Wednesday, December 21, 2016

Does your homeowner’s insurance cover theft from your storage unit? The answer might surprise you.

There’s a reality show on A&E about people who bid – sight unseen – 
on the contents of abandoned storage units. Yep, that's a thing.  

Self-storage is a booming business these days, according to Bloomberg. New warehouses are being built at a record pace to store Americans’ extra belongings. Nearly 10 percent of Americans rented a storage unit in 2015, according to Sparefoot.com, a storage unit comparison site. There are even luxury storage units to store your vintage car collection or to give you another space to hang out in.

Before you rent a storage unit, luxury or otherwise, you should be thinking about what happens if your belongings are damaged or stolen.

Generally, if your homeowner or renter policy covers contents that you store offsite--say, at a storage unit--they limit the coverage to a certain dollar amount, and they do not cover theft from the storage unit. That’s really important information to know before you fill a storage unit full of your belongings.

It may not be a good idea to store items of high value, like art, antiques, jewelry, collectibles, furniture or rugs, in a storage unit. Unless you have had the items appraised and insured for those amounts, it’s likely the dollar limits on your coverage will not be enough to pay to replace your possessions if they are damaged.

If you need to store valuables of that nature somewhere other than your home, talk to your agent or insurance company.

Most storage unit businesses offer their own insurance policies, but are they a good deal? That depends on if you already have coverage through a renter’s or homeowner policy. If not, read the policy offered by the storage company. What does it cover? What does it not cover? What is the dollar limit for the coverage? Is there a time limit for the coverage? What is the deductible on the policy?

Storage businesses that sell these policies are required to be licensed insurance producers. That means if you have trouble, you can file a complaint with us.

Here are some tips if you rent a storage unit:
  • Read your policy or talk to your agent or insurer about covering any contents you are storing anywhere other than your residence
  • If your renter’s or homeowner policy does cover offsite storage, there may be limits on:
    • The dollar amount of coverage.
    • How long things in storage will be covered – think temporary, not long-term or indefinite storage.
    • The types of losses that will be covered – theft likely is not covered.
  • Create an inventory of what you are keeping in storage. It can be as basic as taking photos with your phone, or you can download an app from the National Association of Insurance Commissioners, your insurer, or some other app. Or, you can make a list that you store somewhere safe. 
Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Friday, December 16, 2016

Deadline for Jan. 1 coverage through Exchange extended to Dec. 23

Washington consumers can sign up for health and medical plans through Washington Healthplanfinder until 11:59 p.m. on Dec. 23 for coverage that starts Jan. 1.
  • Online: 24/7 at wahealthplanfinder.org.
  • By phone: 1-855-WAFINDER (1-855-923-4633). Normal hours are 8 a.m. to 8 p.m. every weekday. Extended hours:
    • Dec. 15 from 8 a.m. to 10 p.m.
    • Dec. 17 from 10 a.m. to 2 p.m.
    • Dec. 18 from 10 a.m. to 2 p.m.
    • Dec. 23 from 8 a.m. to midnight.
  • Find help in person with a navigator or a broker.
If you don’t qualify for a subsidy, you can purchase a plan on the individual market directly from an agent or broker. The deadline for Jan. 1 coverage varies by plan.
If you miss the Dec. 23 deadline, you can still get coverage. Open enrollment runs through Jan. 31 for coverage that will likely start March 1. 

Wednesday, December 14, 2016

Direct practices lose 3 percent of patients statewide

Each year, the OIC reports to the Legislature on the status of direct health care practices in Washington state. In a direct health care practice, a health care provider charges a patient a set monthly fee for all primary care services provided in the office, regardless of the number of visits. No insurance plan is involved, although patients may have separate insurance coverage for more costly medical services. Direct practices are sometimes marketed as “retainer” or “concierge” practices.

The December 2016 report contains data from July 1, 2014 through June 30, 2016, two fiscal years’ worth of information.

