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Around the PIA Western Alliance States

Posted By Morgan Dixon, Tuesday, April 3, 2018

California — State Farm Cleared: San Diego Superior Court Judge Katherine Bacal has ruled that State Farm does not have to lower its homeowner and renter insurance rates. In mid-2015 California Insurance Commissioner Dave Jones said the insurer was excessively profiting from those hikes.

Jones ordered them reduced by 7% and told State Farm to issue rebates. The insurer sued and said Jones miscalculated its profits and contends Proposition 103 does not give the commissioner the authority to order retroactive rate cuts.

To date State Farm has not paid out any rebates.

The judge did not address the issue of Proposition 103 but did say that Jones miscalculated the insurer’s profits.

Jones disagrees. “I believe strongly that our regulations are lawful under Proposition 103 and will continue to defend our regulations in order to protect consumers from State Farm gaming the system by charging rates that are excessive and unjustified,” Jones stated.

Source link: Insurance Business America


California — Commissioner, Trump & Health Insurance: Insurance Commissioner Dave Jones submitted a letter to the U.S. Department of Health and Human Services today strongly urging the Trump Administration to withdraw its proposed rule that would allow medical providers, medical facilities, insurers and others to discriminate against patients, delay or deny access to health care, and harm those whose medical care they are entrusted with.

"The Trump Administration's proposed rule conflicts with state and federal anti-discrimination protections and will harm patients and deny them needed medical care. This proposed rule interferes with California's strong civil rights protections for our residents. The Trump rule elevates the personal beliefs of some medical providers, insurers, and other health care entities over the rights of patients to access essential health care services. The Trump Administration rule encourages discrimination and should be immediately withdrawn, so that no patient has to worry that the federal government will deny them their rights to obtain medically necessary health care services. If not withdrawn, we will sue to stop the Trump rule from going into effect."

Oregon — Hit-and-Run Law: The Oregon Department of Insurance wants to clarify the state’s policies on auto collisions.

If you think you may have hit something, you will be required to investigate and report it

If you are involved in a traffic crash, especially a serious one with injuries or fatalities, the event is traumatic and sometimes tragic. It may be difficult at such times to remember the legal duties of a driver or vehicle owner involved in a crash — requirements intended for the safety of people involved in the crash, as well as other motorists and pedestrians.

A new Oregon law taking effect Jan. 1, 2019, will expand and clarify the duties of drivers in potential “hit-and-run” situations. Under House Bill 4055, signed in March by the governor, Oregon will now require drivers to:

  Stop and investigate if you think you have hit something.

  Take action if you didn’t realize at the time that it happened but later learn you may have hit something or someone. That includes calling 911 if you may have been in a crash resulting in an injury or fatality.


Failure to perform the duties of a driver involved in a motor vehicle crash can result in felony charges.

These additions expand on current law, which requires a person involved in a crash involving injury or death to stop, provide aid to the injured, and remain at the scene to exchange information with the person or police. If a crash involves a domestic animal, the law requires the driver to stop, contact the owner, and provide attention to the animal. If a crash involves only property damage, the driver must stop and exchange information with the owner.

Any motor vehicle crash that results in death or injury, or substantial property damage, must be reported to DMV within 72 hours. You must report a crash to DMV if any one of the following apply:

  Damage to any vehicle or anyone’s property is over $2,500 (even if your vehicle was the only one in the crash).

  Any vehicle is towed from the scene.

  Injury or death resulted from this crash.


For more information about crash reporting requirements or to download a crash report form, visit www.OregonDMV.com.

Any time you need to visit a DMV office, first check www.OregonDMV.com to find office hours and locations, and to make sure you have everything you need before your visit. You also can do some DMV business from home at OregonDMV.com. You can renew your vehicle registration, file a change of address or file notice of the sale of your vehicle online without getting in line at an office.


Washington — Kreidler & Health Insurance Market: Insurance Commissioner Mike Kreidler recently approved a new regulation to help stabilize the individual health insurance market by increasing the number of geographic areas an insurer can use to set rates.

Insurers are allowed to vary how much they charge their enrollees depending on provider reimbursement costs in different parts of the state. Previously, Washington was divided into five rating areas. The new rule increases the number of rating areas to nine. Each area is assigned a rating factor based on provider reimbursement costs. This is just one of the factors insurers can use to calculate premiums for enrollees who live in that geographic area. 

“By increasing the number of rating areas, we can more accurately reflect the experience of the insurers in our market and provide incentives for them to offer coverage in more parts of the state, especially in our rural areas,” Kreidler said.

To protect consumers from excessive differences in premiums from one part of the state to another, Washington is one of a few states that caps the allowable difference in premiums. The new rule gives insurers  willing to offer individual health insurance coverage in most or all of the counties in the state somewhat greater latitude in setting their premiums. 

“We anticipate this will encourage insurers to offer individual health insurance in more counties,” Kreidler said.

How much someone pays for their health plan depends on a number of factors, including:

  Their age

  How many people are covered

  Whether or not they smoke

  Where they live

  The type of plan they choose


“More than 300,000 people in Washington state buy their health insurance in the individual market and they’ve faced tremendous uncertainty this year because of deliberate actions by the federal government,” said Kreidler. “Now they’re facing premium increases as well as limited plan choices - especially in rural parts of the state. Expanding the number of rating areas in our state is just one step we can take to help stabilize this market for consumers.”

Kreidler proposed legislation this year to create a state-based reinsurance program for the individual market similar to the federal reinsurance program in place under the Affordable Care Act from 2014-16. Kreidler’s proposal would have lowered premium increases by up to 10 percent. The Legislature supported the proposal but could not reach agreement on a funding source.

“I’m committed to using every tool we have to stabilize the individual health insurance market – including proposing a reinsurance program again,” Kreidler said. “But in the meantime, we must look at every opportunity we have to improve this market. Now that the Trump administration and Congress have failed to help consumers, it’s up to the states to take the lead.” 

In light of the new rule, one insurer – Premera Blue Cross – has already committed to cover any potential “bare” county in 2019.


Source link: Washington Department of Insurance

Tags:  Around the PIA Western Alliance States  Insurance Content  Insurance Industry  Insurance News  Weekly Industry News 

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