Job opening: Senior market analyst

We're recruiting for a senior market analyst position at our Tumwater, Wash. office.

This position is responsible for conducting market analysis of regulated entities under the direction of the Chief Market Analyst. This position protects consumer's interests and promotes a healthy business environment in this state by providing regulatory oversight of market interactions between consumers and insurance carriers.

For more specifics, duties, salary, timeline, etc., please see the full job listing.

May 9 hearing set to consider Washington Dental Service reorganization and merger plan

Insurance Commissioner Mike Kreidler has scheduled a hearing for 10 a.m. on May 9, 2013, in Olympia to consider whether he should approve or deny the request for the merger of Washington-based Washington Dental Services (WDS).


WDS has filed an application for its plan of reorganization and merger transaction that includes a proposed reverse merger of Washington Dental Service with and into a DD of Washington subsidiary to become a subsidiary of an existing holding company.

Here's a summary of the proposal, including background, history, and a brief explanation of the hearings process and what we look at. If the proposal is approved, WDS would become a subsidiary under a new holding company system. WDS would later change its corporate name to Delta Dental of Washington.


To view filed documents and information about the hearing process, go to Washington Dental Service #13-0115. (Scroll down a bit after clicking on that link.) Those documents include the notice of hearing, the reorganization plan, board resolutions, organizational charts, and other requests for transactions filed in this proceeding.

The hearing is open to the public. Any interested parties may submit letters of support or concerns or objections and/or may participate in the hearing by appearing in person or by telephone at no charge. For street address or directions on dialing in by phone (as well as more background on the proposal), please see the hearing order.

See if you'll save money on health insurance next year

Curious about what will happen to your health insurance rates after health reform? Our state Health Benefit Exchange, charged with creating a new online marketplace for health insurance, just launched a consumer-focused website, www.wahealthplanfinder.org and it includes a calculator for estimating your costs.

You can't choose a health plan until the site launches on Oct. 1, but you can use the calculator to see if you might qualify for a subsidy to help with your insurance costs. Keep in mind, it's only an estimate, but it should give you a sense of what to expect.

 

"Is there a grace period for a newly licensed driver to get insurance?"

Nope, not in Washington state. In order to operate a motor vehicle here, the driver must have the state minimum liability insurance. There is no grace period to obtain that insurance.

So parents, check with the insurance agent (or insurer) to see if your young driver is covered under your automobile insurance or if they need their own insurance policy.

New report on health insurance: 84 million in U.S. are uninsured/underinsured

The Commonwealth Fund this morning issued its latest report on uninsured and underinsured adults. Among the key points, in 2012:

• 84 million Americans were uninsured or underinsured.
• Due largely to the ACA, the share of young adults w/o insurance dropped by 1.9 million between 2010 and 2012
• 41 percent of adults ages 19-64 are having difficulty paying medical bills
• Costs prevent many Americans from getting needed health care
• Of the 55 million uninsured for all or part of 2012, 87 percent had incomes that would qualify them for subsidized health insurance under the ACA
• Of the 30 million underinsured, 85 percent would qualify for subsidies

Among the remaining challenges noted in the report:

 "...the law does not provide subsidized coverage to people who are not in the U.S. legally. Jonathan Gruber, an economist at the Massachusetts Institute of Technology, has estimated that of people who will remain uninsured in 2016, about 5 million will be undocumented immigrants. Second, both the Congressional Budget Office and Gruber predict that many Americans will not be insured, even though they are eligible for the new coverage options, whether because they are not aware of their eligibility, they are unable to find an affordable premium, or they elect not to enroll."

 

"I filed an insurance claim. How long will it take for the company to investigate?"

Here in Washington state, insurers should generally complete their claims investigations within 30 days unless there are good reasons why that cannot be done.

That said, all people involved in the investigation of a claim must provide reasonable assistance -- usually meaning providing information as requested -- so the insurer can process the claim.

The law that includes the 30 day standard is WAC 284-30-370.

If you have a claim that you feel is taking unreasonably long -- and you live here in Washington -- feel free to contact our consumer advocacy staff and we'll try to help. You can fill out an online complaint form 24/7, or you can call us toll-free at 1-800-562-6900.\

Here are more tips about filing an auto insurance claim, as well as tips on filing a homeowners insurance claim, and tips on how to file an appeal when your health insurer says no to a payment or treatment.

Job opening: senior market analyst

We're recruiting for a senior market analyst to fill an opening in our main building in Tumwater, Wash.

The position is responsible for conducting market analyses of regulated entitites under the direction of our chief market analyst. The goal is to protect consumers' interests and promote a health business environment in Washington, both of which we help do by providing regulatory oversight of market interactions between consumers and insurance carriers.

For more specifics, including detailed duties, salary, timeline, etc., please see the full job listing.

We knew it! Actuary named best job of 2013.

The jobs website CareerCast.com has named the best (and worst) jobs of 2013. Topping the list (again, yes) is actuary.

The ratings, according to this summary in the Wall Street Journal, were based on physical demands, work environment, income, stress and hiring outlook.

And there are some surprises on the list. Dental hygienist came in among the top jobs, as did veterinarian. Actors, roofers and dairy farmers are among the worst, no surprise there, but so are senior corporate executives and military generals.

The police cited the other driver, but his insurer says I'm partly at fault? How can that be?

We get a lot of consumer calls like this.

Police have the authority to issue citations based on their interpretation of the accident scene and the rules of the road. Drivers who disagree can make their case in traffic court.

But here's the key thing when it comes to insurance: A citation doesn't necessarily establish the issue of negligence, which can include factors including your own driving behavior, weather, speed and visibility. And the reality is that insurers sometimes attribute some portion of fault to both drivers rather than rely solely on who got a ticket at the scene. If an insurer does that, however, they should explain the basis for their decision.

Want to know more? Here in Washington state, the law that allows for this apportionment of fault is RCW 4.22, titled "Contributory fault."

Here's more about your rights when you file an auto insurance claim, and guidelines on what to do if you're in an accident and what to do if you're hit by an uninsured driver.

"Is there an insurance law that says when my car has to be totaled?"

Not that we're aware of, at least here in Washington state.

That said, we're aware that sometimes there is hidden collision damage to a car that can add substantially to the cost of the initial estimate.

With that in mind, insurers may decide to total a car when their initial repair estimate is around 70 percent of the vehicle's current market value. Otherwise, if the repairs are started and costs due to hidden damage escalate another 30 percent or more, they can end up spending more to fix the vehicle than it's actually worth.

