New Bulletin Provides Recommendations to Insurers During COVID-19

Insurers asked to waive prior authorization requirements, cease cancellations and nonrenewals due to missed or delayed payments

Insurance Commissioner Trinidad Navarro and the Delaware Department of Insurance today issued a bulletin with recommended actions for the insurance industry. Requests included asking health insurers waive all prior authorization constraints for lab testing and future treatment of COVID-19, and that insurers consider ceasing cancellations or nonrenewals of insurance policies due to nonpayment throughout the duration of the declared Delaware State of Emergency.

“The insurance industry has the opportunity to help tens of thousands of Delaware residents, businesses, and healthcare providers during this state of emergency,” said Insurance Commissioner Trinidad Navarro. “Waiving prior authorization requirements would help the entire healthcare system to run more efficiently and allow providers to focus on patient outcomes rather than paperwork.”

Prior authorization is a process that requires certain tests, medications, or other health services to be pre-approved by an insurance company before a medical provider serves an insured consumer, which can at times result in delays. Should prior-authorization be voluntarily waived by insurers, that would not mean that residents should not be in contact with their primary care provider prior to visiting a COVID-19 testing site.

The bulletin also asked insurance carriers to voluntarily freeze cancellations and nonrenewals of policies that might have otherwise occurred due to delays in payments through the duration of the state of emergency.

“Throughout Delaware’s State of Emergency, many companies have had to close or reduce their business, and employees have been laid off or fired as a result,” Commissioner Navarro explained. “After hearing from businesses and residents who were concerned about the choices they will have to make with limited finances, we ask insurers to help alleviate some of that stress and ensure that residents and business owners in this difficult situation can have the peace of mind that insurance provides throughout the duration of the emergency.”

Business interruption coverage will vary policy to policy, and some business interruption coverage may explicitly exclude viral infections. Companies are urged to review their related insurance policies and contact their insurance company with questions about coverage. Hospitality small businesses and nonprofits may be able to apply for no-interest loans from the Division of Small Business Hospitality Emergency Loan Program (HELP). Organizations can receive a $10,000 maximum loan per month for rent, utilities, and other unavoidable, non-personnel bills.

On March 18, Governor Carney’s updated State of Emergency Declaration waived certain telemedicine regulations to expand access to these services. The Governor clarified that residents do not need to see a provider in-person before receiving telemedicine services, and that if a Delaware resident is out-of-state, they can still receive telemedicine services. To increase availability of these services, out-of-state providers who are licensed to provide telemedicine in other jurisdictions will also be able to serve Delaware residents through the duration of the emergency declaration. Telehealth and telemedicine can be provided via phone, webcam, facetime, and a myriad of other easily accessible options, as the department recently reminded insurers via bulletin.

Department of Insurance March 20 Bulletin

National Association of Insurance Commissioner’s COVID-19 and Insurance Brief

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Delaware Medicare Assistance Bureau to Hold Public Meetings

Newly Medicare-eligible residents encouraged to attend Welcome to Medicare: 2020

The Delaware Medicare Assistance Bureau (DMAB), a division of the Department of Insurance, has announced a series of Welcome to Medicare: 2020 events taking place throughout the year. More than a dozen public learning sessions will take place across the state. Participants will learn about various parts of Medicare and their benefits, supplemental insurance policies, Medicare Advantage plans, Medicare prescription drug coverage, and details on signing up.

“Bringing information about Medicare to residents in convenient locations throughout the state helps us to increase understanding of the complex healthcare system and encourage the community to reach out to our team for assistance when needed,” said Insurance Commissioner Trinidad Navarro.

Upcoming events include:

  • Wednesday, March 4 at 10:00AM, Delaware Department of Insurance, 1351 W. North Street, Dover*
  • Wednesday, March 11 at 10:30AM, Bear Library, 101 Governors Place, Bear*
  • Wednesday, March 18 at 10:00AM, Rockland Place, 1519 Rockland Road, Wilmington*
  • Thursday, March 26 at 10:00AM, CHEER Community Center, 20520 Sandhill Road, Georgetown

*Commissioner Navarro will attend.
Residents who plan to attend are encouraged to RSVP by calling DMAB at (302) 674-7364 or via Eventbrite. Press should RSVP to Christina.Haas@delaware.gov.

