We've heard from a lot of self-employed or sole-proprietors who want to take advantage of the new group of one law but are having trouble finding a health plan.
(The new law took effect in Oct. and allows qualified self-employed people buy health insurance in the less expensive small group market.)
We think we have something that can help: We've added a direct link to the federal government's Healthcare.gov site. Just type in your zipcode and you'll get a list of health plans available in your county. Of course you can also contact an agent or broker directly, but this gives you another option. Here's the link to information we've posted on our site.
If you want to bypass our website and go straight to the place that let's you enter your zipcode - here you go
Tuesday, November 30, 2010
Monday, November 29, 2010
Kreidler proposes health insurance rate reforms
News release issued by Washington State Insurance Commissioner today:
Insurance Commissioner Mike Kreidler is asking state lawmakers to preserve his authority to scrutinize health insurance rates, boost transparency, and to let him—for the first time—consider some insurers’ surpluses when reviewing rates.
“Some non-profit insurers have built up hundreds of millions of dollars in surpluses in recent years, while still seeking double-digit rate hikes,” said Kreidler. “I want the law changed so we can take a closer look at that, while still maintaining a vital insurance market.”
Under current law, surpluses—including investment income—cannot be taken into account when considering a company’s rate request.
Kreidler also will seek more transparency, so consumers can have a full picture on rate proposals by insurers. Today, most information included in a rate filing is not releasable to the public.
“Tens of thousands of Washingtonians who have to buy insurance on their own struggle to find and keep coverage,” said Kreidler. “We can help protect them by continuing to review rate hikes carefully. They also deserve to see how much of their insurance premium is spent on direct medical care versus administrative overhead and profit.”
Rate review: Kreidler gained the authority to review rates in the individual market in 2008, but it’s scheduled to expire after 2011. He’s proposing legislation to do away with that deadline.
Surpluses: The surplus proposal would only apply to non-profit health insurers, which account for most of the health insurance market in Washington. Also:
• Once a company amasses a surplus equal to 3 months of claims expenses, rate hikes would not be approved.
• The insurance commissioner could grant exceptions, however, if limiting the surplus or rates would pose a threat to the financial health of an insurer.
Transparency: The legislation would allow the public to see:
• What percentage of a specific rate request goes to profit, medical costs and administrative costs.
• How much, overall, a health carrier collected in premiums, how much money it made, and how much it paid out in direct medical claims.
• The medical trends the health carrier is using to project future rates.
“It’s simple: We need oversight of the health insurance industry,” said Kreidler. “And families deserve to see where their money’s going and how their rates are set.”
Insurance Commissioner Mike Kreidler is asking state lawmakers to preserve his authority to scrutinize health insurance rates, boost transparency, and to let him—for the first time—consider some insurers’ surpluses when reviewing rates.
“Some non-profit insurers have built up hundreds of millions of dollars in surpluses in recent years, while still seeking double-digit rate hikes,” said Kreidler. “I want the law changed so we can take a closer look at that, while still maintaining a vital insurance market.”
Under current law, surpluses—including investment income—cannot be taken into account when considering a company’s rate request.
Kreidler also will seek more transparency, so consumers can have a full picture on rate proposals by insurers. Today, most information included in a rate filing is not releasable to the public.
“Tens of thousands of Washingtonians who have to buy insurance on their own struggle to find and keep coverage,” said Kreidler. “We can help protect them by continuing to review rate hikes carefully. They also deserve to see how much of their insurance premium is spent on direct medical care versus administrative overhead and profit.”
Rate review: Kreidler gained the authority to review rates in the individual market in 2008, but it’s scheduled to expire after 2011. He’s proposing legislation to do away with that deadline.
Surpluses: The surplus proposal would only apply to non-profit health insurers, which account for most of the health insurance market in Washington. Also:
• Once a company amasses a surplus equal to 3 months of claims expenses, rate hikes would not be approved.
• The insurance commissioner could grant exceptions, however, if limiting the surplus or rates would pose a threat to the financial health of an insurer.
Transparency: The legislation would allow the public to see:
• What percentage of a specific rate request goes to profit, medical costs and administrative costs.
• How much, overall, a health carrier collected in premiums, how much money it made, and how much it paid out in direct medical claims.
• The medical trends the health carrier is using to project future rates.
“It’s simple: We need oversight of the health insurance industry,” said Kreidler. “And families deserve to see where their money’s going and how their rates are set.”
Tuesday, November 23, 2010
Ice, snow and cars: Filing an insurance claim
First: Unless you signed a contract with an insurance company requiring you to take your car only to a specified shop, you can choose where to take it for repair. But the shop still needs to work with the insurer to come to an agreed-upon price. If not, and they still fix the car, you may be responsible for whatever the insurer doesn't pay.