Some highlights from this year’s report, as of June 30:
  • There were approximately 11,272 direct-practice patients in Washington, a 3 percent drop from fiscal year 2015. That figure represents .016 percent of the state’s population. 
  • There were 30 practices in the state. Two new practices opened in Battle Ground and Edmonds. Five clinics in Seattle, Richland, Spokane and Colville reported they no longer participate in direct practices. 
  • Monthly fees at direct practices ranged from $25 to more than $1,082. The average monthly fee weighted by the number of patients was $154.65, a 15 percent increase from fiscal year 2015.
  • The OIC received no consumer complaints regarding direct patient practices. 
The Affordable Care Act requires consumers to purchase a health insurance plan or pay a tax penalty. Direct practices do not meet the requirements of the ACA and therefore do not qualify as a health insurance plan. That may explain why the number of consumers who purchase direct practice plans has dropped since 2014. However, the incoming federal administration has vowed to alter the ACA, which may drive more consumers to direct practices for primary care. At this point, it’s too soon to tell.

View the full report.

Wednesday, December 7, 2016

OIC has saved auto insurance consumers $32 million since 2010

The Office of the Insurance Commissioner's rate decisions have saved auto insurance consumers more than $32 million in premiums since 2010.

Personal auto insurers are required to file their proposed rates and rating plans with our office whenever there's a rate change. Our actuaries review the proposed rates, rating plans, and supporting documentation to be sure that the rates are not excessive, inadequate or unfair. 

From 2010 through 2015, the rates we approved for the top 20 personal auto insurers in Washington saved consumers more than $32 million in premiums. 
  • 2015: $6.2 million
  • 2014: $6.2 million 
  • 2013: $8.9 million 
  • 2012: $5.6 million 
  • 2011: $2.7 million 
  • 2010: $2.7 million 
Read more about auto insurance in Washington state.

Wednesday, November 16, 2016

Before you wax your skis, brush up on winter activities and your insurance

Snow is starting to fall in Washington state's mountains and in some lower elevations. Before you hit the slopes or backcountry, take a moment to consider insurance implications for winter recreation. 
Snoeshowing at Lake Wenatchee Sno-Park,
courtesy Washington State Parks


Ski and snowboard equipment

Winter sports gear is not cheap, and replacing it in the event of damage or theft can put a crimp in your winter fun. 

Generally, equipment you own will be covered up to a specific amount by your homeowner or renter policy. Check the limit in your policy and decide if that will be enough to replace damaged or stolen equipment. Remember to factor in your deductible. 

If you think you need more coverage, ask your insurance agent about a rider that might allow you to increase coverage (and your premium) for specified personal property.

Snowmobiles

Snowmobiles may be covered under homeowner policies when they are used for maintenance of your insured property. They likely aren’t covered by a renter or auto insurance policy. If you want to be covered, talk to your insurance agent about a snowmobile policy. If you take your snowmobile off your property, carry proof of insurance.

If you are traveling and plan to rent a snowmobile, you may consider rental insurance to cover damage to the snowmobile. Your home or renter insurance might provide coverage for your personal liability while operating a rental snowmobile. Read the contract carefully before signing and ask questions of the agent selling you the coverage if you don’t understand the limits or conditions of coverage.

Travel insurance

Traveling in the winter can be full of surprises. Even if you’re traveling somewhere warm, bad weather en route to your destination can cause delays or cancellations. Travel sites and airlines offer travel insurance when you book your trip. Travel insurance can cover everything from lost luggage to delays and cancellations, but make sure you closely read any policy you consider. Learn more about travel insurance.

Health insurance

If you are out of town without access to your physician or local health care center, review your emergency medical treatment requirements:
  • Are you required to seek medical treatment at a certain hospital or urgent care center that is in your insurer’s network?
  • Will you have a copay?
  • If you need to fill a prescription, do you have to go to a certain pharmacy?
  • If you are traveling in an area that is out of your network, what is the insurer’s requirements for reimbursing your expenses? 
Make a list of these details and carry your insurance card with you when you travel.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Monday, October 31, 2016

What's an umbrella policy?