Additional events are slated to take place throughout the year and can be found on the DMAB calendar. Details of future events may be subject to change.

“These seminars are geared towards new and soon-to-be Medicare beneficiaries who can meet with our professional staff and ask questions,” said Lakia Turner, DMAB Director. DMAB encourages residents turning 65 this year and those newly eligible for Medicare due to a disability to attend one of the Welcome to Medicare: 2020 sessions. You do not have to be retired or without health insurance to apply for Medicare.

While the annual open enrollment for Medicare takes place October 15 to December 7, residents are eligible to enroll up to three months before the month a person turns 65 and up to three months after their birth month. Applying early helps residents to avoid possible financial penalties, avoid gaps in coverage, and reduce wait time for response from Medicare and DMAB, which experience very high volumes of contact during annual open enrollment.

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1(800) 336-7364 or (302) 674-7364 to set up a free confidential counseling session with a trained volunteer at a convenient site throughout the state.

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Companies Save Over $4 Million From Reduced Workers’ Compensation Rates

Workplace Safety Program saves $7.6 million for participants

The Delaware Department of Insurance has analyzed new filings from the state’s top writers of workers’ compensation insurance after announcing the third consecutive year of decreased rates in November. The top writers represent nearly 10,000 companies that hold policies within the state. Policyholders of these companies will see a total premium impact of more than $3.7 million, and when the entire writer universe is included, the Department expects realized savings of more than $4 million.

“Delaware businesses large and small are seeing decreased premiums from the third consecutive year of workers’ compensation rate decreases, and that benefits everyone,” said Commissioner Trinidad Navarro. “We will continue to work to make sure that Delaware has an inviting atmosphere for businesses and safe environments for employees.”

Technology Insurance Company, Inc.’s filing shows that their reduction will save policyholders a total of $845,594. Wesco Insurance Company’s total premium change of $651,721 takes the second-place spot for savings, while eight other top insurers are reporting six-digit premium impacts. Of the state’s top writers, American Zurich Insurance Company filed with the largest overall percentage rate impact, a decrease of 17.50%, with five other companies posting double-digit drops.

While realized savings will vary business to business, more discounts can be accessed through the Workplace Safety Program offered by the department. In 2019, 1,119 companies participated in the program, saving a combined $7.6 million through safety credits on their $72.9 million employer premium total – a savings of more than 10%. Businesses can earn discounts of up to 19% by providing and maintaining a safe place to work. More information on this program is available at insurance.delaware.gov/services/workplacesafety.

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Commissioner Trinidad Navarro Appointed Chair of National Antifraud Task Force

Delaware Commissioner selected from leaders across the country to head important consumer-focused committee

Delaware Insurance Commissioner Trinidad Navarro was appointed Chair of the National Association of Insurance Commissioner’s Antifraud Task Force this week. Commissioner Navarro previously served as Vice-Chair of the committee, and served in law enforcement for much of his career before his election to Insurance Commissioner in 2016. The committee’s work takes on an inclusive consumer protection approach that encompasses identification and reduction of criminal efforts both by and against consumers.

“From my experience as a law enforcement officer to today, I have always prioritized the protection of our residents, and that means being proactive as well as responsive,” said Commissioner Navarro. “Fraud impacts everyone – even if you aren’t the target of a scheme. When an organization takes advantage of a consumer, it hurts the public trust as well as the customer’s wallet. When a resident commits fraud and takes money from an insurer, the companies make themselves whole by increasing costs on policyholders, even though it’s not their fault. Solutions to the problem are important, but we need to focus on stopping fraud before it starts.”

