Power restored at our main building

Just fyi: Our main office in Tumwater, lost power at about 9:19 this morning. It's still out. Many of us are working on backup power.

UPDATE: Power's back on. (10:30 a.m.) This post headline originally said "Power's out at our main building."

Washington to get $500,000 from AIG settlement

Washington state will receive $500,000 as part of a multi-state settlement with American International Group, Inc., better known as AIG.


The settlement includes a $100 million fine, divided among the 50 states and the District of Columbia. The company will also pay roughly $46.5 million in additional taxes and assessments. It also agreed to follow a compliance plan designed to fix the problems uncovered in a multi-state probe.

At issue was the company’s pattern of failing to comply with laws related to their handling of workers’ compensation programs. An examination team found a pattern of widespread violations, including using rating plans that hadn’t been filed with regulators and false reporting of the insurance premiums from workers compensation.

Although Washington state provides workers compensation coverage through a state-run program, it became part of the process because it was uncertain if the premium re-allocation would affect the state.

The $500,000 settlement does not go to the insurance commissioner’s office. The money will be deposited in the state’s general fund to pay for other state services.

Job opening: Receptionist

Due to a retirement, we have a job opening for a receptionist.

The person will greet and help visitors and customers visiting our building, as well as answering the main phone line and provide first-tier assistance for people. The person will also analyze service-of-process papaerwork, assist with mail, scan documents, and other duties.

For a more detailed description, please see the job description. Applications are due by Monday, March 7, at 5 p.m.

Insurance commissioner: Premera is "stonewalling" on public disclosure of rate information

Washington State Insurance Commissioner Mike Kreidler today issued an open letter to health insurance consumers, calling for public disclosure of health insurers' rate requests.

"This is a critical week of the legislative session," Kreidler wrote. "Our biggest battle is still underway -- ending the secrecy of health insurance rates."

Under current law, the insurance commissioner's office is barred from disclosing virtually all the information submitted by insurers to justify health insurance rate requests. Kreidler wants to release those documents to the public, so they can see what’s driving health rates and comment on rate requests. Oregon and nearly a dozen other states have similar policies already.

Two of the state’s largest health insurers – Regence BlueShield and Group Health Cooperative – agree that rate information should be transparent. But a third – Premera Blue Cross – is balking, and only wants insurers to see the information once rates have been decided.

"I'm deeply troubled that Premera isn't willing to let you -- and their own policyholders -- see what's really driving health care premiums," Kreidler wrote, adding that he hopes they'll change their mind and help "put an end to the pointless secrecy of health insurance rates."

"We all know that health insurance rates have been rising dramatically in recent years," he wrote. "I believe that the people paying the premiums deserve to see why."

Pet insurance tips

We're hearing more from consumers about pet insurance, which will come as no surprise to anyone who's paid a vet bill lately.

To help, we put together a pet insurance tips page, with advice on:
-what to look for when comparing coverage
-how to find out how many complaints have been made about a pet insurer
-and questions to ask (such as "Do you give discounts for multiple pets?")

Job openings: market analyst and market conduct examiner

We have a couple of job openings:

Senior Market Conduct Examiner: Among other tasks, this person will review and analyze insurance company records and procedures, including advertising, agency activity, complaint/grievance procedures, corporate structure, rate and form filings, provider networks, underwriting and claim administration. The application period ends March 2 at 5 p.m.

Senior Market Analyst: This person will plan, coordinate and perform market analysis of insurers and other regulated entities, reviewing company data statements and assisting in the design of audit programs. Applications are due by March 9 at 5 p.m.

The links have much more information about duties, qualifications, education, etc., as well as information on how to apply.

Car accident? How to file an insurance claim

Lots of snow, packed snow and ice on roads in Puget Sound this morning, which likely means a lot of fender benders. Here are some tips on filing an insurance claim and key information to know.

First: try to warn oncoming traffic, if it can be done safely. Give reasonable aid to the injured. Call police and, if necessary, an ambulance. If property damage exceeds $700 -- which is very often the case -- you must notify law enforcement.

Then: call your insurer. They can start the claims process and talk you through the details.

Who was at fault? Insurance adjusters typically gather information from the drivers and passengers, any witnesses, and accident reports filed with the state patrol or local law enforcement. If fault isn't clear, adjusters may decide that the fault is shared between drivers.