The short answer: there is no "official" formula in the law for totalling a vehicle. But insurers look at the repair cost potential. If it's close to the value of the car, they may decide not to even begin repairs, and to simply compensate you for the value of the vehicle.

How do they establish that value? The insurer owes you the actual cash value -- i.e. the retail market value -- of your car. Insurers have to look at local values for comparable vehicles, although with your permission, your insurer can extend the search beyond 150 miles.

If you disagree on the value -- and we get these calls all the time -- you can hire an appraiser and go through the appraisal process in your auto policy. If the dispute is with someone else's insurer, you can either file a claim with your own insurer, or you may want to consider taking the matter to court.

Please see our "What happens after your car gets totalled" page for  much more on totalled car values, disputes, and what happens if you opt to keep your totaled car.

We saved Washington consumers $5.6 million in auto insurance premiums last year

Little-known fact: When many types of insurers want to change their premium prices, they must file the new rates with us. Our actuaries and analysts go over the numbers, and -- where justifiable -- we hold those increases down.

Through this process, we've saved Washington state consumers nearly $11 million over the past three years. Here's the annual difference between requested rates and approved rates during that time:

• 2010: $2,655,927
• 2011: $2,714,917
• 2012: $5,603,182

Got an insurance question or problem? We'll try our best to help. (And we won't try to sell you anything.)

Got an insurance question or problem? Call or email our consumer hotline staff at 1-800-562-6900 or AskMike@oic.wa.gov.

We're the state agency that regulates the insurance industry in Washington state.

Our analysts help Washingtonians get millions of dollars in denied or delayed insurance claims each year. They help people get insurance reinstated when it's wrongly canceled, and they can show you how to appeal if your health insurer denies a treatment.

We can tell you what your rights are, help you file a complaint, and would be happy to contact your insurance company on your behalf to find out more. If you don't have health insurance -- or can't afford the insurance you have -- we may be able to find options that are a better fit for you. We can give you some tips on how to push for the maximum value for your totaled car.

And on and on. Just email us or call.

What if you don't live in Washington? Most state insurance departments offer similar help. Here's a handy map, courtesy of the National Association of Insurance Commissioners, showing how to contact your local department.

"My insurer wants me to repair the roof and paint the siding or they won't insure me. Can they do this?"

A written, advance notice is required when an insurer is going to cancel (or "non-renew") a policy. If you got that notice in writing at least 45 days beforehand, then yes, the insurer can do this.

Often, the problem for homeowners is the timing. They simply don't have enough time to find contractors or do the work themselves. In such a case, you might be able to talk to your insurer and figure out a repair plan that will satisfy them. If not, you'd better start shopping for alternative coverage.

You might also ask your agent to talk the insurance company. There's no guarantee that the company will change its mind, but it might help.

Two job openings for financial examiners

We're recruiting for two financial examiner positions, both based at our building in Tumwater, Wash.

These positions plan, conduct, and document financial analysis examinations of less-complex regulated entities to determine their compliance with laws and regulations, and to detect fraudulent activity.

Among the duties:

Examining and analyzing eight annual filings to check compliance and and financial conditions.

Reading and interpreting applicable laws, regulations and standards to ensure that analyses and exams are conducted appropriately.

Writing analysis-examination reports, including updated the risk assessment, profile summary and supervisory plan.

For more details, including other duties, salary information, timeline and benefits, please see the link to the full job listing.

We also have a couple of other jobs open, including a deputy commissioner for legal affairs, a management analyst, and a senior market conduct examiner. To keep current on what we're recruiting for, please check our job openings page frequently.

Do I have to buy personal injury protection (PIP) coverage?

We get this question all the time. The short answer, at least here in Washington state, is no. But agents and insurance companies are required to offer Personal Injury Protection coverage, and when you get a quote, it will include PIP coverage.

If you don't want PIP coverage, you'll need to sign a waiver to eliminate the coverage from your policy. If you don't, then the insurer must issue your policy with the coverage, and you will be charged for it. (If you get a policy with this coverage and don't want it, you can still get it removed if you sign that waiver.)

The same is true, incidentally, for uninsured motorist coverage, which goes by the acronym UIM. It's included when you get a quote, and if you don't want it, you'll need to sign a waiver to eliminate the coverage from your policy. Otherwise, you'll get the coverage and be charged for it.

"It's difficult - and expensive -- to find insurance for my log home. Why is that?"

Here's the situation: Log homes are often considered to be specialty construction by the insurance industry. That's not necessarily a bad thing, but it does mean that log homes have unique construction and repair considerations. That translates into costs that may be above and beyond those associated with modern, conventional home construction.

It's also often the case that log homes are in rural or remote areas where such structures are allowed. That can mean longer response times for firefighters, who may have fewer capabilities than an urban or suburban fire department. All of that means that your homeowners insurance may be more expensive or harder to find.

And these challenges are not unique to log homes, by the way. These same challenges often apply to other specialty structures, such as domes, wood/earth mixed construction, subterranean structures (looking at you, old missile silo owner...), and some types of experimental construction.

Here's our advice: If possible, before you buy one of these types of homes, or decide to finance and build it yourself, please be sure to talk to an insurance agent about the availability of coverage. This can be very important, because if you have a loan on the home, your lender will no doubt insist on proof of insurance coverage in order to protect their interest in the property.

Job opening: Market conduct examiner

We're recruiting to fill a job opening for a senior market conduct examiner in our Seattle office. (It's one of several jobs we have open at the moment; click that link to see the others.)

The position is responsible for performing analysis and examinations under the direction of our chief market conduct examiner. The position would be a lead position, and would lead teams of co-workers in evaluating company activities in the marketplace.

For more specifics, including duties, salary, timeline, etc., please see the full job listing.

Guilty: Man claimed car burglarized at mall; but mall's video indicated otherwise

An Eatonville man has pleaded guilty to felony insurance fraud after falsely claiming that someone burglarized his car while parked at the Tacoma Mall.

Joseph Thomas Rebic, Jr., 48, pleaded guilty Wednesday in Pierce County Superior Court. He was sentenced to 240 hours community service and $1,300 in fees.

On June 11, 2012, Rebic reported that his car had been burglarized while parked for 45 minutes at the Tacoma Mall. He filed reports with Tacoma mall security and the Tacoma Police Department. He immediately filed two claims with his insurer, State Farm.