For more details on "diminished value", non-OEM parts, getting a rental car, etc., please see our "How the auto insurance claims process works" page.
If you're in a wreck and it's more than a fender-bender, you might want to see our "What happens if my car gets totaled?" page. From it:
You have the right to payment of the actual cash value of your auto, and to expect a prompt and fair settlement. Don’t be surprised if your “value amount” and the insurer’s “value amount” do not match. Be ready to negotiate with the insurer when this happens.
The page has a lot more information on how insurers establish the cash value of the totaled vehicle, what happens if you can't find a comparable vehicle, and -- we get this question a lot -- what happens if you want to keep your damaged car.
If you have questions or problems with an insurer -- we're the state agency that regulates the insurance industry in Washington state -- give us a call at 1-800-562-6900 or e-mail us at AskMike@oic.wa.gov.
Friday, November 19, 2010
Issaquah woman sentenced to $300,000 in restitution in insurance fraud case
A King County Superior Court judge today ordered Issaquah's Linda Ann Rose, 67, to pay and forfeit a total of $300,000 in restitution to insurance companies for fraudulent injury claims after a minor accident in a parking lot.
On Nov. 13, 2004, Rose was involved in a parking lot collision in Issaquah. An SUV backed out of a parking stall and struck Rose's rented Ford Mustang. Photos of both vehicles show minimal damage, but Rose claimed that she suffered severe back injuries as a result of the collision.
In 2007, her attorney demanded $656,874 from the SUV owner's insurer, and subsequently filed a personal injury lawsuit in the case.
Investigators from the Washington Insurance Commissioner Mike Kreidler's Special Investigations Unit subsequently concluded that Rose knowingly provided altered medical records to her attorney, and that she had had an injured back "well before" the accident.
Rose entered a modified guilty plea to 3 felony counts of using false claims or proof in an insurance claim.
She was ordered to pay $250,000 to Progressive, $25,000 to Metlife, and to forfeit another $25,000 in a structured settlement from Metlife that had not yet been paid.
On Nov. 13, 2004, Rose was involved in a parking lot collision in Issaquah. An SUV backed out of a parking stall and struck Rose's rented Ford Mustang. Photos of both vehicles show minimal damage, but Rose claimed that she suffered severe back injuries as a result of the collision.
In 2007, her attorney demanded $656,874 from the SUV owner's insurer, and subsequently filed a personal injury lawsuit in the case.
Investigators from the Washington Insurance Commissioner Mike Kreidler's Special Investigations Unit subsequently concluded that Rose knowingly provided altered medical records to her attorney, and that she had had an injured back "well before" the accident.
Rose entered a modified guilty plea to 3 felony counts of using false claims or proof in an insurance claim.
She was ordered to pay $250,000 to Progressive, $25,000 to Metlife, and to forfeit another $25,000 in a structured settlement from Metlife that had not yet been paid.
Thursday, November 18, 2010
Flood coverage: Where to find it -- and what if you can't?
November in the Pacific Northwest generally means rain, and lots of it. (See also December, February, March, April and sometimes May.)
As the rivers swell, we tend to get nervous queries from consumers and businesses about flood insurance. Here are the basics, as well as some special information for businesses in Washington state's Green River Valley.
Does a standard homeowners' insurance cover flooding? No. Many people think it does. It does not.
Where do I get flood coverage? For most consumers and many businesses, the first stop is the National Flood Insurance Program, a federally run program that's been around for decades. But the business coverage maxes out at $500,000 per building and $500,000 for contents, so businesses may need extra coverage as well.
What's it cost? The average federal flood insurance policy costs less than $570 per year.
Am I in a flood zone? Here's a page to search flood maps. You can also get a quick risk estimate by typing your address into the feds' "one-step flood risk profile."
I heard that the federal flood insurance program was suspended. It was, but isn't anymore. The program lapsed several times this year, but Congress in late September reauthorized the program for another year.
Who sells it? Although it's a federally run program, it's sold by many insurance agents. To find a local one who sells it, see the program's agent locator.
And here's the special information for businesses in Washington's Green River Valley, which is in south King County. Last year, businesses in the area reported problems finding additional coverage. To help, we set up a "market assistance plan" that acts as a matchmaker between businesses and insurers. If you live in that area and can't find coverage for your business, the odds are good that the market assistance plan can help you.
For more, please see our flood information page.
As the rivers swell, we tend to get nervous queries from consumers and businesses about flood insurance. Here are the basics, as well as some special information for businesses in Washington state's Green River Valley.