Which auto body shop to go to? In Washington state, unless you signed a contract with an insurer to take your car only to a specified repair shop, you can choose where to take it. But the shop still needs to work with the insurer to agree on a price. If they don't, and the car's repaired, you may be responsible for costs not covered by the insurer.

What if my car was totaled? We get this question all the time, and have a lot of information available about how to determine the vehicle's value (be ready to negotiate), how to keep your damaged vehicle, etc.

Check if your policy -- or the at-fault driver's -- covers "diminished value." This is the difference between the value of an undamaged vehicle and what it's worth after repairs are made.

Rental car? If the other driver was at fault, his or her insurer will negotiate with you for rental car payment. If you were hit by an uninsured driver, your insurance may pay for a rental.

Finally, what's "subrogation?" Subrogation allows your insurer to recover its costs from the person legally responsible for the accident. In other words, they seek reimbursement from the at-fault person.

Winter storm watch -- and info on how to file auto insurance claims

A winter storm watch is in effect from Wednesday morning through Thursday morning for much of western Washington, with snow accumulations of up to 6 inches possible.

Anyone who lives in Puget Sound knows that much-feared snowstorms sometimes turn out to be, well, just more rain. But if this one turns out to be real, and west-siders are trying to drive around in it, here's a link to keep handy. It's our page about how auto insurance claims work -- diminished value, repairs using aftermarket parts,  rental cars, deciding who's at fault, etc.

Also: Many school districts in Washington state use schoolreport.org to put out information on school closures.

Drive carefully.

White Swan fire victims: We may be able to help you with insurance claims

On Saturday, a wind-whipped blaze tore through the town of White Swan, southwest of Yakima, torching 18 homes and leaving 120 people homeless.

If you're one of those families and you had insurance, our office may be able to help. We're the state agency that regulates insurance in Washington state, and we have a toll-free consumer hotline where analysts can help any Washingtonian with insurance questions or problems.

If claims are wrongly denied or delayed, we can contact insurers on your behalf and try to resolve the situation quickly.Call us at 1-800-562-6900 or send an e-mail to AskMike@oic.wa.gov.

If you'd like to help the White Swan families, MSNBC has put together a list of local donation sites. Any Bank of America branch can also accept donations in the name of the "White Swan Relief Fund."

Important note to agents, brokers, insurers and insurance educators

Our office recently adopted new rules that  affect licensees (like agents and brokers), insurance companies, and people who provide insurance continuing education and pre-licensing education.

Under these new rules, licensing must be done online. Licensees must provide a valid e-mail address, which will be the point of contact for all communication from our office, including renewal notices. We will no longer be printing and mailing licensing documents, such as appointments, affliations, etc.

Here's the timeline:

• For licensees (like agents and brokers, which are now known as producers), renewals and applications must be done online starting June 1, 2011.

• For insurance companies, new appointments, appointment renewals and appointment terminations must be done online starting May 1, 2011.

• For insurance education providers, all education courses submitted for our approval must be sent in electronic format (such as an e-mail attachment), starting Feb. 28, 2011.

For more details, please see our "new online licensing rules" page.

Job openings

We have three jobs -- two non-permanent positions, and one project position funded by a federal grant -- that we're trying to fill:

• Communications Consultant 4: This is a project position funded by federal grant dollars from the U.S. Department of Health and Human Services. The project is expected to end on Oct. 15, 2011. The person will work with our consumer protection staffers to develop and manage communication strategies, techniques and tools. The work includes a variety of projects, all of which involve translating complicated health insurance information into materials that can be understood by an average consumers. For more information, see the job listing. Applications will be accepted through Feb. 28, 2011.

• Health Insurance Advisor 1 - Regional Trainer (non-permanent): We're looking for someone who's bilingual in Korean and English to help provide training and technical assistance to volunteer health insurance benefit advisors in Clallam, Jefferson, King, Kitsap, Snohomish and Pierce counties. For details, here's the job listing. Note: The application period ends Friday afternoon.

• Forms and Records Analyst 2 (non-permanent). Among other tasks, this person will act as a publications liaison between a health insurance advisory program and the state Department of Printing. For more details, salary information, etc., here's the job listing. Note: This application period also ends Friday afternoon.

Wind gusts tonight in western WA

Weather Underground is predicting gusts of up to 45 miles an hour in Seattle this evening.

To answer common questions about what storm damage is covered by insurance, we built a web page largely devoted to wind damage and insurance.