The car's rear driver's door window was broken, and there was damage to the trunk liner. Rebic said that the thief had stolen several items, including a $179 GPS device, an $1,189 Canon camera and lenses, and a $1,200 bow and arrows. All told, he said, the stolen valuables were worth about $2,880, and the damage to the car totaled about $350.

The problem: The mall's parking lot video showed none of that. The video shows no one approaching the vehicle or taking items from it after Rebic leaves.

State Farm eventually closed Rebic's claim without payment after he canceled an appointment with a State Farm investigator. They then forwarded the case to our anti-fraud Special Investigations Unit.

Note to agents and brokers wondering about their role under health care reform and the Exchange

Are you an agent or broker wondering what your role will be with Health Care Reform and the Washington Healthplanfinder, also known as the Washington Health Benefit Exchange? We get frequent questions from agents about this.  

How the Exchanges are set up varies by state. Here in Washington, the exchange is a separate entity from the state's insurance regulator (that's us).

The Exchange holds monthly public meetings to discuss agent requirements, business processes and to help determine agent/broker training and certification in order to access the Exchange system.

To participate in future meetings and find out what you need to do in order to become Exchange trained and certified,  information is posted at  http://wahbexchange.org/committees/agents-brokers-tac/. 

If you want to attend the next teleconference on May 1, 2013 contact the Exchange at info@wahbexchange.org .

(Note: This is actually a repost of a post we put up early this morning. It was the easiest way to fix a font error. The wording's unchanged.)

"My agent told me I had to add all my cars to my policy, even if I don't use them. Is this true?"

We are not aware of any Washington state law requiring the addition of all owned cars to a policy. If your agent claims there is -- and we hear this from consumers with some frequency -- he or she should be able to tell you what section of law it is.

There is a section of state law (RCW 46.30, regarding mandatory liability insurance) that requires drivers operating certain vehicles on state highways to be able to show proof of liability insurance if asked to do so by law enforcement officers or a court. However, simply owning a vehicle that's not driven doesn't appear to require proof of insurance under that law.

If you're driving it around, yes, of course get insurance on it. The fines for driving without insurance are steep, and the potential losses in an accident could be much steeper.

For more specifics on the mandatory insurance law, including requirements and types of vehicles that are exempt, please see our mandatory auto insurance page.

Update on Commissioner Kreidler

As you might recall from a post last week, Commissioner Kreidler is recovering from planned heart surgery on April 2. His doctors had been monitoring his health status over the past several months, leading to the scheduled bypass and valve-replacement surgery.

He's doing very well. After three days of recovery at Providence St. Peter Hospital, he returned to his home in Olympia on Friday. Like most people who have major surgery, he's happy to be home with his family, and pleased that things went so well.

He's been checking in regularly via phone and email, and appreciates the cards, emails and Twitter messages of support. He wanted to be sure that we posted an update here to let folks know how he's doing.

During his recovery, the commissioner's duties are being handled by Acting Chief Deputy Deb McCurley, who's been with the agency since 2006.

Cowlitz County driver faces multiple charges in insurance fraud case

A Cowlitz County woman faces multiple charges after she allegedly ran into another vehicle, fled the scene, and falsely filed reports with police and her insurer claiming that her car had been stolen.

Kaitlyn D. Karthauser, 21, was charged March 27th in Lewis County Superior Court with hit and run, second-degree perjury, insurance fraud, and making a false statement to police.

On Oct. 20, 2012, around 3:30 a.m., according to investigators, Karthauser was driving her gray Saturn north on Interstate 5 when she rear-ended a white car in front of her. She allegedly pulled over, looked over her car for damage, then drove off. The other driver sustained head and back injuries and was taken to a hospital in nearby Centralia. Troopers discovered the front license plate from Karthauser's car among the collision debris at the scene.

About 40 minutes later, the Chehalis Police Department spotted Karthauser's Saturn abandoned in a city park one freeway exit up from where the collision took place.

Eight hours later, Karthauser called the Castle Rock Police Department and reported that someone had stolen her car the night before. She signed a theft report. An hour after that, she called her auto insurer and filed a claim for her stolen car.

On Oct. 22, when told that the State Patrol would check her cell phone records to determine where she was during the time of the crash, Karthauser allegedly admitted to a State Patrol investigator that she lied when she reported the car stolen. The following morning, she called her insurer and told them the same thing.

She said she was driving to a friend's house late at night when she fell asleep and hit the other car. She was jarred awake by the collision, and upon seeing the damage, she said, she panicked and drove off.

"My insurer's using values from all over the country to value my totaled car. Can they do this?"

Under Washington state law, unless you gave your insurer permission to search over 150 miles from your home, no, they cannot use cars from all over the country when trying to find comparables. Feel free to refer them to the insurance rule on this issue, which is known as WAC 284-30-391 ("Methods and standards of practice for settlement of total loss vehicle claims.")

And even if you are dealing with someone else's insurer, they still need to look for comparable cars in and near where the vehicle is normally garaged or parked.

If you have problems with this -- and you live in Washington state -- feel free to file a complaint with our office so we can help ensure that the rules are followed. If you live in another state, check with your state's insurance department.

Cease and desist order issued to Charles D. Oliver, American Equity Advisory Group, and "the Chuck Oliver team"

A few minutes ago, we issued this cease and desist order telling Charles D. Oliver, American Equity Advisory Group LLC, and "the Chuck Oliver team," as well as their employees, agents and affiliates, to immediately stop selling insurance products in Washington without a license.

We received a complaint from a woman who -- despite the fact that she is unmarried and has no children -- had bought  two $1 million life insurance policies and an annuity from Oliver and an associate, Steven H. Minnich. From the order we issued today:

"In the end, Mr. Minnich and Mr. Oliver sold (the woman) two life insurance policies and an annuity, as part of a complex scheme they call `maximum funding' or the `Missed Fortune' concept. Essentially, the plan was to deposit a large amount of premium into the plans for the first five years, and then stop paying on the contract.

"Mr. Minnich and Mr. Oliver told (her) that, if she did not touch the life policies for 10 years after that, she would be able to borrow $75,000 per year against the life insurance death benefit to use as retirement income, without paying any taxes and with minimal or no interest. They told her she would be able to do that without paying any further premiums on the policies, and for as long as she may live.

"This is not correct. Based upon the non-guaranteed amounts in the illustrations provided, there is a theoretical possibility that it could occur. However, the guaranteed amounts show that, within a few years (the buyer) would run out of cash value in the policies against which to borrow. This would happen by operation of the loans themselves, in addition to the accrued interest. In addition, the death benefits would decrease when (she) reached certain age milestones. Thus, not only would (she) not be able to use the policies for retirement income, she would also need to pay additional premiums simply to keep the policies in force. Thus, it is vastly more likely that the plan would not have performed as represented to her by Mr. Minnich and Mr. Oliver, and would leave her in a far worse financial state than if she had left her money where it was.

