Kreidler: Premera doesn't want you to see what's behind your health rates

 

 

Insurance Commissioner Mike Kreidler called out Premera Blue Cross for attempting - again - to gut a bill that would give the public access to health insurance rate filings.

 

"I'm extremely disappointed in Premera," said Kreidler. "Their latest attempt to gut our legislation is very troubling. What don't they want the public to see?"

  

Kreidler's proposal (ESHB 1220) makes the information in a health insurance rate filing public shortly after his office receives it. This includes how much of the proposed rate will go to:

  

• Pay medical claims
• Cover administrative costs -- including salaries
• Profit

 

Kreidler added, "People who pay their premiums year after year -even when their rates go up - deserve to see what's behind those increases. Today, state law prevents me from sharing that information with the public. Now, more than ever, people struggling to pay for health insurance deserve full transparency."

 

Under the latest amendment sought by Premera, the public would see only summaries of rate filings, and only for those filings with increases greater than 10 percent. They could not see the entire rate filing.

 

"Premera's latest attempt to water down transparency is nothing more than a cruel charade on the public," said Kreidler. "Giving people a pre-canned summary of only certain rate filings is meaningless. Washington consumers deserve better."

 

A vote on the bill could come as early as tomorrow.

 

Read the full release and see letters of support from two other major health insurers.

WA insurance commissioner issues more than $167,000 in fines against insurers

Insurance Commissioner Mike Kreidler has fined insurance companies more than $167,000 for violations including wrongly denying medical claims and overcharging customers.
“It’s important that companies follow the law, and when they don’t, we’ll hold them accountable,” said Kreidler. “Consumers, competitors and the marketplace all rely on insurers following the rules.”
In 2010, Kreidler’s office levied $583,750 in fines. Fines collected 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.
Fines and disciplinary actions so far this year include:
■Aetna Life Insurance Co., of Hartford, Conn., was fined $65,000 for violations, including unreasonably denying 220 claims for acupuncture treatment. The company also refunded $16,427 to policyholders.

■Ace American Insurance Co., of Philadelphia, Penn., was fined $50,000 for violations, including using rates that it had not filed with the state.

■Progressive American Insurance Co., Progressive Northwestern Insurance Co, and Progressive Max Insurance Co, all of Mayfield Village, Ohio, were fined $30,000 for improperly deducting sales tax and fees from cash value calculations in more than 1,700 auto claims. The company also refunded $415,299 to customers.

■Homesite Insurance Company of the Midwest, of Mandan, N. Dakota, was fined $12,000 for overcharging more than 300 policyholders for renter’s insurance. The policyholders are receiving refunds.

■Austin Mutual Insurance Co., of Maple Grove, MN, was fined $10,000 for issuing insurance policies that weren’t in accordance with the rates it had filed with the state. As a result, 324 policyholders were overcharged a total of $26,200. The company also agreed to refund the overcharges to policyholders within 60 days.

■Doctors and Surgeons Benefit Association, of Charlestown, Nevis, West Indies; and several related entities were ordered to stop selling unauthorized insurance in Washington state.

In addition, Kreidler also took the following actions against agents or brokers:
■Mitchell A. Steitz, of Cashmere: License revoked, effective March 31, for misappropriating $12,500 from clients and spending it himself, rather than investing it.

■Allen D. James, of Sumner, agreed to pay a $1,000 fine for failing to promptly pay a premium refund to a client.

For details on cases, please see the agency's disciplinary orders site.

Tom Hanks sues his insurance broker

Actor Tom Hanks and his wife, Rita Wilson, are suing their former insurance brokers of 20 years, alleging that the brokers:

-falsely inflated and overcharged the couple, "misrepresenting the amounts of the premiums on insurance policies"
-"altering insurance documents and related records to conceal their fraudulent scheme"
-"and...taking other acts to engage in, and conceal, their embezzlement scheme through manipulation and deceit."

(All these quotes are from the Hanks' legal complaint.)

How much, you ask? The complaint says "hundreds of thousands, if not millions, of dollars."

How'd they find out? The couple last month got a new broker, who promptly told their business managers "that he was concerned that the insurance premiums from policies in the last year to two years appeared extraordinarily high for the coverage provided."

The complaint also alleges that the brokers illegally issued certificates of insurance without appointments, charged the Hanks for insurance that was never procured (or overcharged them), and bought "unecessarily duplicative insurance coverage," among other things.

Free app helps you create a home inventory

If you're like most of us, you know you need to create a home inventory, but you haven't taken the first step.

The National Association of Insurance Commissioners has just made it easier. They've developed a cool app for your iPhone - and it's free.