Commissioner Kreidler recently participated in a Facebook live Q&A with KIRO TV reporter Jesse Jones, where viewers submitted their insurance questions. Jesse and Commissioner Kreidler got lots of great questions, including a couple about umbrella policies.

Umbrella policy is one of those insurance terms that a lot of people have heard but many aren’t quite sure what it means. Simply put, an umbrella policy extends your liability coverage beyond what is covered by your homeowner and auto policies. Umbrella policies pay only after you exhaust the liability limit of your homeowner or auto policies, which are referred to as underlying policies.

Here’s an example: Your dog bites a visitor in your home. The visitor sues you for damages and wins a $1 million award against you. Your homeowner’s insurance policy will only pay up to the $300,000 liability coverage limit listed in your home policy. If you have a $1 million umbrella policy, it will pay the remaining $700,000, minus any deductible. According to the Insurance Information Institute, a $1 million umbrella policy costs $150-$300 per year – that’s about $13 to $25 per month in premiums.

If you are interested in buying an umbrella policy, you should contact your insurance agent or company.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Tuesday, October 18, 2016

Fight health care fraud: guard your Medicare number!

Medicare open enrollment is here (October 15 to December 7), which means fraudsters and identity thieves will increase their efforts to get and abuse Medicare numbers from people.

Fortunately, there are many measures you can take to fight health care fraud:
  • Guard your Medicare number. Protect it the same way you do for your credit card numbers. Medicare will never contact you for your Medicare number or other personal information. Don’t share your Medicare number or other personal information with anyone who contacts you by phone, email, or by approaching you in person, unless you’ve given them permission in advance. 
  • Don’t ever let anyone borrow or pay to use your Medicare number.
  • If you’re looking to enroll in a Medicare plan, be suspicious of anyone who pressures you to act now for the best deal. There are no “early bird discounts” or “limited time offers.” Any offer that sounds too good to be true probably is.
  • Be skeptical of offers for free gifts and free medical services. A common ploy of identity thieves is to say they can send you your free gift right away—they just need your Medicare number to confirm. Decline politely but firmly. 
  • Do your part to protect your friends and neighbors: remind them to guard their Medicare numbers, too.
  • Check your Medicare Summary Notice (MSN)–which gives you information on services submitted under your Medicare number–to make sure you and Medicare are only being charged for services you actually received. While the MSN is only mailed to you every 3 months, you can access your Original Medicare claims at any time on MyMedicare.gov. You’ll usually be able to see a claim within 24 hours after Medicare processes it.
You can report suspected fraud by calling 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048. 

To learn more about how to protect yourself from health care fraud, visit Medicare.gov/fraud, or contact our state’s local Senior Medicare Patrol (SMP), which is the OIC's Statewide Health Insurance Benefits Advisors (SHIBA) program.

Tuesday, October 4, 2016

Outdoor, indoor features that you think are covered may surprise you

Many consumers think their homeowner policy covers everything they own, both inside and on their premises outside of their home. However, you should be aware that most homeowner policies do not cover everything you own. 

Creative Commons Backyard Pool by
Alvin Smith is licensed under CC BY 2.0 
Here are some common features that people may think is covered by a standard homeowner policy. 

Outside your home:
  • Retaining walls
  • Pools that sit above and below ground
  • Gazebos
  • Spas/hot tubs 
  • Rockeries and other landscaped areas
  • Driveways
  • Sidewalks
  • Foundations
  • Fences
  • Pump houses
  • Garden sheds
  • Greenhouses 
  • Playground equipment
Inside your home:
  • Collectibles
  • Money
  • Jewelry
  • Artwork 
  • Musical instruments
Talk to your agent or broker to find out if items like these are covered.  If coverage isn’t available, you’ll want to maintain and safeguard the property at your own cost, and do the best you can to keep it from damage. It’s a good idea to have a discussion about these types of property before you buy a policy.

Read more about homeowner's insurance on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Wednesday, September 7, 2016

Areas hit by wildfire are at risk for flood damage – are you covered?


