Once again, a Washington Appellate Court has ruled that an insurer’s blanket denial of payment of a medical bill that exceeds a predetermined amount constitutes an unfair practice in violation of the state Consumer Protection Act. [Stan Schiff v Liberty Mutual Fire Insurance Company, No. 82554-2-1 Decided 11/28/2022 footnote 8 at 12] “Insurers must make…
When a traditional marketplace changes and we save money, we cheer it as “disruptive innovation.” That was one of the big ideas behind the Affordable Care Act (ACA) healthcare marketplace and Exchanges like Washington’s Healthplanfinder. Buy direct and save; avoid sales commissions. Be your own insurance broker or ask a “navigator.” But, as the Harvard…
Government response to the Coronavirus has included a wide range of emergency measures governing health plan administration. Some of these measures address dislocations caused by sudden change in employment status while others address administration of benefits for employees marooned at home. The fast pace of change wrecks the predictability required for health care benefits tied…
Catastrophe reveals character and exposes fraud. From one shut-in to another, I’ve quickly learned from the flood of calls and “chats” that some clients rush to the aid of customers and others rush to the bunkers. A reckoning will come later when I evaluate my own contributions and assess the decent use of my time…
The Washington Insurance Commissioner (OIC) has proposed new rules to codify current procedures for filing large group health plans for bona fide associations. Under current requirements, the agency provides instructions for filing association health plans qualifying as a single large group plan under ERISA rather than rules governing these filings. The OIC requires that insurance…
Bless their hearts, the U.S. Department of Labor (DOL) has issued proposed regulations to improve access to association health plan markets. Their two biggest ideas for improvement are to force existing bona fide associations to stop risk rating health plan coverage at the employer level and to start counting individuals as groups. Where to begin……
