Around the PIA Western Alliance States – Week of March 2, 2026

Nevada — 21% Jump in Work Comp Loss Costs: The National Council on Compensation Insurance (NCCI) said the Nevada Division of Insurance has approved a 21.6% rise in workers’ compensation loss costs.

The increase began on March 1st.

“Nevada’s experience is unique, shaped by a combination of elevated large losses, flattening claim frequency, rising claim severity, and a payroll limitation that adds pressure on loss ratios during periods of strong wage growth,” NCCI Chief Actuary Donna Glenn said in a statement.

Source link: Business Insurance — https://bit.ly/46BJG0y

Oregon — Consumer advocates recover over $1 million in fourth quarter 2025 to put last year’s total at more than $7 million: In the fourth quarter of 2025, Oregon Division of Financial Regulation (DFR) consumer advocates helped recover more than $1 million for Oregon consumers. The fourth quarter consists of the last three months of the year. The $1,118,375 recovered brings the 2025 total to $7,039,774 – money that goes directly back to Oregonians.

Consumer advocates have extensive knowledge across many areas of regulation, including helping those experiencing difficulties with insurance, mortgages, banking products, securities, student loans, and a variety of other financial services regulated by DFR.

“The agency’s work to protect consumers by holding companies accountable to their customers helps to make Oregon more affordable for all of us,” Gov. Tina Kotek said.

The final quarter of last year saw 1,454 complaints come through DFR’s consumer advocates for a total of 5,663 complaints in 2025. Insurance complaints led the way in each quarter, with 935 in the last three months of 2025, while more than 3,700 insurance complaints came in throughout the year. Credit union complaints were the next highest of areas DFR regulated with 59 complaints for the quarter and 212 for the entire year. Advocates also received 254 insurance complaints that were not regulated by DFR.

Examples of consumer complaints successfully resolved by DFR advocates in the last three months of 2025 include:

·       Following a dental trauma, a consumer was seen at an in-network emergency room and referred to an out-of-network specialist for follow-up care. The in-network doctor submitted a prior authorization for the specialist’s services, but the consumer did not understand that since the specialist was out-of-network, they would be responsible for the full bill, which totaled $12,000. The insurer denied the consumer’s appeal to pay the claim and waive the charges, so the consumer filed a complaint with DFR. During the insurer’s review, because the in-network emergency room provider requested prior authorization from an out-of-network provider instead of an in-network provider, the insurance company agreed to negotiate a single case agreement, which means the consumer will be responsible only for their in-network cost share.

·       A consumer filed a complaint indicating a debt management service provider charged for services while he resided in Oregon when the provider was not licensed in the state. The service provider credited the consumer $3,176.48 for fees earned while he lived in Oregon.

·       A consumer reported a hail loss in July 2025. The company’s estimate and the contractor’s estimate were significantly different. The two areas of concern were skylights and roofing materials. The consumer lived in a homeowner association that set requirements for the quality of materials used for building or repairs. Some differences appeared associated with those requirements and, based on the insurance contract, were not owed by the insurer. However, through the complaint process, the company reassessed these two areas of the repair estimate and made adjustments to properly reflect like kind and quality of the repair materials. Additional payments totaling $4,389.17 were issued.

·       A consumer traveled to Cleveland, Ohio, to see a specialist for a rare type of cancer and ongoing treatment. During travel, an emergency occurred requiring the consumer to be hospitalized for a full month and to undergo multiple procedures. The provider had previously been in-network. However, the consumer’s employer recently changed insurers, and the provider was now out-of-network. The consumer was not aware there would be such a drastic difference in benefits. The consumer returned to Oregon as soon as they were able, but now had significant bills due of about $40,000. After corresponding with the insurer, the insurer agreed to retroactively approve continuity of care for the consumer, which allowed several large claims to be reprocessed as in-network. Partnering with the consumer and the insurer to verify outstanding balances and claim statuses, four separate previously out-of-network claims were able to be reprocessed, saving the consumer $38,800.75.

“Last year saw over 5,000 complaints come in to our consumer advocates, and they handled them professionally,” said Sean O’Day, director of the Department of Consumer and Business Services. “We have a dedicated group of employees who have a common goal of helping Oregonians navigate the often complicated world of insurance and financial services.”

Oregon Insurance Commissioner TK Keen said consumer advocates have a tough job and handle it professionally.

“I am very proud of our team of industry experts, who continue to put their knowledge to work for the benefit of Oregonians,” said Keen, who is also the DFR administrator. “Many of the cases they deal with are highly complex and take a lot of time to navigate. I am happy to see their hard work benefitting so many people in our state.”

Anyone who may need a consumer advocate can call 888-877-4894 (toll-free) or email dfr.insurancehelp@dcbs.oregon.gov for insurance-related issues and dfr.finanicialserviceshelp@dcbs.oregon.gov for financial-related issues.

Washington — Legislature adopts Governor Ferguson, Commissioner Kuderer bill to strengthen Washington state’s decision-making authority regarding vaccines: Governor Bob Ferguson and Insurance Commissioner Patty Kuderer’s proposal to shift decision-making authority on vaccines and other critical preventive health care services away from the federal government passed the Legislature today in a bipartisan 36-12 vote. The bill allows the state Department of Health (DOH) to propose vaccine recommendations based on medical and scientific expertise and evidence.

House Bill 2242, sponsored by Rep. Dan Bronoske (D – Lakewood), is now on its way to Governor Ferguson’s desk for his signature. It previously passed the House 57-39. The bill, requested in partnership with the Office of the Insurance Commissioner (OIC), is one of six Governor Request Bills. Sen. Annette Cleveland (D – Vancouver) sponsored the companion bill.