We are reaching the end of a “normal” fire season, thanks to this year’s snowpack and spring rain. While that is good news, the more than 15,000 acres that have burned are at higher risk for flash flooding and mudflows. Vegetation absorbs water and reduces runoff that causes mudflows. Even areas that are not historically prone to flood are at risk due to the landscape changes caused by fire. Flood risk remains high until vegetation grows back, up to five years after the fire. That means that the million-plus acres that burned the last two summers are still at higher risk for flooding and mudflows. 
Photo courtesy Washington state Department of Natural Resources

Homeowner’s and commercial insurance policies do not cover flood or mudflow damage. Consumers who want to protect their property must purchase a flood policy, available only through the National Flood Insurance Program (NFIP). Most properties qualify for flood insurance, as long as it is located in a community that participates in the program.

Typically, there is a 30-day waiting period before your flood insurance policy takes effect. This time of year is a good time to do some research into flood insurance, before the fall and winter weather that can bring floods start in earnest.

More information:
Questions? Get more information about flood insurance or contact our consumer advocates.

Tuesday, August 9, 2016

Consumers should be wary of short-term health plans


Consumers looking for health insurance outside of the annual open enrollment period should be wary of short term health plans. These plans may be marketed as alternatives to Affordable Care Act (ACA) health insurance, but they could leave you without adequate coverage and facing financial penalties at tax time. 

Originally, short-term health plans were sold as a stop-gap measure until you could get real major medical coverage. After the ACA kicked in, people had many other options for coverage, but these limited plans were still being marketed to consumers as a viable alternative. However, short-term  plans do not count as 'minimum essential coverage' under the ACA - meaning you'll have to pay a tax penalty. They also do not cover the 10 essential health benefits, can limit your annual benefits to $100,000 or less, and deny you coverage for any pre-existing conditions. 

These policies are sold year-round, unlike ACA-plans that must be purchased during the annual open enrollment period, unless you qualify for a special enrollment. Some states allow for coverage to last up to a year and policies can be renewed. This effectively takes people out of the insurance pool that the ACA was designed to expand, leading to increased costs for everyone. 

In an effort to bring the limited short-term health plans back to their original purpose and to protect consumers, the federal government is proposing a regulation to limit the duration of these policies to three months and increase consumer awareness of their limitations.

Insurance Commissioner Kreidler agrees with this effort and sent a letter yesterday in support of the new regulation.

Friday, August 5, 2016

Learn more about Medicare at free event Aug. 6 in Kent

Are you new to Medicare? The Office of the Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) will be at the Kent Senior Activity Center from 10 a.m. to 2 p.m. on Saturday, Aug. 6

You will learn about:
  • Medicare parts A, B, C and D
  • Your Medicare benefits and options
  • How to get help paying for Medicare if you qualify
Find registration and parking information for this event.

Other resources:
Do you have Medicare questions? Call 1-800-562-6900.

Monday, August 1, 2016

Breastfeeding and insurance: learn your rights

This week is World Breastfeeding Week, when people from all over the world celebrate breastfeeding. It may surprise you to hear that there’s a connection between breastfeeding and insurance.

The Affordable Care Act requires most health insurance plans to provide breastfeeding and lactation support, equipment and counseling to women during and after pregnancy as long as they are breastfeeding.

  • While insurers must cover breast pumps, plan vary by what type of pump they cover, if they help pay for a rental or purchased pump, and if the pump needs to be pre-authorized. Contact your insurance company to find out what your plan covers. 
  • Insurance plans must also cover lactation support for mothers and babies who are having trouble with breastfeeding or pumping. 

According to womenshealth.gov, babies who are breastfed have lower risks of many health conditions including asthma, ear infections, SIDS, type 2 diabetes and respiratory infections. Breastfeeding also benefits mothers’ health, promotes infant-mother bonding and is more economical than buying formula.

Find more information:


Read more about women’s health insurance rights on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Friday, July 8, 2016

Consider your options when you lose your employer-sponsored insurance

Finding out you are being laid off is stressful, and in addition to that, you have to make important decisions about health insurance that can save you—or cost you—thousands of dollars at a critical time. It’s important to consider all your options when deciding between COBRA or buying your own plan.