"Neither Mr. Minnich nor Mr. Oliver even suggested to (the buyer) that this was a possibility, let alone informed (her) of the extreme risks she was taking."

In this case, the premiums amounted to $110,000 a year. The woman, who had minimal annual income, was only able to make the first two years' payments by borrowing from one life insurance policy, cashing in another, borrowing from her IRA, and opening a home equity line of credit. Mnnich and Oliver, according to our order, "knew that she does not, and never did, have the assets to be able to make the $110,000 payments for five years."

Our order alleges that these transactions included nearly a dozen violations of Washington state law, including Oliver's selling insurance without a license, selling an unapproved policy, taking a commission without being licensed, describing the plan in a way that could be misleading, engaging in unfair or deceptive practices, and "by knowingly making, publishing or disseminating false, deceptive or misleading representations" of an insurance transaction.

The respondents can demand a hearing. The order, which was signed today, takes effect immediately.

"My lender wants my homeowners policy to cover the home AND the land value. Can they do that?"

No, not in Washington state.

Since the land itself is not considered covered property, including it would inflate the cost of your insurance premium. And you could never collect on a claim for the value of that land, since it's not covered property.

To preclude such a waste of your premium dollars, Washington state law bans insurers from issuing a policy that includes the value of non-covered land. The title of the relevant section of law says it all: "Over-insurance prohibited."

That said, however, you can get a policy for what's called "replacement cost" coverage for your home. With that kind of coverage, you could collect the cost to replace the home in the event that it was totally destroyed by a covered event and had to be rebuilt. And that replacement cost can be more than a home's current market value, particularly if the home is older or in less-than-sterling condition.

Questions? The law we're referring to is RCW 48.27.

Kreidler recovering from planned heart surgery

Washington Insurance Commissioner Mike Kreidler is recovering after successful heart surgery.

 Kreidler’s doctors had been monitoring his heart status over the past several months, leading to the scheduled bypass and valve-replacement surgery, performed Monday at Providence St. Peter Hospital in Olympia.

“The commissioner was upbeat and confident about the operation,” said Sandi Peck, Deputy Insurance Commissioner for Public Affairs. “He called our office this morning, and he sounds as if he’s well on the road to recovery. As a staunch advocate for health care reform, he’s definitely looking forward to getting back to work.”

During Kreidler’s recovery, Acting Chief Deputy Deb McCurley will be handling the commissioner’s duties. McCurley has been the deputy insurance commissioner for operations since 2006.

“The consumers we serve and industry professionals we regulate shouldn’t notice any changes,” said McCurley. “We have a dedicated, professional staff, many of whom have long experience dealing with insurance.”

Kreidler, 69, was re-elected to a fourth four-year term in November 2012. He is a former member of Congress, state lawmaker and doctor of optometry.

 

Health insurance tips: What if the billing code is wrong?

We often hear from consumers who tells us that they're having health insurance problems related to billing codes. People think the wrong code was used, but don't know how to find out for sure. And then they're not sure how to change it.

Billing codes are the shorthand way that doctors and other health care providers describe their services. The most widely used type are called "CPT codes." They were created by the American Medical Association.

You see these codes all the time on those letters -- which are known as Explanations of Benefits, or EOBs -- that your insurer sends you after each health care appointment. Sometimes there's an accompanying line indicating what the service was, but it's not always clear.

If you're trying to figure out more about what a particular code means, you can go to this web page set up by the AMA. It will tell you the definition of a particular code. With that information, you can go to your health care provider and ask them to redo the coding.

If that doesn't work and you still feel that the CPT code doesn't correctly describe the services you received, you can ask your health care provider for a copy of the chart notes. You can send these notes to the insurance company, where one of the insurer's billing specialists can review the notes to decide whether to use a different code. (Note that the provider's office can make you pay for the copy of the chart notes, so be ready for that if it comes up.) We have seen consumers win insurance disputes using this technique, though, so it's worth a try.

Landslides: Does homeowners insurance cover that?

There was a large landslide on Whidbey Island early this morning, reportedly knocking one home off its foundation, destroying a road and threatening multiple other homes. Photos from the scene -- like this one, or this one -- are pretty amazing.

Anytime this happens in the rainy Northwest -- and it does happen with some regularity -- we get phone calls from people wondering if their homeowners insurance covers landslides.

The answer: Sorry, but probably not.

Mudslides and landslides are NOT covered by a standard homeowners policy, which is what most people have. So it can be very difficult to collect for losses caused by any form of land movement.

So what can you do if you're worried about a potential landslide affecting your home? You may be able to buy a special rider -- i.e. an add-on -- to your homeowners policy that includes coverage for contents for all perils, including earth movement, unless the policy specifically excludes it. But these types of riders typically only cover the contents of your home, not the structure, and some insurers don't offer this option at all.

For the structure, you may be able to buy separate earth-movement coverage from what's known as the "surplus lines" market, meaning insurers who specialize in risks that the traditional insurance industry doesn't cover. But know that if your home is on a steep hillside, it may be difficult to get this kind of coverage.

For the folks affected by the slide this morning, it would be worth checking with their lenders. Mortgage lenders in some cases require earth-movement coverage as a condition of a loan. Although such insurance protects the lender, rather than the homeowner, it could help if the home is no longer useable.
Complicating things for folks close to a landslide, insurers often declare moratoriums on new coverage until a particular event is completely over. We've seen this with earthquakes (due to the fear of aftershocks) and sometimes during wildfire season in parts of Eastern Washington.

"Wait a minute -- I thought insurance companies can't have waiting periods for pre-existing conditions!"

We’re hearing this a lot these days, because people are aware that the federal health care reform law affects pre-existing condition waiting periods.
For kids under 19, this part of the health care reform law has already gone into effect. So insurance companies cannot apply pre-existing condition waiting periods when kids go on health insurance policies.
Here's where the confusion comes in: the rules are different for adults. But not for long.

Starting Jan. 1, 2014, the same rule that now applies to kids -- no waiting period for pre-existing conditions -- will apply to adults. For now, however, insurance companies can, and do, apply pre-existing condition waiting periods when adults go on policies.

So hang in there. Starting in January, health insurance companies have to cover treatment for pre-existing conditions starting as soon as you go on the policy.

