Commissioner Trinidad Navarro Announces National Improper Marketing of Health Plans Working Group

National Antifraud Task Force takes on new charges to protect consumers

Delaware Insurance Commissioner Trinidad Navarro, Chair of the National Association of Insurance Commissioners’ (NAIC) Antifraud Task Force, announced today the successful creation of the Improper Marketing of Health Plans Working Group, which aims to tackle some of the nation’s most serious consumer-centered health scam efforts and end the siloed approach to addressing the issue.

“Robocalls, search engine advertisements, mailers, and endless telemarketing efforts aim to steal from those seeking comprehensive health insurance. All across the country we have seen scam artists build out networks of communication that center around selling insurance plans that do not offer residents adequate protection. They are merciless in their efforts, and they trick consumers into thinking they will have the coverage they need for their medical care” said Insurance Commissioner Trinidad Navarro. “There’s no need to sugarcoat it – there is deception occurring, and its being directed towards some of the most vulnerable residents. COVID-19 rightfully increased consumer concerns and led more people to seek out affordable insurance – but this concern has been manipulated by scammers. This Working Group will make headway towards ending these efforts to exploit residents.”

The Working Group is a new approach to address concerning increases in consumers being marketed away from ACA-compliant plans to other products that do not offer comprehensive coverage for things like preexisting conditions or hospital visits. Many improperly marketed health plans claim to be compliant, or advertise under look-a-like naming that deliberately creates confusion, such as “Bidencare,” or “Healthcare.com.”

These products may be inadvertently found by consumers searching for legitimate coverage, or on websites where a fraudulent entity has purchased advertising. Often, a consumers’ inquiry can be turned into a request for a quote without consent, and contact information is sold to third parties. The plans use of lead generators and telemarketing is so pervasive that department investigators must purchase dedicated phones for their investigations due to the intrusive, rapid-fire robocalls and text messages that can mount to more than 40 per day from a single webform completion.

The Working Group has meet informally since March 2020 to create a comprehensive conversation on the issue, combining discussions that previously took place in separate health, market conduct, and fraud committees. State and federal level regulators have attended, discussing the latest bad actors and efforts in their jurisdictions, often finding that those efforts are echoed elsewhere. Movement of scams from state to state after regulators shut them down is one of the key reasons that regulators sought approval of the subcommittee and its charges by NAIC’s Executive and Plenary Committees.

“The formation of this Working Group can help stop scams before they start,” shared Delaware Special Deputy Frank Pyle, who has served decades in law enforcement, fraud investigation, and market conduct, and lends his expertise to the new subgroup as Co-Chair. “With greater communication between regulators, those who aim to exploit consumers should be scared. Running from state to state will not be an option.”

The Working Group’s official charges include:

  • Coordinate with regulators, both on a state and federal level, to provide assistance to and guidance on monitoring the improper marketing of health plans, and coordinate appropriate enforcement actions, as needed, with other NAIC Committees, task forces, and working groups.
  • Review existing NAIC Models and Guidelines, including laws and regulations, that address the use of lead generators for sales of health insurance products and identify models and guidelines that need to be updated or developed to address current marketplace activities.

“The Nebraska Department of Insurance is pleased with the official recognition of this group by the NAIC. When we started this group, our goal was to create open communication between all states and the federal government in order to identify and investigate these bad actors in the improper marketing of health plans. Today, that goal is achieved, but the work is just beginning. We will utilize this group to further investigations and prosecutions of those entities and strengthen our laws so we can protect the insurance buying public from these activities,” shared Martin Swanson, Deputy Director of the Nebraska Department of Insurance and Chair of the Working Group.

Following approval of the Working Group, regulators can now formally join the committee. Ad hoc virtual meetings have consisted of contributors from nearly every state, with meetings regularly engaging 100 to 300 participants. The Working Group’s members have already taken multiple administrative actions against entities and schemes identified by the group to protect consumers. Meetings are regulator-only.

The Working Group is part of the National Antifraud Task Force, which works with insurance regulators across the country, as well as local, state, federal and international law enforcement and antifraud organizations. The Task Force provides guidance and resources for insurance departments across the country and in the U.S. Territories, including tracking and analyzing trends in fraud. Numerous subgroups inform the Task Force’s work, including the Antifraud Education Enhancement Working Group and the Antifraud Technology Working Group.