What is COBRA? COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, which is a federal law that allows you and any of your immediate family members to stay on your employer’s health plan under certain circumstances :
  • You lose or quit your job 
  • You get a divorce 
  • The employee dies 
  • You are no longer covered as a dependent due to your age
Only employers with 20 or more workers in the previous year are required to offer COBRA coverage. State and local governments fall under COBRA, but the federal government and certain religious organizations do not.

COBRA can be expensive. People who choose COBRA coverage must pay the entire premium, including the portion previously paid by the employer, plus a 2 percent administrative fee. Be warned, if you enroll in COBRA and later on want to switch to a health plan directly to an insurance company or through the Washington Healthplanfinder, you will have to wait until the next open enrollment period if you don’t qualify for a special enrollment.

Options other than COBRA
Before you decide to go with COBRA, find out if you can buy a health plan through the Washington Healthplanfinder and receive a subsidy to help pay your insurance premiums. You can also purchase coverage directly from an insurance company, broker or agent if you don’t qualify for any subsidies.

If you choose a health insurance plan, you likely will be responsible for a full yearly deductible. Generally, health insurance deductibles are not prorated for partial-year enrollees, no matter how few months are left in the plan year. Individual or family qualified health plans operate on a calendar year, from January through December. There is no way to transfer the money you spent toward another plan’s deductible when you switch plans mid-year.

Read more about losing your health insurance on our website. Questions? Contact our consumer advocates online or at 1-800-562-6900.

For COBRA- specific laws and questions, contact:

U.S. Dept. of Labor, Employee Benefits Security Administration
Seattle District Office
300 Fifth Ave., Ste. 1110
Seattle, WA 98104
206-757-6781

Tuesday, July 5, 2016

Learn more about Medicare at free event July 9 in Seattle

Are you new to Medicare? The Office of the Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) will be at the Seattle Central Library from 11 a.m. to 1:30 p.m. on Saturday, July 9.

You will learn about:
Medicare parts A, B, C and D
Your Medicare benefits and options
How to get help paying for Medicare if you qualify

Find registration and parking information for this event.

Other resources:
Find out more events on the SHIBA calendar.
Read more about SHIBA and how it can help you.
Do you have Medicare questions? Call 1-800-562-6900.

Thursday, June 23, 2016

Kreidler speaks to consumers in Shoreline about Medicare

Attendees to a Medicare birthday event on Saturday morning got to hear Insurance Commissioner Kreidler talk about why Medicare is important and what SHIBA does for Washington consumers. 
Commissioner Kreidler and Judy Ellis, SHIBA volunteer  with Sound Generations in Shoreline
Commissioner Kreidler and Judy Ellis, SHIBA volunteer
with Sound Generations in Shoreline 

SHIBA stands for Statewide Health Insurance Benefits Advisors. It’s a statewide network of nearly 400 highly trained volunteers who have been helping seniors and others understand their health insurance options for more than 35 years in Washington state. Washington was the first state in the nation to establish a SHIBA program, before the federal government offered assistance in reaching out the consumers who are or are about to be enrolled in Medicare.

Medicare provides health coverage for nearly 45 million Americans who are age 65 and older, and for 7 million younger adults with permanent disabilities. Medicare has been in existence for 51 years, which really isn’t that long ago. 
Shoreline Medicare event attendees
Attendees at the Medicare birthday event 
on June 18 in Shoreline 
Commissioner Kreidler recalled for the attendees a time before Medicare existed when his grandmother had to move in with his parents because she was ill and didn’t have health coverage. Her medical bills prohibited her from living on her own. If Medicare had existed, it would have provided a lifeline for her to have access to the health care she needed.

SHIBA offers free, unbiased assistance with health care choices, including Medicare, to more than 100,000 Washington residents each year. You can find more SHIBA events around the state at http://bit.ly/SHIBAevents.

