Wednesday, November 26, 2014

Direct practices lose 35 percent of enrollees, raise fees 23 percent

Each year, the OIC reports to the Legislature on the status of direct health care practices in Washington. A direct health care practice is an arrangement where a health care provider charges a patient a set monthly fee for primary health care services. The provider doesn’t bill the patient’s insurance for the services and only provides certain medical services in the office.

The December 2014 report contains data from July 1, 2012 through June 30, 2014, which is two fiscal years’ worth of information.

Some highlights from the report:
  • As of June 30, 2014 there were approximately 8,658 direct-practice patients in Washington at 29 practices around the state. Patient participation decreased by 35 percent from fiscal year 2013. Four new practices opened in Seattle, Camas and Centralia. Three practices closed in Spokane and Lakewood.
  • Monthly fees at direct practices ranged from $25 to more than $200. The most expensive was $910 per month. The average monthly fee weighted by the number of patients was $150.78, a 23 percent increase from fiscal year 2013.
  • The OIC received no consumer complaints regarding direct patient practices in fiscal year 2014.
The Affordable Care Act now requires health insurance plans to cover 10 essential health benefits, which include preventive services and chronic disease management. It also puts a cap on deductibles that consumers pay each year and direct practice fees do not count toward that yearly maximum. In addition, Washington expanded its Apple Health (Medicaid) program and the state’s individual health insurance market grew 30 percent in fiscal year 2014 to more than 327,000 people.

View the full report to the Legislature.

Friday, November 21, 2014

What should I know about travel insurance?

If you are getting ready to travel for the holidays, here are some things to consider about travel insurance before you purchase it.

Many travel companies—airlines, cruise lines, resorts—offer travel insurance that will refund most or all of the cost of the trip in certain circumstances. Policies typically cover things like trip cancelations due to illness, civil unrest, job loss, or the transportation carrier going out of business. They’ll also pay for fees incurred by missed connections and delays; baggage damage or loss; medical expenses incurred by an injury or illness while traveling; emergency evacuation; car rental damage; and accidental death.

Before you decide whether to purchase travel insurance, you should consider:

  • What your medical insurance covers when you travel.
  • What your homeowner or renter insurance covers in the event of lost or stolen belongings.
  • What your life insurance policy covers in the event of accidental death while traveling.
  • The cancelation policy is for the travel insurance.
  • Read the policy's fine print. Some don't cover certain activities such as hang-gliding, bungee jumping or other activities. Some also exclude certain pre-existing conditions from the medical coverage they offer.
  • You should also make sure the travel insurance company is licensed to sell insurance in Washington.
Read more about travel insurance on our website.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Monday, November 17, 2014

Some homeowner policies offer percentage deductibles

When you are considering homeowner insurance, it’s good to be aware of what type of deductible you have. Some insurance companies charge deductibles that are a percentage of the home’s value, rather than a flat dollar amount. For example, if your deductible is 0.5 percent and your home’s value is $500,000, your deductible would be $2,500.

Some people would prefer to pay a higher deductible and get a lower monthly premium. It’s important to do the math and find out what that half-percent will cost you. Keep in mind, your home’s value is likely to increase over time, which means your deductible will, too.

Read more about homeowner insurance on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Wednesday, November 12, 2014

Been in an auto accident? Beware of this scam

KING 5 news reported yesterday that some accident victims are being scammed into getting unnecessary chiropractic treatment to drum up payments from insurance companies. Consumers who experience this -- or any other type of insurance scam -- should report it to our consumer advocates at 1-800-562-6900 or online.

According to KING 5, the scammers use Washington State Patrol’s collision reports to find people who've been in auto accidents. One family reported they were led to believe the insurance company wanted them to be seen and gave them a time limit for the visit.

"They said the claim was going to close immediately. They said we need to come in if we want to have any future claims," the victim told KING 5. 

If you are involved in an accident, the auto insurance company will not require you to see a doctor. It is up to you to seek medical treatment at your discretion. However, if you claim you have medical problems related to an accident, the insurance company may request verification from a medical professional. Consumers should always contact their insurance company’s claim representative or their insurance agent or broker when they have questions about a claim.  

In addition to misleading consumers, tricking consumers into getting unnecessary treatment can drive up insurance rates. Insurance companies base their rates in part on the claims they paid in previous years and unnecessary claims get factored into future rate increases.

Read more about insurance fraud and scams.

Wednesday, November 5, 2014

Can OIC recommend insurance agents to consumers?

Consumers call our hotline daily to ask us questions about insurance. Sometimes, consumers ask us to refer them to insurance sales agents who might be able to sell them the type of coverage they are looking for.

While we do regulate the insurance industry, we do not refer consumers to specific agents or brokers. However, we encourage consumers to check the licensing status of agents, brokers or companies on our website. Consumers can also call our hotline and ask one of our consumer advocates to look up that information on their behalf.

Read more about your insurance on our website.