Report: Claims cost of individual health insurance in WA likely to rise 13.7 percent by 2017

A new report by the Society of Actuaries predicts that medical claims costs for individual health insurance plans -- meaning coverage that people have to buy on their own, rather than get through an employer or government program -- will rise 13.7 percent in Washington by 2017. That's substantially less than in many other states.

About 300,000 Washingtonians now buy their own insurance on the individual market. That number's expected to increase sharply next year as people who are now uninsured start buying coverage.

It's too soon at this point to say what the final rates will be. We don't expect to see the first rate proposals for these policies until next month, and premiums include more than just medical claims costs.

There is, however, some good news for many of these folks. The report does not attempt, for example, to factor in the federal subsidies that many people in the individual market will qualify for, starting in January. Under federal health care reform, a family of four earning up to $94,200 could qualify for help paying for their insurance.

Also, under health care reform, the vast majority of policies will cover much more than they do today. It's rare, for example, to find an individual health plan that covers prescription drugs. Many don't cover the birth of a child. Starting in January, most policies will have to cover those things and more.

Lastly, the sad fact is that the individual health insurance market is no stranger to big increases in rates. In 2009 -- well before health care reform -- those policies in Washington rose an average of 16.5 percent. That's in a single year. And the year before that was even worse: an average increase of 18 percent.

Tacoma man arrested for insurance fraud

A 24-year-old man facing multiple charges in an insurance fraud case was arrested this morning by the King County Warrant Team at a residence in Tacoma.

Andre Romeo Zamora Sarmiento was charged last year with second-degree theft, forgery and insurance fraud for allegedly filing altered and fake medical bills after a car accident. He failed to appear for arraignment on Dec. 24, 2012, resulting in the warrant that led to his arrest this morning.

The fraud case involves a November 2011 auto collision in Tacoma. A car turned in front of Zamora's car, cutting him off, and leading to the crash.

Zamora subsequently filed a claim with the other driver's insurer for injuries to his back and $2,542 for vehicle damage to his vehicle. For the medical claims, Zamora filed several bills totalling $14,857.

A subsequent investigation by our anti-fraud Special Investigations Unit revealed that several bills were altered and grossly inflated. A bill for $360, for example, had a "9" added, to make it look like a bill for $9,360. A bill for $33.50 was turned into what looked like a bill for $3,358.80.

All told, Zamora submitted claims for $13,236 more than he actually paid. The insurer paid Zamora $5,497 before discovering that the bills were fraudulent.

Q: "My homeowners insurer sent an inspector to look at my home. Can they do this?"

It is not unusual for home insurers to periodically inspect the homes they insure.

Generally an inspection might be done after years of providing insurance when an insurer may ask if it's still insuring the same risk that it started out with.

The company might ask your agent to do a site inspection, or might hire an independent company to do site inspections and write reports about what they see, such as maintenance, property/landscape care, and any dangerous conditions that might increase the chance of a loss or injury at your home or on your premises.

There are no insurance laws that prohibit site inspections. Of course you’ll want to set up an appointment so you can be there when the site inspection is made. If a site inspection is made on a ‘drive by’ basis, there is a chance that a report may not be accurate, as you won’t be there to answer questions about any issues that could cause an inspector to be concerned, maybe unnecessarily. If you have questions about the process, we recommend that discuss the issue with your agent.

Job opening: Deputy insurance commissioner for legal affairs

Due to a retirement, we're recruiting for one of the top jobs at the Office of the Insurance Commissioner: the deputy commissioner for legal affairs.

The person will be responsible for forming the agency's legal positions related to enforcing compliance with the state insurance code and related federal laws, including matters related to insurers, agents, brokers and unauthorized insurance transactions.

He or she will manage a division of 20 employees and serve as general counsel for the insurance commissioner. The division includes staff attorneys and investigators who support the agency's consumer protection mission.

For more, including detailed responsibilities, requirements, salary and application process, please see the full job listing.

Insurance questions: "What's an `examination under oath,' and do I have to take it?"

Q: "My insurer asked me to attend an `examination under oath.' Can they make me do this?"

A: The company has the right to request that you be examined under oath, but it's your decision whether to actually attend and participate. So you can refuse. But keep reading.

Here's the big caveat: As the insured person, you have a responsibility to cooperate with your insurer during an investigation and to provide support for your claim. If you refuse to attend an examination under oath -- these are often known by the shorthand "EUO" in insurance documents -- your insurer has the right to deny your claim and close their case based on what they will call non-cooperation.

The upshot: We recommend that you attend an examination under oath and that you cooperate with your insurer in support of your claim.

After your insurer has the information it's requested and has completed the exam, then it's their responsibility to provide you with a timely coverage decision. If they deny your claim, they need to clearly explain to you why they made that decision.

If you live in Washington state and have insurance questions or want to file a insurance complaint, you can reach us by e-mail or call us at 1-800-562-6900. You can also file a complaint 24/7 through our new online complaint form.

If you live in a different state, here's how to reach your state's insurance regulator.

"An accident drove up my insurance rates, but I wasn't at fault. What's up?"

Some auto insurers base their rates only on at-fault accidents, but others take into consideration all claim activity, whether you were the one at fault or not.

Insurers operate on the statistical principle  that people with current claim activity represent a higher future potential risk than those who have no claims.

Here's the good news: insurers compete against each other, and in Washington we have a particularly vibrant auto insurance market. And rates can vary considerably from company to company, even among similar policies. So -- as we say often -- it really can pay to shop around for alternatives.

"I got the check for my car repair, but it doesn't include all the damage."

Q: "The insurance claims adjuster sent me a check for my car repair, but what if there are added repairs that still need to be made?"

If there is other accident-related damage that was missed in the initial estimate, then have the repair shop call the claims adjuster to verify the damage and authorize repair.

Here's the key part, though: That call has to happen before repairs are made, since the adjuster must verify that the damage is related to the covered accident.

If there is no verification and repairs are made, you may be responsible for paying the added costs.

Jury convicts Spokane man of fraud in case of $200,000 patio cover

A Spokane jury this afternoon convicted a Spokane man of insurance fraud and attempted theft after a snow-damaged patio cover worth about $4,000 mushroomed into a fraudulent insurance claim for nearly $200,000.

Keith R. Scribner, 48, will be sentenced April 16th in Spokane County Superior Court. Both the charges are felonies.