Friday, May 20, 2016

Department of Health looking for experts on patient out-of-pocket costs

During the last legislative session, Washington's Department of Health was charged with convening a task force on patient out-of-pocket costs. Senate Bill 6569 directed the task force to focus on two key areas:

1. Evaluating factors that contribute to out-of-pocket costs for patients and to the state.
2. Considering the health and economic impact of out-of-pocket patient costs to patients and to the state.

If you have particular expertise in this area and represent patient groups, insurance companies, pharmacists, pharmacy benefit managers, unions, business associations, or biotechnology representatives please consider joining this important task force.

Members of the task force will be asked to attend no more than four half-day, in-person meetings in the Puget Sound region between July 1 and Dec. 1, 2016.

To be considered for the task force, please respond to DOH Secretary John Weisman's letter by COB May 24, 2016 via email to C4PA@doh.wa.gov

Friday, May 13, 2016

Join telephone town hall to get answers to your questions about Social Security, Medicare

Join the King County Library System (KCLS) for a live telephone town hall meeting with specialists from the Social Security Administration and Washington Statewide Health Insurance Benefits Advisors (SHIBA)This free event will take place on Wednesday, May 18 from 10:30 a.m. - 11:30 a.m. 

Topics will include how to make the most of your Social Security benefits, health insurance and Medicare coverage. 

A telephone town hall is like a radio talk show, but you simply listen on your phone! Experts will take live questions from the audience. 

On the day of the telephone town hall you will receive a telephone call from the library between 10:25 a.m. and 10:40 a.m. Please answer the call and stay on the line, as it could take a few minutes before the call starts. You will hear some introductory remarks and then be connected.

Be sure to include your telephone number in the registration to receive a phone call! 

Brought to you by the Social Security Administration, Washington State Office of the Insurance Commissioner, the KCLS Foundation and AARP.

Register here for the telephone town hall. 

Tuesday, May 3, 2016

Need help with Medicare? Events being held around the state through summer

Consumers get help at a SHIBA event in Washington state
The Office of the Insurance Commissioner has a program that helps Washingtonians sign up for Medicare and other health care programs. It's called Statewide Health Insurance Benefits Advisors (SHIBA) and it offers free, unbiased and confidential assistance with Medicare and other health care choices.

SHIBA can help you:
  • Understand your health care coverage options and rights.
  • Determine your general eligibility for health care coverage programs.
  • Evaluate and compare health insurance plans.
SHIBA holds events around the state to help people who are just getting signed up for Medicare--called birthday events--and information sessions for people who are new to Medicare or simply have questions about it.

Upcoming events:
  • May 5: Lacey Community Center 
  • June 18: Shoreline Conference Center
  • June 23: Community Cultural Center of Tonasket 
  • June 24: Grand Coulee Senior Center 
  • July 9: Seattle Central Library
  • Aug. 6: Kent Senior Activity Center
Find out more about these events and other events on the SHIBA calendar

Read more about SHIBA and how it can help you. Do you have Medicare questions? Call 1-800-562-6900.

Friday, April 22, 2016

Gov. Inslee honors Cowlitz County SHIBA volunteer

From right: SHIBA Volunteer Coordinator Terri Osbourne,
volunteer Elouise Maahs and volunteer coordinator Sarah Clark
Congratulations to SHIBA Volunteer Elouise Maahs for receiving the Governor’s Volunteer Service Award in the health care category.

Elouise, who volunteers for SHIBA with Lower Columbia Community Action Council in Cowlitz County, was honored on April 11 at the Governor’s mansion, where she receive her award from Gov. Jay Inslee. A SHIBA volunteer since 2008, Elouise serves as a data specialist, where she records and processes client cases. In the past year she’s processed over 6,000 client cases. Eloise was nominated for her dedication and commitment to ensuring that seniors and people disabilities have their Medicare issues, complaints and appeals processed in a timely manner.

In addition to meeting the Governor on April 11, Eloise also stopped by the Office of the Insurance Commissioner/SHIBA and had the opportunity to receive congratulations personally from Insurance Commissioner Mike Kreidler.