The myHOME app helps you capture photos, bar codes and serial numbers of your items. It also organizes the information for you, room by room, and creates a back-up file for e-mailing.

Need health insurance for your kids?

If you'd like health insurance for your kids - don't wait to enroll! You have until April 30 to get an individual health plan or add them to your coverage. (Individual plans are for people who don't get health insurance through their employer).

Until April 30,you can get health insurance for your kids without having them take a health screen.

Use this map to see which companies are available in your county. Then, contact the company directly to enroll. If you have any problems, call our Insurance Consumer Hotline at 1-800-562-6900.

The next chance to get an individual plan for your kids is Sept. 15-Oct. 31. There are some exceptions for people to enroll outside of these time periods. You must apply 31 days after one of the following events:

• You no longer qualify for a state program.


• You lose your coverage due to a divorce.


• You lose your employer's health plan (including COBRA).


• You move and your plan is not available where you live.


• Also, parents or guardians can apply year-round for a health plan with 60 days of birth, adoption.

More tips and what if you miss an enrollment period?

How do you get tsunami insurance?

How do you get tsunami insurance?

Buy a flood policy.

Earthquake coverage generally doesn't include damage and flooding from a tsunami. But flood policies under the National Flood Insurance Program, a federally run program that insures millions of homes and businesses, do cover tsunami damage. The surge of water is treated the same way as a storm surge from a hurricane would be.

We double-checked this with the NFIP, which steered us to the following definition of flood in the National Flood Insurance section of federal law:

Sec. 1370 (42 USC 4121)

(1) The term “flood” shall have such meaning as may be prescribed in regulations of the Director and may include inundation from rising waters or from the overflow of streams, river, or other bodies of water, or from tidal surges, abnormally high tidal water, tidal waves, tsunamis, hurricanes, or other severe storms or deluge.

The federal flood program has issued more than 5 million policies across the country, insuring more than $1.2 trillion in property. Here in Washington state -- a quake-prone region with hundreds of miles of coastline -- some 51,000 policies are in force. Coverage is particularly heavy in places like Centralia, Aberdeen, King County and Snohomish County.

Here's a plain-language summary of federal flood coverage.

And we should also point out that the federal program does not cover things like business-interruption coverage, which can be crucial for businesses. Also, NFIP commercial coverage maxes out at $500,000 for a building and $500,000 for contents. The good news: insurance brokers can find additional flood coverage for you, often through what are called surplus line insurers.

WA insurance agent arrested in alleged $1 million theft

Investigators from the Washington state insurance commissioner’s office on Tuesday arrested a King County woman on suspicion of stealing more than $1 million in retirement funds from five elderly insurance clients.

Jasmine Jamrus-Kassim, of Kent, was arrested in Factoria by members of the insurance commissioner’s Special Investigations Unit and the Washington State Patrol. She was booked into the King County Jail on 21 counts of first-degree theft.

“This is an appalling abuse of trust,” said state Insurance Commissioner Mike Kreidler. “Vulnerable people trusted this agent with much of their life’s savings. And she just pocketed the money.”

A months-long investigation by Kreidler’s office found that several of Jamrus-Kassim’s clients repeatedly cashed out large portions of their annuities with Bankers Life and Casualty. Jamrus-Kassim was an agent for the insurer.

“We want to see justice done,” said Kreidler. “We also want to see if there’s any way to make these victims whole. We’re still investigating to what extent Bankers Life may have any liability for the actions of their agent.”

The victims, who ranged from age 74 to 90, typically made out their checks to “S.A. Saad” and gave them to Jamrus-Kassim. Several said they believed that S.A. Saad was an insurance company official. They thought their money was being reinvested.

In reality, Jamrus-Kassim has two daughters, both with the initials and surname “S.A. Saad.” Most of the money was deposited briefly in the girls’ accounts, then moved to Jamrus-Kassim’s personal credit union account. Jamrus-Kassim’s financial records show thousands of dollars spent on clothes, jewelry, and a trip to Mexico. They also show large payments to online psychic advisors, including $20,000 in charges from one psychic website in one month.

In total, Jamrus-Kassim is believed to have stolen at least $1,052,088 from the five victims between late 2007 and late 2009. She returned $25,503 to a 90-year-old Renton woman after the woman complained to the insurance commissioner’s office. That’s one of two complaints that triggered the state investigation.

Jamrus-Kassim submitted a letter of resignation to Bankers Life on Jan. 13, 2010.

Subsequent investigation by state insurance officials found three other victims. Last week, investigators interviewed an 83-year-old Seattle man who had no idea that Jamrus-Kassim had taken his $352,000.