The Task Force works with insurance regulators across the country, as well as local, state, federal and international law enforcement and antifraud organizations. As Chair, Commissioner Navarro will work to provide guidance and resources for insurance departments across the country and in the U.S. Territories, including tracking and analyzing trends in fraud, one of which is the rapidly changing cybersecurity environment.

“Methods of fraud are always evolving, and with more of our personal data being shared digitally than ever, there is no more important time to place serious emphasis on fraud prevention than now,” said Commissioner Navarro. “To be successful, we have to be clear that a vital piece of protecting our policyholders lies in protecting their data.”

Data, its collection, use, and misuse, has quickly risen as a key issue within the insurance community and the public at large. In 2019, multiple data breaches at insurers impacted more than 100,000 Delaware residents. Commissioner Navarro, with the help of the General Assembly, worked to make sure that Delaware passed the Insurance Data Security Act following these breaches, one of the first states to do so.

Protecting residents and policyholders is central to the Commissioner’s administration. The Department of Insurance Fraud Bureau investigates consumer complaints and inquiries, polices the conduct of carriers, agents, and brokers doing business in Delaware, and prosecutes insurance fraud amongst other duties. From 2015 to date, the Bureau has seen an approximate 23% increase in reports. The department has brought forward 37 civil cases, 54 criminal charges, 18 criminal arrests, and more than $47,400 in civil penalties since 2018. In the same time period, 1,100 fraud tips and referrals have been provided to the office.

The Delaware Department of Insurance Fraud Division can be reached toll free at (800) 632-5154, or (302) 672-7350, or by emailing fraud@delaware.gov. Reporting known or suspected fraud is free of charge, and can be done confidentially.

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Department of Insurance Recovers Nearly $700,000 in Fines through Company Compliance Exams

Investigations result in discovery and correction of issues impacting consumers

The Delaware Department of Insurance’s Market Conduct Examinations resulted in the receipt of nearly $700,000 in fines during 2019 from more than a dozen companies found to violate the Insurance Code or other related regulations. The fines are contributed to the General Fund, providing funding for state programs and services and reducing taxpayer burden.

“As the state’s largest consumer protection organization, the Department of Insurance takes company examinations very seriously. We don’t just fine a company and move on, we work to ensure that corrective action is completed to improve products and consumer experience while reducing future infractions.” said Commissioner Trinidad Navarro.

The department works to provide remediation requirements to ensure compliance with the Insurance Code and related regulations for violations such as excessive charges, failure to distribute required notices, improper licensing, failure to pay claims in a timely fashion, and other issues impacting consumers. Over 20 exams were completed by the department in 2019, and more than 55 are open or underway.

“It’s important that we emphasize that not all companies being fined are deliberately acting in bad faith,” said Deputy Commissioner Tanisha Merced. “Many companies are unaware of their violations before our team investigates, and act quickly to correct their actions and safeguard consumers.”

For example, LifeShield, whose financial penalty is pending, took immediate action upon release of the company’s examination, implementing positive changes for their customers, and their company as a whole. After thorough consideration, the company decided to cease issuance of new short-term medical insurance policies nationwide and engage a new administrator. It has also hired additional staff to mitigate the risk of future issues. While these actions will cost the company more than $100,000, there will be no impact to consumer premium costs.

“The Department of Insurance’s thorough review process shows how much they care for the wellbeing of Delaware residents, and we hope that our rapid response to their findings does the same,” LifeShield’s president remarked. “Compliance with laws and regulations is of critical importance to us, as is maintaining best practice as we seek to provide the products and services our customers want and need.”

The Department’s examiners conduct investigations of organizations and agents and participate in multi-state enforcement efforts to ensure the consumer safety of residents nationwide. While exams are conducted regularly, the Department also examines companies based on consumer complaints. When issues are discovered through the exam process, positive correction action, fines, and suspension of licenses can occur. In 2018, the Department collected $950,000 in fines. In some cases, where a company’s violations impacted individual customers, the Department will require companies to compensate residents directly.

The Department’s Market Conduct Enforcement Actions and Fines are available online as are all complete and final Market Conduct Examination Reports.

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