Hope you don't need it, but if you do, it may help. (And yes, that ladder doesn't look too safe to us, either.)

"I'm self-employed. How can I get `Group of 1" health coverage?"



We get this question all the time. And we've got an answer for you.

First, a little background: Last year, a new state law law took effect that allows sole proprietors to be considered "groups of 1." This way, they can qualify for small-group health coverage, instead of having to find coverage on the individual market. Small-group tends to have better benefits, lower costs, and no health screening.

To find out who's selling these policies in your area, type in your zip code here and scroll down the page to see a list of insurers, contact information and tips on picking plans. For more information, you can also contact an insurance agent or broker. Here's an online tool to help you find an agent in your city.

Health carrier cutting your commission? Thinking of charging fees?

We've gotten a lot of calls over the past few weeks from agents and brokers deeply unhappy that their commissions are being reduced -- or eliminated completely -- by some insurers.

We've also been asked whether fees can be charged directly to the consumer instead.

For more on this, click here.

Interesting reports

No, really.

Oregon has put out its annual "Health Insurance in Oregon" report. Among the findings:

-About 17 percent of Oregonians had no health insurance in 2009.

-Enrollment in commercial health policies through Oregon's 7 largest insurers fell 15 percent from 2007 to 2009.

-Reforms under federal health care reform "have typically accounted for no more than 4 percentage points of the rate increases submitted to the division" recently.

-And Oregon regulators in some cases approved lower rate hikes than an insurer requested, due to the size of insurer's surpluses.

-Oregon, under a federal grant, is studying how to use its rate review authority to help lower medical costs.

And in much sunnier Tampa, the Insurance Information Institute's Robert Hartwig yesterday released a new report looking at long-term trends -- 80 years of them -- in the property/casualty insurance market. Claims paid since 1931, he said, total $12.5 trillion, after adjusting for inflation.

Among Hartwig's points: that "claim payouts in recent years are volatile but have reached a jagged plateau."

Hearing Thursday on transparency for health insurer rate increases

A state Senate committee will hold a hearing at 1:30 p.m. Thursday in Olympia on a couple of our key legislative requests.

The first -- and the less controversial -- is that we retain the authority to review health insurance rate hikes in the individual market (e.g. insurance you buy yourself, instead of get through an employer.) If this bill doesn't pass, our authority do review those rates on behalf of consumers will end at the end of the year -- and the feds will do it instead. This is Senate Bill 5398.

The more controversial bill -- at least among insurers -- is our proposal to make public all the information that health insurers send us when filing for a rate increase. As things stand now, much of that information is secret. Hundreds of consumers have told us that they feel they have a right to see it. And we agree.

We're arguing that consumers should have the right to see what they're paying for, and exactly what's driving the large premium hikes in recent years. Everyone's data would be released, making it a level playing field for all the companies. (The bill is SB 5120.)

We don't have to look far to see how this process would work, because Oregon is already doing it. What's more, that state's largest health insurer said it supports a transparent filing process.

Washington State Insurance Commissioner Mike Kreidler testified about the transparency proposal last week in front of a House committee. Here's an excerpt:

Seattle Times weighs in on health insurer surpluses

Speaking of our legislation involving large surpluses held by nonprofit health insurers, the Seattle Times just posted an editorial on the topic.

It recounts testimony at Thursday's hearing in a state House of Representatives committee:

The companies testified against any penalty for piling up surplus, raising the specter of earthquakes, epidemics and President Obama's health-care reform. The first two might bite into their holdings, and the third, they said, surely would. They said they need every cent they have.

"How much is enough?" asked Rep. Kevin Van De Wege, D-Sequim.

Their answer was a thing with no defined form — something about consumers needing "strong, muscular companies." Van De Wege asked his question again, and again received vapor.

Kreidler re: health insurer surpluses: "How much is enough?"

On Wednesday and Thursday, Insurance Commissioner Mike Kreidler testified in front of Senate and House committees about his proposal to limit further contributions to non-profit health insurers' already-large surpluses.

Here's an excerpt from the Senate hearing:

Non-profit health insurer surpluses: Hearings scheduled for Weds and Thurs

The state House of Representatives and state Senate are holding hearings this week on some of our key bills.

We want to:

1. Limit the rate increases of nonprofit health insurers once they build up a large cash surplus.
2. Make health insurer rate filings public, like Oregon does. Much of the data is now considered a trade secret, meaning we can't release it.
3. Renew our authority -- now set to expire at the end of this year -- to review individual health insurance rates.