In late July 2009, Scribner's mother, Marilyn Warsinske, filed a claim with Liberty Mutual insurance. She said a patio roof at a home she'd purchased had collapsed due to the weight of snow some 6 months earlier. The policy covered "like kind and quality" replacement. Her son, she told the company, would handle the claim.

Scribner told the insurance company that patio cover was an extensive structure, spanning the entire length of the patio and wrapping around the home's chimney. Claims officials, inspecting the site, wondered why was there no flashing or holes in the masonry. Scribner said that house painters must have made repairs.

He sent the insurance company three bids to replace the cover based on his description. The bids ranged from $195,586 to $213,815.

Claims officials asked Scribner for any photos of the roof prior to the damage or after it collapsed. Perhaps some were taken during a home appraisal prior to the purchase, they suggested. Scribner said there were no photos and was no appraisal.

But a claims handler discovered an aerial photo of the home on a real estate website. It showed a much smaller patio cover than Scribner claimed.

The company launched a fraud investigation and notified Insurance Commissioner Mike Kreidler's anti-fraud Special Investigations Unit.

As it turned out, there had been a home appraisal, the investigators discovered. In fact, Keith Scribner met with the appraiser. And the appraisal included photos of the patio cover. A real estate agent interviewed by investigators described the cover as being "small and nothing special or significant."

The home's previous owner also provided photographs of the structure. It was originally canvas. When that because troublesome to remove each year, the homeowner bought a polycarbonate cover. Cost: About $300.

An architect told a state fraud investigator that he'd met with Scribner in 2008 -- months before the snow collapse -- to discuss plans to replace the deck cover with new, larger one.

A local company, provided with measurements and photographs of the original structure, drew up replacement bids at the request of a state fraud investigator. The bids: $3,913 and $4,782.

Hearing: Proposed acquisition of Western United Life Assurance

Commissioner Kreidler has scheduled a 10 a.m. hearing on March 21 to consider a request to acquire Washington-based Western United Life Assurance Company.

Central United Life Insurance Company is proposing to acquire common shares of Western United Life Assurance Company from Western United's current owners, Global Life Holdings Inc. The acquisition would allow Central United to acquire all common shares of Western United and become its controlling entity.

Central United Life Insurance is an Arkansas stock life insurer with its headquarters in Houston, TX. It has been licensed in Washington since 1974. It writes mainly life and accident and health policies in Washington. Western United Life Assurance is a Washington stock life insurer with its headquarters in Spokane, WA and was established in 1963. Western United writes mainly annuity considerations in 16 states.

Any interested parties may submit letters of support or concerns or objections and/or may participate in the hearing by appearing in person or by telephone at no charge.

For more on this hearing, please go to our hearings archive and look forWestern United Life #13-0033. There you'll find details on how to participate in the hearing and view all documents filed in this matter.

"My agent said I had `full coverage' but won't pay my claim. What gives?"

Q: My agent said I had "full coverage," but when I turned in a claim, I was told that the claim was excluded. What's going on?

In insurance, there's rarely any such thing as "full coverage." Virtually all (if not all) insurance policies have conditions, limitations and exclusions.

It's critical to find out what those conditions, limitations and exclusions are before buying a policy and before you have a claim.

If an agent won’t explain the conditions, limitations and exclusions, then find one that will. If you don’t ask, then you may be surprised and angry when you are told there is no coverage.

What does insurance have to do with climate change?

A lot, as it turns out.

Last year, three states -- Washington, California and New York -- surveyed dozens of major insurance companies about what they're doing to adapt to risks posed by climate change, a potential game-changer for insurers' investments and the risks they take on.

An independent climate-change group, Ceres, this morning released its analysis of the responses to that survey.

Of the 184 companies surveyed, Ceres concluded that only 23 of the companies had comprehensive climate change strategies. "Those companies provide a roadmap for the rest of the industry as it begins to wrestle with the issue," the report's authors wrote.

"Why do I have to do the insurance company's work to get my claim paid?"

This is another question that we hear a lot. Whether or not you are dealing with your own insurer or someone else’s insurer, be prepared to be involved in the claim.

Here's why: Processing a claim is rarely one-sided, and your participation is needed.

You may be asked to provide information, statements, photos, receipts or other things to support your claim.

You may be asked to attend what's called an "exam under oath" or go to an independent medical exam to verify claim details and injuries.

In order to promote a resolution to your claim, we recommend that you actively be involved, ask questions, and be ready to help with processing your claim.

What you can do when your health insurer says no

Little-known fact: When your health insurer denies a treatment or won’t cover a bill, that’s not necessarily the final answer. In most cases, you can appeal that decision.
Even if the insurer says no, consumers can often appeal to an independent group with the power to overrule the company. Nearly a quarter of Washingtonians who do that end up winning.
Our office has posted an easy-to-use guide to filing appeals on its website at www.insurance.wa.gov/your-insurance/health-insurance/appeal. Since we're the insurance regulator for Washington state, it's designed for Washington residents, but many of the tips apply more broadly.
The guide has been recently overhauled to make it easier to use. It includes step-by-step tips, examples, and downloadable letters that consumers can fill out and send to their insurer.
We also experts on staff who can help Washington state consumers with their appeal. They can be reached at 1-800-562-6900 or AskMike@oic.wa.gov.

And if you don't live in Washington state, here's a handy map showing how to contact your state's insurance regulator.

Large health insurer surpluses could help ease premiums

The News Tribune of Tacoma and the Bellingham Herald this morning ran an op-ed column by Commissioner Kreidler, talking about the fact that -- under current law -- our rate reviews of health premiums have to ignore the billion-dollar surpluses that some non-profit health insurers are sitting on.

From the op-ed:

Two of this state’s largest insurers – Premera Blue Cross and Regence BlueShield – are sitting on surpluses totaling $2.2 billion. In fact, their surpluses grew almost a quarter-billion dollars in the first nine months of 2012 alone.


As the state’s insurance regulator, I review insurance premiums. If they’re unjustifiably high, I tell companies they cannot charge that much. This is a critical protection for Washington consumers.

But here’s the elephant in the room: Under current law, I am barred from taking those surpluses into account when I review rates. This is despite the fact that regulators in nearly a dozen other states, including Oregon, have the authority to do so.

We're seeking legislation -- House Bill 1349 -- that would allow us to take surplus into account when the rates are reviewed.

By factoring surpluses into rate reviews, I can help protect consumers from sticker shock in their health care premiums, while still ensuring that carriers are financially healthy. It would be a tragedy – both for the economy and for individuals – if lawmakers chose to put the interests of insurance companies ahead of their constituents.

