Around the PIA Western Alliance States – Week of September 18, 2023

California — Commissioner Lara orders protections for more than 15,000: Helping consumers continue their recovery from wildfires, Insurance Commissioner Ricardo Lara ordered insurance companies to preserve residential insurance coverage for more than 15,000 policyholders affected by fires in Del Norte County and Siskiyou County after Governor Gavin Newsom issued emergency declarations on August 29, 2023. The Commissioner’s Bulletin shields those living within the perimeters or adjoining ZIP Codes of the Smith River Complex fire and the Happy Camp Complex fire from insurance non-renewal or cancellation for one year from the date of the Governor’s August 29 emergency declaration regardless of whether they suffered a loss.

“Consumers affected by these recent wildfires need to have peace of mind that they have time to assess, rebuild, and recover, and not have the added pressure of worrying about their insurance. My number one priority is to protect California consumers,” said Commissioner Lara. “My moratorium Order is just one of the many ways that I am taking action to provide relief to homeowners while I continue to work with stakeholders and climate experts to address the root causes of these ever-intensifying natural disasters in order to prevent even greater losses.”

The Commissioner’s ability to issue moratoriums is a result of a California law he authored in 2018 while serving as state senator in order to provide temporary relief from insurance non-renewals and cancellations to residents living within or adjacent to a gubernatorial-declared wildfire disaster.

Since 2019, Commissioner Lara’s actions have protected nearly 4 million homeowners. Today’s order protects over 15,000 policyholders for one year, effective August 29, 2023. Consumers who were non-renewed prior to the emergency declaration date and are unable to obtain insurance or are dissatisfied with their current coverage should contact the California Department of Insurance for assistance in shopping for insurance.

Consumers can go to the Department of Insurance website to see if their ZIP Code is included in the moratorium. Consumers should contact the Department of Insurance at 800-927-4357 or via chat or email at insurance.ca.gov if they believe their insurance company is in violation of this law, or have additional claims-related questions.

Commissioner Lara’s actions since taking office in 2019 include:

Announced “Safer from Wildfires,” a new insurance framework that incorporates wildfire safety measures to help save lives while making homes and businesses more resilient.

Safer from Wildfires was created by a first-ever partnership between the Department of Insurance and the emergency and preparedness agencies in Governor Newsom’s Administration, including CAL FIRE, the Governor’s Office of Emergency Services (CalOES), the Governor’s Office of Planning and Research, and the California Public Utilities Commission.

Finalized new regulations to incorporate Safer from Wildfires in insurance pricing, driving down costs for consumers who have taken actions to protect their communities while increasing transparency about their home’s or business’s “wildfire risk score.”

Sponsored new insurance protections signed into law by Governor Newsom — despite opposition from insurance companies — that will mean larger payouts for some claims, less red tape from insurance companies, and more help for people under evacuation orders.

Ordered the FAIR Plan, the state’s insurer of last resort, to offer a more comprehensive homeowners policy as an option, which a judge upheld, as well as expanding residential and commercial coverage limits for the first time in 25 years to keep pace with increased costs.

Following Governor Newsom’s state of emergency declarations, the Department of Insurance partners with CAL FIRE and CalOES, pursuant to existing statute, to identify wildfire perimeters for mandatory moratorium areas. The Department of Insurance will continue to collaborate with CAL FIRE and CalOES to identify additional wildfire perimeters for any fires where there is a gubernatorial declaration of a state of emergency.

Washington — Essential Health Benefit (EHB) public meeting series: Health Management Associates’ Wakely Consulting Group is the actuarial firm assisting OIC with the EHB update project.  We have scheduled a public meeting on October 20, 2023 from 3-4:30pm.  At the meeting, the Wakely team will present their generosity test results and preliminary benefit pricing results.

The meeting will be virtual.  Please register for the meeting — https://wa-oic.zoom.us/meeting/register/tZIuf-mqrzwvE9wEwrmHhvlHE4pFBHg9U0td?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=#/registration

— Average rate increase of 8.9% approved for 2024 individual health insurance market

Contact Public Affairs: 360-725-7055

Fourteen health insurers have been approved to sell in Washington’s 2024 individual health insurance market.  Insurers requested an average increase of 9.11% but 8.94% was approved. How much premium someone pays will depend on the plan they select, the number of people covered, their age, whether or not they smoke and where they live.

“I’m relieved to see that our competitive health insurance market is continuing and that people in every county will have choices,” said Insurance Commissioner Mike Kreidler. “But I’m deeply concerned at what these increases mean for individuals and their families. We need to do the hard work of getting at the underlying costs of health care. We know that several factors drive health care cost increases, including getting the timely care we need and the prices hospitals and health care providers are paid to deliver that care.  The Legislature considered several bills earlier this year that would strengthen competition in the health care industry and target increasing health care costs. To help move those bills, we’ll be delivering a report in December that will highlight what the business of health care looks like in Washington state and offer additional policy options.” 

As of July 2023, an estimated 220,059 were enrolled in the individual health insurance market. Approximately 192,085 people bought their coverage through the Exchange and more than 75% of them received some financial help to pay their monthly premium. The individual market is designed for people who do not get employer-sponsored health insurance. 

Premium changes are driven by increased utilization, including pent-up demand for elective surgeries, prescription drug costs and changes to what payments the insurers either owed or received under the Affordable Care Act’s risk adjustment program.  This program stabilizes the market by spreading the financial risk across all insurers. It requires federally collected funds be redistributed from plans with lower-risk enrollees to plans with higher-risk enrollees. Kreidler’s office reviews the proposed rates for each plan to see if they’re justified in relation to the benefits they’re providing. If the proposed rate changes can be actuarially justified, his office is required by law to approve them.

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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