The first hearing only includes the surplus bill, HB 1301/SB 5247. It's at 8 a.m. on Wednesday in Hearing Room 4 of the J.A. Cherberg Building, on the capitol campus in Olympia.

The second hearing -- which includes all three bills mentioned above -- is at 10 a.m. on Thursday in Hearing Room B of the John L. O'Brien Building, which is also on the capitol campus in Olympia.

Job opening: .NET application developer

We have a project job opening for a .NET application developer at our Tumwater office. The application period closes at 5 p.m. on Thursday.

This position will serve as a senior software developer for the agency, responsible for:

...analyzing system and business requirements, completing assigned coding and development assignments in accordance with defined project timelines and quality expectations, preparing user screen mockup and prototypes, preparing "developer" test cases and performing system testing and data verification. This position will perform this work using .NET programming skills including C#, ASP.NET, ADO.NET, MS SQL stored procedures and triggers.

The position, which is funded by a federal grant related to health care reform, is expected to last until Oct. 15, 2011.

For more, please see the full job listing.

Washington state fines six Chubb subsidiaries $534,000 for violations

Washington State Insurance Commissioner Mike Kreidler has ordered six subsidiaries of Chubb & Son to pay a $534,000 fine for repeatedly violating state insurance laws.

Federal Insurance Co, Pacific Indemnity Co, Great Northern Insurance Co, Executive Risk Indemnity, Inc.; Vigilant Insurance Company and Northwestern Pacific Indemnity Co. agreed to pay the fine. An additional $534,000 fine was suspended, as long as the companies follow an agreed-to compliance plan that, among other conditions, requires semi-annual self-audits.

In November, Kreidler called for a $534,000 fine and a nine-month suspension of the six companies’ insurance certificates, which would have barred them from writing new coverage during that time period. Under the consent order, there will be no suspension as long as the companies commit no further violations for three years.
“The companies have assured me that compliance is a top priority,” said Kreidler, “and I’m hopeful that this approach will resolve these ongoing problems.”
A key issue was the companies’ repeated failure to properly document the reasons for charging higher or lower rates on certain policies. Exams and audits dating back to 1998 found the same problems cropping up repeatedly. Since 2000, Washington state insurance officials have repeatedly fined Chubb and Chubb subsidiaries, and urged them to fix the problems.

Nonetheless, repeated examinations and a series of company self-audits ordered by Kreidler since 2007 found hundreds of violations of state law, including numerous recent ones. In some cases, more than half the sample files checked had violations.

Fines imposed by the state insurance commissioner’s office do not go to the agency. The money is deposited in the state’s general fund to pay for other state services.

(And here's the link to search disciplinary orders by Washington state's insurance department.)

Kreidler responds to health reform repeal efforts

On the eve of the first vote to repeal health reform, Commissioner Kreidler joined Gov. Chris Gregoire in a letter to the Washington delegation, touting the progress made to date and their willingness to enhance the Affordable Care Act where it falls short. They called out several new consumer protections already benefiting our family, friends and neighbors:

• Children with significant health care needs cannot be turned away by insurance plans.
  
• Young adults can stay on their parents' health plan until age 26.
  
• No more cost sharing for preventive service, including cancer screenings and immunizations.
  
• People with pre-existing conditions who've been uninsured for at least six months can get health insurance through the new federally-funded Pre-existing Condition Insurance Plan.
  
• Small businesses that offer their employees health insurance can qualify for tax credits.

In a news release issued by the Washington Public Interest Rearch Group yesterday, Kreidler said, “Putting politics aside, our current health insurance system is unsustainable. Washington families and businesses are hurting. They contact my office every day, calling for help, because they can’t find insurance or afford the coverage they have. The new reforms just starting to take effect will help, but we need the full reforms coming in 2014. Any effort to repeal health reform now is short-sighted and will only harm consumers.”

Both Kreidler and Gregoire admit in their letter to the delegation that the Affordable Care Act may not be perfect, but they make the argument that repealing it - and all of the work that has been done to date to implement the reforms - would be a giant step backwards for our state and nation.

New 2011 open-enrollment periods announced for kids

The individual health insurance market will have two special open-enrollment periods for children this year. Parents who want to add their children to their individual health plans or buy child-only plans can do so from March 15 to April 30, 2011 and from Sept. 15 to Oct. 31, 2011.