More information about non-compliant health plans


Department Of Insurance Renews National Accreditation

Bureau of Examination, Rehabilitation, and Guaranty (BERG) team from back left: Tracey Weaver, Alisa Pritchard, Danielle Hopp, Matthew Aidala, Kelly West, Laura Hufschmidt, Deputy Commissioner Tanisha Merced, Jasmine Jenkins, Beth Short, Hollylynn Ford, Sherry Wilson, Blake Synnestvedt, and Steven Carlson. From front left, Nicole Brittingham, Charles Santana, Rylynn Brown, Commissioner Trinidad Navarro, Dave Lonchar, Tom Hudson and Adrienne Lupo.

After anticipating accreditation from the National Association of Insurance Commissioners (NAIC) in March at their meeting in Phoenix, Arizona, the Delaware Department of Insurance earned a five-year accreditation from the organization on June 23. The cancellation of the NAIC spring meeting due to COVID-19 led to a months-long delay in confirmation after the department completed on-site reviews in February. NAIC’s Financial Regulation Standards and Accreditation Committee’s intensive assessment consisted of an in-depth review of department regulations, state laws, financial analyses and examinations of companies, personnel practices, licensing, and interaction with domestic insurers.

Insurance Commissioner Trinidad Navarro praised department staff for their performance: “Earning accreditation, along with such impressive feedback, speaks to our team’s hard work and expertise. This was my first accreditation process, but we have been planning for this for years by implementing key processes, working with the General Assembly to pass legislation, setting regulations, and investigating company financials. Our commitment to these sound management principals is representative of our commitment to the public.”

The accreditation renewal signals the department’s performance these specific areas, but also the achievement of widespread consumer protection – ensuring that companies are financially solvent safeguards their ability pay consumer claims when they arise without going under and taking paid premiums with them.

During the process of accreditation, a comprehensive, independent review of the department took place on-site in Delaware, with a focus on standards and processes related to the financial solvency of insurers domiciled in the state. The work of the Bureau of Examination, Rehabilitation, and Guaranty (BERG) team was scrutinized closely, and interviews were conducted with Commissioner Navarro and Deputy Insurance Commissioner Tanisha Merced. During the NAIC meeting on the matter, the committee praised the department’s leadership and the expertise of its staff.

“The decades of experience in our office show a passion for public service that is unmatched across the country, and I couldn’t be more proud of the hard work that went into earning this five-year accreditation,” said Deputy Insurance Commissioner Tanisha Merced.

BERG has many critical roles in the insurance management process, including reviewing applications to do business in Delaware and monitoring the financial operations of 1,800 foreign and 140 domestic insurers licensed in the state.

In total, Delaware-domiciled insurers held approximately $650 billion in assets at year-end 2019. BERG completed 26 financial exams and reviewed an additional 750 projects and form submissions in 2019, completing 485 hours of training as well. The work of BERG preserves a healthy, competitive market, while protecting the public.

More information on accreditation from NAIC


Boomerang Kids Create Insurance Issues

Commissioner Stewart helps Baby Boomers and Gen Xers navigate empty nest reversal

 DOVER, DE — Nearly half of adults in their 40s and 50s have a parent age 65 or older and are either raising a young child or financially supporting an adult child.1 These baby boomers and members of Generation X are feeling the pressure of empty nest reversal from boomerangs – adult children returning home to live – and live-in elders – seniors trading their current home for a loved one’s spare bedroom. In addition to negotiating cooking and cleaning responsibilities, Delaware Insurance Commissioner Karen Weldin Stewart encourages families to make sure everyone understands how a change in address might affect insurance needs.

“American households are experiencing a dramatic shift. Whether it’s aging parents moving in with their grown children or young adults moving back in with mom and dad — today’s households come in all shapes and sizes,” said Stewart. “As family dynamics evolve, the National Association of Insurance Commissioners and I urge consumers to understand the insurance implications of their unique living arrangements.”

Aging Relatives 

For seniors, moving in with an adult child can be uncomfortable. Before the first box is packed, parent and child need to talk about finances, including insurance.