“Donald Trump’s CDC has become a political tool that increasingly peddles ideology instead of science,” Governor Ferguson said. “We must protect Washingtonians’ health from the chaos of the federal government.”

“These are important services for people who choose to use them,” Commissioner Kuderer said. “This bill ensures that the recommendations will continue to come from trained medical experts, rather than political appointees with no background in medicine or science.”

“Guaranteeing access to preventive services for health conditions diagnosed and treated early is key to maintaining quality of life and lowering overall costs,” Rep. Bronoske said. “These preventive health services include well-child visits, cancer screenings, immunizations and chronic disease management.”

“It is vitally important to take steps to safeguard our state’s health care system and our public’s trust in that system from federal changes,” Sen. Cleveland said. “This bill ensures that individuals and families can be assured that health care guidance and recommendations in our state continue to be rooted in science and evidence-based practices.”

The legislation delinks the Washington state statute for immunization coverage (RCW 48.43.047) from the federal Advisory Committee on Immunization Practices (ACIP), ensuring Washingtonians have access to vaccines that are grounded in science. DOH will engage with professional medical organizations, local health organizations, the West Coast Health Alliance and others to determine recommendations going forward.

The law also preserves Washingtonians’ access to preventive services, including immunizations, without cost-sharing for residents enrolled in commercial health plans who choose to utilize these services.

In 2010, when the Affordable Care Act was passed, it required coverage of preventive services as recommended by the United States Preventive Health Services Task Force, Health Resources and Services Administration and the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. In 2018, Washington state codified this requirement in RCW 48.43.047, which was updated in 2024. The intent was to ensure access to preventive services with no cost-sharing for Washingtonians covered by commercial health plans regulated by OIC.

This legislation will preserve health plan coverage for DOH-recommended vaccines and freeze coverage for federal preventive services recommendations.

This law does not establish new vaccine mandates, change any laws related to consent for immunizations or mandate the use of any preventive service.

Washington — On Campus: Sen. Claire Wilson on insurance for child housing service providers: The OIC Answers podcast’s On Campus miniseries continues with guest Sen. Claire Wilson, who represents the 30th District.

The Office of the Insurance Commissioner sent a report to the Legislature in December on the availability of insurance coverage for child-placing agencies and family homes. The report focuses on liability coverages, which include professional liability insurance, sexual abuse coverage, and excess or umbrella coverage.

Child placing agencies and group family homes, in particular, are able to find liability coverage for events that may occur in the future, but many insurance companies are unwilling to provide new coverage for potential acts in the past. Without coverage for those prior acts, which could have occurred years in the past, CPAs and GFHs run the risk of financial collapse in the event of a lawsuit.

Sen. Wilson, a longtime educator, sits down with Insurance Commissioner Patty Kuderer to discuss why the issues exist, what happens if they’re not addressed, and what policy options exist to make coverage more available.

TO SEE THE PODCAST — https://bit.ly/4lcq3m0

Washington — Balanced Billing Update: On January 27, 2026, OIC released its fifth request for information (RFI) for the Balance Billing Protection Act (BBPA) dispute resolution mechanism. OIC solicited comments as to whether, under the authority provided in RCW 48.49.040, Washington state should transition to the federal No Surprises Act Independent Dispute Resolution (NSA IDR) process on July 1, 2026, or delay the transition.

The OIC will delay that state’s transition to the NSA IDR system for a minimum of two years. This determination was made based on the following factors: 

1. Comments received on the RFI; 

2. the continued high volume of cases in the NSA IDR process;

3. pending federal litigation related to the NSA IDR process;

4. pending civil litigation related to the misuse of the federal NSA IDR system; and 

5. the volume of claims introduced by private equity-backed provider groups. 

The OIC will revisit this decision in 2028. 

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Washington — Bill to preserve preventive services protections passes Senate: Preventive services will remain covered in full by health insurance plans for Washington residents who choose to use them, thanks to legislation passed on Thursday, Feb. 26, by the state House of Representatives.

Engrossed Substitute Senate Bill 2242, requested by both Gov. Bob Ferguson and Insurance Commissioner Patty Kuderer, passed by a 36-12 vote. The bill maintains the no-cost coverage for services like well-child visits and immunizations that Washingtonians have had since 2010.

“These are important services for people who choose to use them,” Kuderer said. “This bill ensures that the recommendations will continue to come from trained medical experts, rather than political appointees with no background in medicine or science.”

Recommendations currently come from the federal Advisory Committee on Immunization Practices (ACIP), the U.S. Preventive Health Services Task Force, and the Health Resources and Services Administration. The federal government recently narrowed access to certain vaccines.

“Donald Trump’s CDC has become a political tool that increasingly peddles ideology instead of science,” Gov. Ferguson said. “We must protect Washingtonians’ health from the chaos of the federal government.”

ESSB 2242, sponsored by Rep. Dan Bronoske (D–Lakewood), changes state law to tie the coverage of vaccines to recommendations from the Washington state Department of Health. The bill sets the coverage standards for other preventive services based on recommendations from the U.S. Preventive Services Health Task Force and Health Resources and Services Administration, effective on June 30, 2025.

The Senate version of the bill, SB 5967, was sponsored by Sen. Annette Cleveland (D–Vancouver).

The Department of Health and Kuderer’s office will be responsible for implementing the new law, which now heads to Gov. Ferguson’s desk for a signature. The 2026 legislative session concludes on Thursday, March 12.