Commissioner Kreidler created the open-enrollment periods through a regulation filed today. The individual health insurance market is for people who do not have access to employer-sponsored health insurance.

New consumer protections under the federal Affordable Care Act prevent health insurers from denying coverage to children with pre-existing health conditions. However, special open-enrollment periods are allowed.

During open-enrollment times, children under age 19 cannot be denied health insurance because of a pre-existing condition. People looking for coverage for their children outside of the enrollment dates can apply either to the Washington State Health Insurance Pool (WSHIP), or if they qualify, to the new Pre-existing Condition Insurance Plan (PCIP-WA). To enroll in PCIP-WA, you must have been uninsured for at least six months and have a pre-existing medical condition.

Exceptions where parents can apply for individual coverage for their kids anytime include the birth or adoption of a child or if a child or the parent:

• Is no longer eligible for a state program.
• Loses coverage due to a divorce.
• Loses employer-sponsored coverage.
• Moves and their plan is not available where they live.

In 2014, when the full health reforms take effect, no one of any age can be denied insurance because of a pre-existing condition.

Anyone with questions about the individual health insurance market is encouraged to call our Insurance Consumer Hotline at 1-800-562-6900.

Insurers fined more than $580,000 in Washington in 2010

In 2010, we issued more than $580,000 in fines against insurers for a variety of violations, including illegal phone solicitation and overcharging customers.

The Doctor's Company, of Napa, Calif., for example, was fined $104,200 -- with $50,000 suspended -- for failing to file insurance rates with us prior to using those rates.

Metropolitan Casualty Insurance Co., of Warwick, R.I., and several related entities were fined $45,000 with $20,000 suspended after an examination found numerous problems with insurance documentation. Among the problems: $190,704 in overcharges to senior citizens. (The company also refunded the money to the affected policyholders.)

The point of the fines is to ensure that insurers follow the rules. This protects consumers and preserves a fair marketplace.

We should probably also point out that the money doesn't go to our agency. It's deposited in the state's general fund to pay for other state services. In 2009, fines totaled $407,600. A year earlier, the total was more than $1.2 million.

Here's a link to a list of our enforcement actions over the past six months.

And to search more than a decade's worth of past orders and fines -- including violations by agents and brokers -- check out this online lookup tool we built.

Job opening: Staff attorney

We're trying to fill a staff attorney position in our Tumwater office. (We're the state agency that regulates the insurance industry in Washington state.)

The person will provide legal advice to agency staff, handle enforcement matters, and participate in the drafting of legislation and regulations, among other duties. Some travel is expected for witness interviews and to work with other insurance regulators.

The application period will be open until the position is filled. For more details, including salary, benefits, and qualifications, please see the full job listing.

Why we're proposing legislation to limit the surpluses of non-profit health insurers

Among our legislative proposals this year: a bill to limit non-profit health insurers' rate hikes once the company's surplus funds grow above a certain level.

It would allow the insurers a substantial cushion of cash for unforeseen emergencies, but also help keep premiums from growing any more than absolutely necessary.

The background: Insurers, by the nature of their business, collect and invest substantial amounts of money. They need to do this, in order to pay out claims. They have to comply with solvency regulations designed to ensure that the company can make good on its promises to policyholders. If that's in doubt, we can take the company over and try to rehabilitate them so that policyholders and medical providers are protected.

But at this point, the state's three major non-profit health insurers (Regence, Premera, and Group Health) have large surpluses that have grown dramatically over the past 8 years. Together, they have more than $2 billion more than they expect to pay out in claims. At the same time -- this will come as news to no one -- health insurance rates have grown dramatically.

So we're seeking the explicit authority to consider surpluses -- and investment income -- when reviewing proposed rates.

Here's what those surpluses look like. (Capital and surplus means the balance of assets after making provisions for the payment of claims):

 

Our proposal would work like this: Once an insurer has enough to pay its expected claims plus an extra three months of average claims, we would not approve a rate that adds more to the surplus. (An exception could be granted, however, if the restriction would threaten an insurer's financial health.)

The three insurers listed above have surpluses equal to 4-5 months of claims each. They'd still have a substantial cash cushion in case of unforeseen costs, but we believe our proposal would also help keep premiums down.

The proposal would affect the lines of insurance over which we have the authority to review rates: individual and small group coverage.

The legislative session begins next week. Stay tuned.