WA insurers and agents fined $2 million in 2012

From a news release we issued minutes ago:

Insurance Commissioner Mike Kreidler issued more than $2 million in fines against insurers, agents and brokers in 2012.


“Ideally, we’d have full compliance and no fines,” said Kreidler. “But the reality is that sometimes it takes a fine to get a company to address problems. And in many cases, these fines were accompanied by compliance plans aimed at making sure the problems don’t recur.”

The fines totaled $2,033,990. Violations included charging customers for coverage they’d never agreed to, charging unapproved rates, allowing unlicensed staffers to sell policies and failing to register with the state.

“Fortunately, these cases are the exception,” said Kreidler. “Most companies, agents and brokers follow the rules.”

The agency posts all disciplinary orders – including those that don’t include fines – at www.insurance.wa.gov/orders/enforcement.asp.

The total for 2012 was higher than the previous year’s $1.4 million.

Fines collected by the insurance commissioner’s office do not go to the agency. The money is deposited in the state’s general fund to pay for other state services.

Over the past 12 years, Kreidler has issued more than $15 million in fines for violations of Washington’s insurance laws.

Hearing set to consider request to buy Soundpath Health

We've scheduled a hearing on March 1 at 10 a.m. to consider Catholic Health Initiative's request to acquire Washington-based Soundpath Health Inc.

From our public notice about the hearing:

Catholic Health Initiatives (CHI) through its subsidiary, CollabHealth Plan Solutions, is proposing to acquire common shares of Soundpath Health from Soundpath’s current owners, Northwest Physicians Network and Physicians of Southwest Washington. The acquisition would allow CHI and CollabHealth Plan Solutions to own approximately 56 percent of common shares of Soundpath Health and become controlling entity of Soundpath Health.

Catholic Health Initiatives is a national nonprofit health system with headquarters in Englewood, Colo. The faith-based system operates in 19 states and includes 81 hospitals; 40 long-term care, assisted, and residential-living facilities; two community health-services organizations; two accredited nursing colleges; and home health agencies. In fiscal year 2012, CHI provided more than $715 million in charity care and community benefit, including services for the poor, free clinics, education and research. With total annual revenues of more than $10.7 billion and approximately 86,000 employees, CHI ranks as the nation’s second-largest faith-based health system.

If approved, CHI through CollabHealth Plan Solutions, Northwest Physicians Network and Physicians of Southwest Washington would be co-owners of Soundpath Health.

The public is notified that all interested parties may submit letters of support or concerns or objections and/or may participate in the hearing by appearing in person or by telephone at no charge.

To view the Notice of Hearing, which includes advice on how to participate in the hearing process, and to view all documents filed in this matter including the Purchase Agreement between the parties, and all other documents such as organizational charts and finances, current and past states’ regulatory actions and other litigation filed in this proceeding, go to Soundpath Health #13-0039 at
http://www.insurance.wa.gov/laws-rules/administrative-hearings/judicial-proceedings/s-t/.

Insurance tips: "My insurer wants more money due to an 'audit.' What's that?"

Q: I paid my business policy premium, and now, after the policy period is over, the insurer wants more premium because of an "audit." What's going on?

This is a common question.

This issue deals with the audit provision found in the typical commercial policy. Because businesses may experience both decreases or increases due to business cycles, estimated premiums are commonly used in commercial policies when they are first issued, with an annual audit option to identify any premium that needs to be added or subtracted due to the business cycle. Insurers may or may not decide to exercise their right to audit.


The good news is that the audit, while it may increase your premium for the prior business period, could also decrease it.

Job openings: Market analyst and financial analyst

We have three job openings, both in our main office in Tumwater, Wash.

One is for a financial analyst. Duties include examining and analyzing insurance company financial filings and data to discern their financial condition, difficulties, trends and compliance with laws and rules.

Required qualifications include a bachelor's degree with major study in finance, business administration, economics or accounting; a CPA license or Accredited Financial Examiner credential, and three years of professional experience in accounting or auditing.

For a full list of duties, qualifications, and application information, please see the full job listing.

The other job openings -- two of them -- are for market analysts. These people -- this won't be surprising -- conduct market analysis and participate in data surveys, using data from various sources, including other states' insurance departments. They also review company information on Facebook, Twitter, carrier websites, agent sites and blogs.

The market analyst jobs require a bachelor's degree in business administration or a related field, although work experience may also be submitted. They also require two years of experience in life, helath or property and casualty insurance company operations. For details, application info, etc., please see that full job listing.

Thanks for your interest!

Insurance tips: "My PIP claim is months late. What's going on?"

Q: My auto insurance was supposed to pay for medical expenses under my Personal Injury Protection (PIP) coverage, but my insurer didn't pay all the bills. They waited for two months before making a decision. What's going on?"

Our consumer advocacy hotline gets questions like this fairly frequently. Insurers should be reviewing the bills as they are received. As a general rule, we would expect that an insurer would review the bills and make a coverage decision within 30 days of getting them. If there are delays, we'd expect the insurer to be able to explain why.

If you're having problems getting your insurance -- health, auto, homeowners, etc. -- to pay a claim, feel free to contact us. We accept complaints online 24/7, and have a toll-free consumer hotline (1-800-562-6900) staffed by experts.

Insurance Q&A: "How much is a pet worth?"

We periodically field questions from bereaved pet owners who've had a pet killed by a car, only to be offered what seems like a very low sum -- typically $50 to $100 -- from the driver's insurance company.


The reality is that pet owners usually can't recover much more than their out of pocket expenses when an animal is killed due to someone's negligence. And sometimes they won't even cover medical expenses for the injured animal.

Here's why: under current law, pets are valued as property and valued at what they'd cost to replace. (That's the same way insurers decide the worth of, for example, a totaled car.) You may be able to negotiate a slightly higher payment -- our consumer advocacy staff once helped get more money for a slain goat -- but the sentimental value of a longtime pet is often much, much higher.
In recent years, there have been a growing number of cases in which plaintiffs are arguing that a beloved pet is more than just property, and that insurance payouts should recognize that.

The Wall Street Journal last week reported on a Texas case in which a shelter mistakenly put a dog to death. The owners sued, claiming emotional damage from the loss of their 7-year-old dog, whom they felt was part of their family. An appellate court ruled in the couple's favor in 2011, saying that the special value of "man's best friend" should be recognized.

The case is now in the hands of the Texas Supreme Court.