Questions? Contact our consumer advocates online or by calling 1-800-562-6900.

Tuesday, November 4, 2014

Online services are running slowly due to network issue

OIC's online services are running very slowly at this time due to network issues at the state level. Users may experience difficulty trying to access our online services while technicians work to resolve the issue. Thank you for your patience.

Friday, October 31, 2014

Seattle area warned about landslide risk

Today, the Seattle Times published a warning about the risk of landslides due to recent heavy rains: Heavy rains bring increased risk of landslides, SPU warns. "With rain late Thursday and Friday morning, Seattle exceeded the official U.S. Geological Survey’s landslide threshold."

In addition to taking the steps outlined in the article, homeowners should take a look at the insurance policies. Homeowner policies typically do not cover damage caused by land movement or a landslide if the underlying case is excessive water.

There are options for homeowners who wish to have coverage in the event of a landslide. Consumers can purchase a rider that covers the contents of their home from all perils, including landslides. Some companies also sell earth-movement coverage for any structures on your property. Flood insurance may cover landslide damage that is due to heavy rains. Your insurance agent or broker can tell you what type of coverage is best for your situation.

Read more about flood insurance on our website. If you have questions, contact our consumer advocates at 1-800-562-6900.

Friday, October 24, 2014

Insurance tips for consumers affected by Longview tornado

Yesterday, people in the Longview area experienced a tornado, a rare occurrence in Washington state. Luckily, there are no reports of injuries but there was some property damage to buildings and vehicles, according to news reports. Read more about the tornado in The Columbian newspaper.
Photo courtesy
Standard homeowner and commercial property policies typically cover damage caused by tornados or wind. Damage from tornados can damage building exteriors and roofs, which can leave them susceptible to water damage from rain, and can cause trees to fall on buildings and cars. Personal auto and commercial auto policies would need to have comprehensive coverage in order pay for damage caused by wind.  

If you experienced any damage from yesterday’s tornado, contact your agent or broker to discuss what coverage you actually have and to get your claim started. If you have questions, you can contact our consumer advocates online or at 1-800-562-6900.

Wednesday, October 22, 2014

Insurers largely unprepared for climate change

A report issued today found only 9 percent of insurers are well prepared to face the risks posed by a changing climate. Only two of those insurers are headquartered in the United States.  
Ceres today released its 2014 climate preparedness scorecard, which ranks the nation's 330 largest insurance companies on what they are saying and doing to respond to escalating climate risks. The report is based on a 2013 survey of insurers with an excess of $100 million in direct written premiums conducted by insurance regulators in Washington, California, Connecticut, Minnesota and New York.
More results:
  • 276 of the 330 companies that responded scored in in the bottom half.
  • The top nine best-prepared companies are: ACE, Munich Re, Swiss Re, Allianz, Prudential, XL Group, The Hartford, Sompo Japan and Zurich. Only The Hartford and Prudential are headquartered in the United States.
  • Overall, property and casualty (P&C) insurers are better prepared than life and health insurers, which are largely unprepared.
Washington Insurance Commissioner Mike Kreidler and the other insurance regulators care about this issue for a couple of reasons – first, climate change brings extreme weather events, which can cause widespread damage to homes and other property, as we saw during this summer's wildfires. More frequent and more severe natural disasters mean more claims, which means insurance companies need to make sure they have enough money to pay those claims. Insurers can help maintain their financial solvency by making sure their money is invested soundly and in climate-friendly ways. Secondly, insurance companies can reduce their risk by being proactive. Kreidler has called for insurers to get involved in building codes, land use practices and working with developers to help mitigate the effects of climate change.
“The insurance industry is uniquely positioned as the bearer of risk to make adjustments now to lessen dramatic impacts we know are coming. This is not a partisan issue, it’s a financial solvency issue and a consumer protection issue,” Kreidler said in the Ceres news release.

Thursday, October 16, 2014

Consumer alert: Trade marketers banned from selling health care products

The federal government this week banned a trade association from selling health care-related products to consumers. The OIC issued a cease-and-desist order against the same group in 2012 for selling discount health plans in Washington without a license.

The Federal Trade Commission banned the Independent Association of Businesses (IAB) from selling any products that could be construed as health insurance or health care products to consumers. The group marketed its products as health insurance but consumers who purchased it were in fact enrolled in an IAB membership that included discounts on many services, including travel protection, identity theft protection and certain medical visits that were subject to broad exclusions and limitations.

IAB indicated to our investigators that it had sold 190 memberships to 161 Washington consumers as of September 2010 and it was still doing business at the time of our order in February 2012, even though it knew it wasn’t legal to do so. Consumers should be wary if they see marketing from IAB or any of its affiliated business names: International Association of Benefits, International Marketing Agency, Independent Association of Businesses, or IAB. You can report any activity from this marketer to the FTC’s online complaint center. If you have questions about health insurance, call our consumer experts at 1-800-562-6900 or visit us online.