Insurance Division Fines Regence

 

On one occasion, it took Regence 154 days to respond to a query from the Insurance Division despite repeated requests; another time they didn’t respond for 84 days.

 

Regence’s Medicare Advantage Plans could also take a big hit next year with the insurer asking for an overall 45 percent premium increase. Seniors living in select counties in Washington will see their premiums skyrocket by 75.8 percent, from $149 to $262 for the MedAdvantage +_Rx Enhanced PPO Plan. On June 30, Regence had 59,691 Medicare Advantage members.  

 

Meanwhile, Regence is preparing to lay-off 400 employees across its four-state region, and currently employs 2,900 people in Oregon and another 3,400 in Washington, Idaho and Utah. The insurer had already announced cutbacks to its employee benefit plans.

 

Regence wasn’t the only insurer facing admonition from the Insurance Division. In fact, Providence received the heftiest fine: $30,000 for mishandling nearly 7,000 claims and not conducting a reasonable investigation.

 

Eventually Providence did pay $53,500 to members who had submitted valid claims from July 2006 through August 2008. The investigation by the Insurance Division was spearheaded by a consumer complaint.

 

Kaiser Permanente, meanwhile, had denied coverage of bariatric surgery to three people whose insurance policy covered the procedure and was assessed a $9,000 penalty by the Insurance Division.