Washington Insurance Commissioner Issued $262K in Fines for Violations

Washington Insurance Commissioner Mike Kreidler issued fines in July and August totaling $262,250 against insurance companies and insurance producers for violating state insurance laws and regulations.

Following is a breakdown of the fines and the reported offenses:

Insurance companies

Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Seattle, Wash.; fined $200,000.

Kaiser violated state network access standards by failing to provide its enrollees with access to in-network healthcare providers in several Washington counties from 2020 through 2022. This impacted 10,356 claims from 8,016 consumers. Kaiser also didn’t have approved alternative access delivery requests on file with the OIC to protect enrollees from incorrect cost-sharing or being balance billed for covered services from out-of-network providers because of these network gaps.

State Farm Life Insurance, Bloomington, Ill.; fined $10,000.

State Farm failed to verify that nine of its insurance producers had received long-term care education before being permitted to sell long-term care insurance policies. The nine producers that did not complete the required long-term care education sold 31 policies in Washington and earned $6,911.28 in commissions.

Cigna Health and Life Insurance Company, Bloomfield, Conn.; fined $25,000.

Cigna incorrectly processed 11,324 claims, impacting 5,406 members, during the COVID-19 public health emergency. The company failed to waive cost share amounts for members and incorrectly denied provider claims for personal protective equipment.

Unauthorized insurers

Chet Jenkins, P.C., Chet Jenkins II P.C., and Chet Jenkins III P.C., Richland, Wash.; fined $25,000.

The three professional corporations (composed of 25 dental practices) offered a dental membership plan that the OIC found constituted insurance without being authorized to do so in Washington. The membership plan had an estimated 624 enrollees. As part of this enforcement action, they agreed to cease and desist from insurance transactions in Washington.

Producers, agents & brokers

Pronto Insurance Agency, LLC, Bellevue, Wash.; fined $2,000.

Pronto Insurance and its licensee, Olga Radutskiy, failed to remit premiums, maintain a separate premium fund account, and respond to the OIC in a timely manner.

Teresa Ona Lynch, Seattle, Wash.; fined $250.

Lynch failed to disclose a misdemeanor in her application for a Washington state insurance producer license.

Since 2001, Kreidler has assessed more than $39 million in fines, which are directed to the state’s general fund to pay for state services.

Topics Washington