Does a standard homeowners' insurance cover flooding? No. Many people think it does. It does not.
Where do I get flood coverage? For most consumers and many businesses, the first stop is the National Flood Insurance Program, a federally run program that's been around for decades. But the business coverage maxes out at $500,000 per building and $500,000 for contents, so businesses may need extra coverage as well.
What's it cost? The average federal flood insurance policy costs less than $570 per year.
Am I in a flood zone? Here's a page to search flood maps. You can also get a quick risk estimate by typing your address into the feds' "one-step flood risk profile."
I heard that the federal flood insurance program was suspended. It was, but isn't anymore. The program lapsed several times this year, but Congress in late September reauthorized the program for another year.
Who sells it? Although it's a federally run program, it's sold by many insurance agents. To find a local one who sells it, see the program's agent locator.
And here's the special information for businesses in Washington's Green River Valley, which is in south King County. Last year, businesses in the area reported problems finding additional coverage. To help, we set up a "market assistance plan" that acts as a matchmaker between businesses and insurers. If you live in that area and can't find coverage for your business, the odds are good that the market assistance plan can help you.
For more, please see our flood information page.
More from our case files...
Having trouble with an insurance company, agent or broker? Give us a call; we can often help. We're the government agency that regulates the insurance industry in Washington state. (If you don't live in Washington, here's an easy map with contact info for our counterparts in your own state.)
In Washington state, we're at 1-800-562-6900 or AskMike@oic.wa.gov. You can now also file a complaint easily online.
Here's a sampling of the sorts of things we help with virtually every day:
In Washington state, we're at 1-800-562-6900 or AskMike@oic.wa.gov. You can now also file a complaint easily online.
Here's a sampling of the sorts of things we help with virtually every day:
- A woman contacted us on behalf of her 75-year-old mother, who had forgotten to pay her long-term care insurance premium due to health issues. The company had cancelled the policy for non-payment. After multiple attempts to have the policy reinstated, the daughter sought our help. The policy was reinstated.
- A company that had sold an illegal discount health plan here agreed to pay a consumer $3,825.
- A widow whose annuity request had been delayed complained to us. We contacted the company, which honored the request, sending her a check for more than $250,000.
Wednesday, November 17, 2010
Job openings
We have a couple of job openings:
We're looking for an administrative assistant 4 for a limited-duration position funded by federal grant dollars related to health care reform. This person will perform "a wide range of complex administrative duties related to planning and implementation of organizational change, grant management and program support functions." The job duties include compiling statistical information and preparing written reports for executive managers and the grant funding agency. The position is funded by federal grants through November 2011.
Here's the link to the job posting, but if you want to apply, please do it quickly. Applications are due by 4:59 p.m. this Friday.
We're also looking for a financial examiner 2 to work in our Seattle office. This person will plan and conduct financial examinations of insurance companies and other regulated entities. From the job listing:
We're a small state agency -- we have a total of about 200 workers between our Tumwater, Olympia, Seattle and Spokane offices -- that regulates the insurance industry in Washington state. We have a pretty broad consumer-protection mission. We:
We're looking for an administrative assistant 4 for a limited-duration position funded by federal grant dollars related to health care reform. This person will perform "a wide range of complex administrative duties related to planning and implementation of organizational change, grant management and program support functions." The job duties include compiling statistical information and preparing written reports for executive managers and the grant funding agency. The position is funded by federal grants through November 2011.
Here's the link to the job posting, but if you want to apply, please do it quickly. Applications are due by 4:59 p.m. this Friday.
We're also looking for a financial examiner 2 to work in our Seattle office. This person will plan and conduct financial examinations of insurance companies and other regulated entities. From the job listing:
This position works with Financial Analysts (certified public accountants, certified financial examiners, and accredited financial examiners), attorneys, and other regulators on a state, national, and international level. This position examines, audits, and verifies specific groups of insurance companies, including bonds and stocks, mortgage loans, real estate, policy loans, premium notes, collateral loans, policy reserves, and capital stock.For qualifications, pay, and application information, please see this job posting. The deadline for applications is 5 p.m. on Dec. 3.
We're a small state agency -- we have a total of about 200 workers between our Tumwater, Olympia, Seattle and Spokane offices -- that regulates the insurance industry in Washington state. We have a pretty broad consumer-protection mission. We:
- monitor insurers' finances to make sure they can make good on their promises to policyholders.
- license tens of thousands of agents and brokers, and investigates complaints about them.
- scrutinize rate hike requests and makes sure that policies comply with the law.
- go after scams, both from unlicensed insurance companies and by people trying to defraud insurers.
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