Insurance Division Fines Regence

400 employees face layoffs by the state’s largest insurer

November 12, 2009 -- Regence BlueCross BlueShield officials are in a world of hurt these days. Not only will the state’s largest health insurer lose 103,000 members to Providence Health Plan in January, but the Oregon Insurance Division has fined the company $5,000 for failing to provide information in a timely manner.

 
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.

Providence and Kaiser also fined

 
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.

 

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