Consider the following questions:

  • Are you current on health, auto and life insurance premium payments?
  • Are you covered by Medicare?
  • Is long-term care insurance something we should look into?
  • What are your end-of-life wishes?

This level of detail will help both parties decide what changes, if any, need to be made to existing coverage. Most importantly, seek to make your loved one feel cared about, not cared for. 

Boomerang Kids 

For the first time in more than 130 years, adults 18-34 years old are more likely to be living with their parents than in any other scenario — including living with a spouse or partner, other family or friends, or alone.2 Experts say hosting an adult child can cost between $8,000 and $18,000 per year.3

Before welcoming an adult child back home, set clear expectations:

  • How will health insurance be covered? Who will pay for what?
  • Will we combine auto policies? How will driving records affect premiums?
  • What belongings are you bringing? Will expensive items such as electronics or sporting equipment increase homeowner’s insurance premiums?

To avoid misunderstandings, the NAIC developed the Welcome Home contract. In addition to outlining basic rules of adult co-habitation, the document places under signature key insurance-related agreements between adult child and parent.

For insurance tips to help modern households of all shapes and sizes including baby boomers, same-sex couples, single parents, millennials and more, visit InsureUonline.org. Delawareans interested in state-specific insurance information can contact the Department of Insurance at 1-800-282-8611 or visit http://www.delawareinsurance.gov/.

 

Sources

1 Pew Research Center

2 Pew Research Center

3 The Wall Street Journal

 

#  #  #

 


Department of Insurance Receives National Accreditation

DOVER, DE  – The Delaware Department of Insurance has successfully completed the requirements for full accreditation from the National Association of Insurance Commissioners. NAIC conducts this review of each state insurance department every five years to ensure that all states have enacted appropriate laws and provided necessary financial oversight in accordance with national financial solvency standards.

 

“The NAIC review process is quite demanding, and I am delighted that we came through it with flying colors,” said Commissioner Karen Weldin Stewart. “I am proud of our directors and all our employees for performing so well under pressure.”

 

The full accreditation program relies on state certification by other states’ regulators, who conduct risk-focused financial surveillance including an on-site examination. The NAIC review team spent a week at DOI’s Dover office, working side-by-side with analysts and supervisors to ensure compliance with national standards. The regulators made sure that the department followed solvency-related model laws, rules and guidelines that have been produced by NAIC members through consensus and collaboration.

 

The accreditation standards require state insurance departments to have adequate statutory and administrative authority to regulate an insurer’s corporate and financial affairs, and to have the necessary resources to carry out that authority. NAIC also requires each state’s insurance department to undergo a desk audit annually.

 

For more information, go to http://www.delawareinsurance.gov/mission.shtml

 

For more information:  Jerry Grant 302-674-7303


Commissioner Karen Weldin Stewart Engages Federal Policymakers – Protecting Consumers and Bolstering Markets are Priority Topics

WASHINGTON, D.C. (May 20, 2013) – Last week, Karen Weldin Stewart met with members of her Congressional delegation to discuss insurance issues affecting the Delaware residents. Commissioner Stewart joined insurance regulators from more than 35 states and territories in Washington, D.C. to meet with representatives from various federal agencies as well as their elected Members of Congress. Coordinated by the National Association of Insurance Commissioners (NAIC), the meetings enhance collaboration between state and federal officials on a national scale. “The intersection of state and federal policy has never been more critical to the insurance sector as it is right now,” said Commissioner Stewart. “My job is to protect consumers, and part of that is to ensure that decisions made in Washington are in the best interest of the citizens of Delaware.”
Regulators were briefed by Secretary Kathleen Sebelius, of the Department of Health and Human Services and Governor Daniel K. Tarullo, of the Federal Reserve Board. Congressman Randy Neugebauer of Texas, chair of the House Financial Services Subcommittee on Housing and Insurance, also addressed the group. Subjects discussed included the impact of Dodd-Frank and Affordable Care Act on states, the agenda of the House Financial Services Committee as well international regulatory developments. Commissioner Stewart was pleased with the outcome of the meetings and stated, “The First State is fortunate to have such dedicated representatives in Washington, D.C., and I look forward to working with them on all matters of insurance that impact the lives of Delawareans.”