The good news: your insurance likely covers meteorites & space junk

In light of the passing asteroid and the (unrelated, apparently) meteorite that hit Russia last night, we'd point out that in the extremely unlikely event of a meteorite or old satellite crashing into your home, your insurance would likely cover the damage to you, your car, business or -- hopefully not -- yourself.

The Insurance Information Institute took a look at this issue a couple of years ago, concluding that:

"Damages caused by falling objects are generally covered under standard auto, business, homeowners and life insurance policies."

Our in-house consumer hotline folks add that if a meteor struck near a home, with no direct hit, but that the impact and shock wave caused damage, that damage too would likely be covered in a standard policy.

Again, the odds of getting hit by something like this are very, very low, although not zero. An Alabama woman was struck by a meteorite in 1954, and in 1992, a car in New York state was hit.

Insurance tips: "My insurer won't pay my policy limits!"

Q: "I turned in a valid claim and my insurer won't pay me the limits that I have on my policy. What's going on?"

A: We get this type of question a lot. The limits shown on your policy are simply that -- an upper limit that is the maximum available to you for a covered claim.

But being paid the maximum is rarely automatic. Even though it is your policy, and you've paid your premiums faithfully, you still have the responsibility to document the value of your claim. It's not at all unusual for the value of a claim to be below a policy's limits.

Industry professionals: We want your opinion on our new website

Note to agents, brokers, and insurers licensed in Washington state: We're evaluating our newly redesigned website, with the goal of making it as easy as possible for industry professionals to find what they need.

Please take a few minutes to take our online survey. It takes about five minutes to complete.

Your feedback will help us improve the website.

Thanks much.

Buying a used car? Here's a way to check if it's stolen or salvaged.

The National Insurance Crime Bureau, an anti-fraud group made up of hundreds of insurance companies, car rental companies, auto auctions, etc., runs a free online site where you can check to see if the car you're about to buy has been reported as stolen or salvaged.

It's called "VINCheck." You type in the vehicle identification number. On most modern cars, the VIN is usually a long combination of numbers and letters on a plate or tag at the front of the dashboard. It's easily read from outside, through the windshield.

VINCheck will tell you if the vehicle has been reported as stolen and unrecovered, or if it has been reported as a salvage vehicle, by participating NICB members.

A maximum of five searches are allowed from each IP address per 24-hour period.

"My homeowners insurer canceled me because I made two water claims in three years. Is that legal?"

Yes, it often is. Insurers are required to send you a written, advance notice listing the reason why they're canceling your coverage, but they're not prohibited from canceling (or not renewing) coverage due to claims.

What can you do? Well, you can talk to your agent, who may be able to work with the insurer to keep your coverage, albeit possibly with some changes.

The insurer might want you to take on a higher deductible, for example, or might want a home inspection report by an outside consultant.

If it's the latter, they'll likely be paying particular attention to the overall condition and care of the home and condition of the utilities.

If you like your insurer, it's worth at least asking the question.

Also, if you have questons like this and you live in Washington state, we're happy to contact your insurance company on your behalf and ask for an explanation of their decision. You can file a complaint online 24/7 or give our consumer advocacy staff a call at 1-800-562-6900.

Two insurers fined $250,000

A California insurer and its sister company are being fined $250,000 for multiple violations of Washington’s insurance laws.

Health Net Health Plan of Oregon, Inc. and Health Net Life Insurance Co., of Woodland Hills, Calif., have signed a consent order jointly agreeing to pay the fine.

The violations include:

• As an illegal inducement to keep customers, the companies offered an unapproved premium holiday – a month of free insurance -- to hundreds of customers. (State law says that insurers must use the rates they file with state regulators.)

• Customers were transferred to new plans with a different company, but were wrongly told that the change was simply a “renewal” of the policy.

• By not telling customers that they had been transferred to a different company, the companies also violated a state law requiring insurers to use their own names.

“I’m all for consumers getting a break on their health insurance premiums,” said Insurance Commissioner Mike Kreidler. “But insurers have to follow the same rules their competitors do. If they say they’re going to charge a particular rate, that’s the rate they should use.”

Our new, much different website

Yesterday (yes, during the Seahawks game, yes, yes) we launched our new, faster, and hopefully much-easier-to-use website.

It's the product of months of testing with a variety of demographics, and the site is designed to be much more intuitive than our former site. On the old site, consumers could complete only 1/3 of the typical tasks we gave them. Now it's over 80 percent, and we're going to keep tweaking things to try to improve that further.

Take a look.

Our website's about to change dramatically. Here's what agents/brokers/insurers need to know

On Sunday, Jan. 13, we'll be rolling out our new agency website. It looks a lot different. We've tested the design on a variety of consumers and industry professionals, we've overhauled the navigational structure, and we've given the whole site a distinctly different look and feel.

There's one thing we're sure of: The site will be much more intuitive and easy to use. Early testing showed that consumers had a 1 in 3 task completion rate on our current site. On the new version, that jumped to 80 percent. And we hope that further fine-tuning boosts it further.

Here's the important part for agents, brokers and companies: The new site immediately splits users into a "consumer" area for laypersons and an "industry professionals" section for the folks that have to interact with our site for licensing, continuing education reporting, tax filing, financial statements, etc.

Update: And it's live! At the top of the home page, you'll see a tab marked "For industry professionals." There you go.

Two of WA's largest nonprofit health insurers have $2.2 billion in surplus

From a press release we sent out today:
OLYMPIA, Wash. – With two of the state’s largest health insurers sitting on surpluses totaling $2.2 billion, Washington’s top insurance regulator wants to use some of that money to lower costs for consumers.

According to the companies’ most recent financial statements, Regence BlueShield’s surplus has grown to $1.05 billion. Premera Blue Cross’ surplus is $1.15 billion.

“These are non-profit companies,” said Insurance Commissioner Mike Kreidler. “It’s hard to square their billion-dollar surpluses with the fact that families are struggling to afford health insurance.”

Kreidler is proposing legislation that would allow his office to consider surpluses when reviewing nonprofit health insurers’ proposed rates. As things stand now, his staff must ignore them.

“As I’ve said before, it’s like trying to ignore an elephant in the room,” Kreidler said. “And the elephant’s getting bigger.”

The surpluses of both Regence and Premera have more than doubled in a decade. In the first nine months of 2012, Regence’s grew by $60 million. Premera’s grew by nearly $182 million.

“It’s important to remember that these are not reserves, which are set aside to pay future claims,” Kreidler said. “These billion-dollar surpluses are in addition to their reserves.”