Around the PIA Western Alliance States – Week of March 4, 2024

Montana — Montana Supreme Court Affirms Agency Verdict: Rames Inc. — formerly Central Insurance Agency — has lost its appeal to the Montana Supreme Court. The agency was sued by TCF Enterprises for failing to purchase additional insurance requested by a subcontractor for a general contractor.

The decision means Rames will be responsible for the $1 million verdict from a lower court.

The high court said Rames did not procure the requested insurance as part of a contract with C&H Engineering and Surveying. It was to insure work done by Malmquest Construction. That work had flaws and damages were done, damages that were not insured.

The court said Rames breached its duty of care by not picking up the coverage.

Source link: Business Insurance — https://bit.ly/3SWmaDS

Oregon — Oregon Division of Financial Regulation issues $160,000 in fines to Laura O. Shean for conducting unlicensed investment adviser activities: The Oregon Division of Financial Regulation (DFR) issued a cease-and-desist order and fined Laura O. Shean and her company, PlanNow, LLC, a total of $140,000 for conducting unlicensed investment adviser activity and engaging in securities fraud.

The division, in an order filed in December 2023, also ordered Shean to pay $20,000 of previously suspended civil penalties because Shean violated a prior order the division issued in 2019. Shean was licensed as a securities salesperson, investment adviser representative, and resident insurance producer, but her insurance and securities licenses in Oregon were revoked by DFR in 2019. The division revoked Shean’s licenses because Shean misappropriated, through a series of six unauthorized transactions in 2017, more than $124,000 from an elderly client. In 2018, the Financial Industry Regulatory Authority (FINRA) permanently barred Shean from associating with any FINRA member in any capacity. In 2019, Shean consented to an order issued by the division that permanently bars her from holding any securities or insurance licenses in Oregon and ordered Shean to cease and desist from violating the Oregon securities law.

Following the issuance of the 2019 consent order, the division investigated Shean’s ongoing business activities and compliance with the consent order. The division learned through a consumer complaint that Shean, through PlanNow, was willfully and repeatedly engaging in unlicensed investment adviser activity, contrary to the terms of the consent order and in violation of the Oregon securities law. Shean was operating the PlanNow business in a manner calculated to conceal her unlawful business activities.

During the division’s investigation of Shean’s ongoing business activities and compliance with the consent order, Shean filed a false statement with DFR in 2021. In that statement, Shean falsely denied that she engaged in investment adviser business activities after the division issued the 2019 consent order.

DFR reminds people to do business only with investment professionals who are licensed in Oregon. On DFR’s website, you can check for a license and file a complaint if you believe you have been defrauded or been the victim of a scam. Our consumer advocates can be reached by calling 888-877-4894 (toll-free) or emailing dfr.financialserviceshelp@dcbs.oregon.gov.

The division also has recently published a tool – the Oregon Investor Guide – to give consumers another resource before investing money.

Oregon — The Oregon Division of Financial Regulation recently announced the following proposed rulemaking: Filing Caption: Rules implementing insurer and PBM reporting requirements of SB 192 (2023)

Amend Rule: 836-053-0473

Rule Summary: This rule describes the materials that must be filed by an insurer as part of a rate filing for small group and individual health benefit plans. The amendment removes the language related to annual reporting by insurers for the Drug Price Transparency Program.

Adopt Rule: 836-053-1630

Rule Summary: This rule restates the language removed from OAR 836-053-0473 with slight modification to reflect the expanded reporting requirements. The draft rule describes the information that must be submitted by insurers annually to the Drug Price Transparency Program.

Adopt Rule: 836-200-0418

Rule Summary: This rule describes the information that must be submitted to the department annually by Pharmacy Benefit Managers under SB 192 (Oregon Laws 2023, Chapter 466).

Filed: February 26, 2024

Hearing: March 26, 2024, 11:00 a.m.

This is a hybrid meeting conducted in-person and virtually via Microsoft Teams. See Notice of Proposed Rulemaking for Teams meeting instructions.

Last day/time to offer comment: April 2, 2024, 5:00 p.m. 

For more information on this recently adopted rule, please visit the division’s website:

https://dfr.oregon.gov/laws-rules/Documents/Proposed/20240326-sb192-reporting-requirements.pdf

Washington — Third RFI for BBPA dispute resolution mechanism: On February 13, 2024 the OIC released a third RFI related to the BBPA dispute resolution mechanism soliciting comments as to whether Washington state should transition to the federal No Surprises Act Independent Dispute Resolution system (NSA IDR system) on July 1, 2024, or continue to use the Balance Billing Protection Act (BBPA) arbitration system to resolve disputes between carriers and nonparticipating providers. For more information on this RFI or the BBPA please visit our webpage on arbitration. In response to comments received on the RFI and pending federal litigation related to the federal NSA IDR process, the OIC will delay transition to the NSA IDR system for a minimum of 12 months or July 1, 2025.

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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