Healthcare is a part of UnitedHealth Group and also operates as Optum. Change Healthcare’s services are used by a substantial number of hospitals, health care providers, health care facilities, and pharmacies in Idaho. As a result of the cyber incident, some providers are unable to request prior authorization; engage in concurrent or retrospective reviews; request reconsiderations; submit internal appeals, external appeals, or claims within the standard timeframes; verify an insured’s eligibility for coverage; or obtain timely payment for health care services.

The DOI is asking every health insurance company in Idaho to actively work to mitigate any impacts to their members and healthcare providers who have been impacted from Change Healthcare’s system issues. This should include either effective alternatives for healthcare providers to obtain the information needed for prior authorizations, appeals, claims submissions, as well as temporarily waiving or deferring such requirements if they are delaying needed health care services or prescriptions.

The cyber incident has also impacted cash flows for some providers.  Issuers should work with any affected network providers to provide assistance if financially feasible and prudent, after considering the liquidity and solvency of the issuer.  Where assistance is needed to avoid any disruption of services provided by a provider, the state strongly urges the issuer and the provider to work together to develop a mutually acceptable plan to provide assistance to the provider, which may include periodic interim payments during the cyber incident.

Further, DOI also requests these insurance companies to update their websites and create materials that explain how affected members can get help during this time. Insurers should post clear contact information for this issue, so providers, members, and the DOI can reach out if needed, as everyone works to recover from the cyberattack.

You can find updates on Change Healthcare’s efforts to deal with the cyber-attack at https://www.unitedhealthgroup.com/ns/changehealthcare.html

This Bulletin is not new law but is an agency interpretation of existing law, except as authorized by law or as incorporated into a contract. Requests for additional information or other inquiries regarding this Bulletin can be directed to Deputy Director Wes Trexler at 208-334-4214 or weston.trexler@doi.idaho.gov.

Idaho — NAIC Accounting Practices: This Bulletin provides guidance regarding the version of the NAIC’s Accounting Practices and Procedures Manual to be used by authorized insurers when preparing 2024 quarterly and annual financial statements filed with the Idaho Department of Insurance and the NAIC, pursuant to Idaho Code §§ 41-210(4), 41-335, and 41-336.

Additionally, this Bulletin provides guidance for minimum reserve requirements regarding the version of the NAIC’s Valuation Manual to be used by authorized insurers providing life insurance, accident and health (A&H) insurance, annuity contracts, and deposit-type contracts when calculating reserve amounts to be reported to the Idaho Department of Insurance and the NAIC, pursuant to Idaho Code § 41-612.

Unless otherwise prescribed or permitted, the March 2024 version of the NAIC’s Accounting Practices and Procedures Manual, which applies to the 2024 quarterly and annual financial statements, has been adopted by the Director.

Unless otherwise prescribed or permitted, the January 1, 2024, edition of the NAIC’s Valuation Manual, which applies to the 2024 quarterly and annual financial statements, has been adopted by the Director.

Pursuant to Idaho Code, Sections 41-6305(1) and 41-6403(1), the NAIC’s Financial Analysis Handbook, 2023 Annual and 2024 Quarterly Edition, is prescribed.

This Bulletin is not new law but is an agency interpretation of existing law, except as authorized by law or as incorporated into a contract. Requests for additional information or other inquiries regarding this Bulletin can be directed to the Company Activities Bureau Chief/Chief Examiner, Eric Fletcher at 208-334-4230 or Eric.Fletcher@doi.idaho.gov.

Idaho — Life Insurance Deferments: Idaho Code Sections 41-1927(3) and 41-1927A(3)(b) permit an insurer to defer the payment of any cash surrender value under a life insurance policy or individual deferred annuity when payment of the surrender value is requested by the policyholder with surrender of the policy.  If payment of the surrender value is deferred, the same code sections require that the insurer pay interest to the policyholder.  Non-tender of payment of the surrender value within 30 days of a request therefore is considered an election by the insurer to defer payment. The thirty-day period begins on the date the request was received by the insurer or its authorized agent or representative.

Effective July 1, 2023, insurers must pay a minimum interest rate of 10.250% on deferred payment of cash surrender values, pursuant to Idaho Code Sections 41-1927(3) and 41-1927A(3)(b). The 10.250% interest rate is computed in accordance with Idaho Code § 28-22-104(2) and is effective from July 1, 2023, through June 30, 2024. The Idaho State Treasurer announces a new rate on or about July 1st of each succeeding year. The rate calculation can be reviewed at the State Treasurer’s website: https://sto.idaho.gov/Reports/Legal-Rate-of-Interest.

This Bulletin is not new law but is an agency interpretation of existing law, except as authorized by law or as incorporated into a contract. Any questions regarding this Bulletin can be directed to Deputy Director Wes Trexler at 208-334-4214 or weston.trexler@doi.idaho.gov.

Washington — Kreidler fines Molina Healthcare $100,000 for enrollment and billing errors: Washington state Insurance Commissioner Mike Kreidler fined Molina Healthcare of Washington $100,000 on Tuesday (fortress.wa.gov) for errors in the company’s enrollment and billing system.

“Consumers in Washington should be able to rely on their health insurer providing accurate, reliable information,” Kreidler said. “In this situation, the system in place did not provide that assurance for thousands of people, adding confusion and stress to the process of simply obtaining health care.”

Kreidler’s office opened a review of Molina’s enrollment and billing system in 2021 after a significant increase in consumer complaints against the company. That included two complaints about claims for pre-authorized services being denied.

Molina transitioned to a third-party enrollment and premium billing platform in April of 2021 to address an increase in enrollment through the Washington State Health Benefits Exchange. 

Prior to the change, Molina identified several issues with its billing system — including sending incorrect invoices to nearly 2,000 people and incorrectly terminating coverage for 22 members. 

The company continued to experience issues with enrollment and billing after the change; 2,309 members’ account balances were lower than the amount shown on their invoices; 55 members were erroneously terminated for non-payment; 259 transactions weren’t fully loaded into the system, which led to incorrect premium balances. 

After the OIC’s examination, Molina identified another 42 claims for pre-approved services that were denied due to issues with the claims processing system.

Molina has been operating as a health maintenance organization in Washington since 1985. 

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.


PIA WESTERN ALLIANCE VALUES OUR STERLING PARTNERS

More Industry News