Read more about SHIBA, which provides free, unbiased, and confidential assistance with Medicare and health care choices.

Friday, April 15, 2016

If I switch health plans halfway through the year, can my deductible be transferred or prorated?

Insurance companies are not required to credit money consumers already paid in cost sharing from prior plans but sometimes they do for employer-sponsored replacement policies. If you lose employer-sponsored insurance in the middle of the year, and you've already met your deductible the year, you may want to consider COBRA for the rest of the calendar year and get an individual or family plan during open enrollment.

If COBRA is not an option, you likely will be responsible for a new, full deductible. Generally, health insurance deductibles are not prorated for partial-year enrollees, no matter how few months are left in the plan year. Individual or family qualified health plans run from January through December. There is no way to recoup the additional money you may spend towards your health insurance deductible when you switch plans mid-year after paying the first plan’s deductible. However, sometimes medical and dental expenses like deductibles, co-pays and coinsurance can be deducted from your federal taxes, which will lower the taxes you pay that year.

When you choose a health insurance plan, it will be important to understand what your insurance company covers without requiring you to pay your deductible. Then you can decide whether you want a plan with lower monthly premiums and higher deductible or one with a higher monthly premium and a lower deductible. Many health plans cover some services such as emergency room or routine doctor visits such as preventive care without requiring you to pay toward your deductible. 

Deductible amounts vary by plan and can be separated into individual or family deductibles. Some health plans also cover other benefits like doctor visits and prescription drugs even if you haven’t met your deductible. 

Your best course of action is to read your policy and contact the insurance company to find out more about the health plan’s benefits. 

If you have questions about your plan or your rights as a consumer, you can contact our consumer advocates online or at 1-800-562-6900.

Friday, March 11, 2016

Most colonoscopies should be covered 100% by your insurance

The Affordable Care Act (ACA) requires that insurance companies cover 100 percent of the cost of preventive colonoscopies for adults older than age 50. Of course you’ll need to see a provider who is part of your plan’s provider network.

However, despite this new reform, we do hear consumers who’ve had a routine preventive colonoscopy only to have their insurer process their claim as “cost-shared diagnostic care,” which is subject to their annual deductible and coinsurance.

We also sometimes hear from consumers who receive a substantial surgical bill when a polyp is discovered and removed during a preventive colonoscopy. The Affordable Care Act and other federal guidelines protect consumers from extra charges for polyp removal during a preventive colonoscopy. If you receive a bill for polyp removal, you should file a complaint with us and we’ll help you get those charges reversed.

If you are diagnosed with colon cancer, any previous related symptoms may result in your provider processing the cancer screening as diagnostic and not preventive. In that case, your treatment would not be covered as preventive care and you’ll likely have additional costs. If you have any questions, check with your doctor.

Be aware that if a procedure or treatment is not a recommended preventive service, it may be subject to your plan’s deductible and cost-sharing. Also, if a medical recommendation or guideline regarding a preventive service does not specify the frequency, method, treatment, or setting for that service, your insurer may limit your coverage.
Here are some important tips to remember:

Thursday, March 10, 2016

Protect yourself from Medicare fraud

The Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) program is Washington state’s Senior Medicare Patrol (SMP). A federally funded and volunteer-based program, SHIBA/SMP volunteers provide education on how to prevent, detect and report Medicare fraud.

Medicare is the national health care plan for all U.S. citizens age 65 and older. It also covers people younger than age 65 who receive Social Security Disability Income and people who are diagnosed with certain medical conditions.

In Washington state, SHIBA/SMP volunteers help protect seniors and fight health care fraud, leaving more money in the system for everyone. Our state’s volunteers educate beneficiaries on how to avoid becoming victims of health care fraud, and how to report abuse or fraud, related to their Medicare benefits.

We all pay a price for Medicare fraud, waste and abuse, which contributes significantly to rising health care costs. There are three things you can do to help fight Medicare fraud:

  1. Know your rights. As a person with Medicare, you have certain rights and protections designed to help protect you and make sure you get the health care services the law says you can get.
  2. Protect your identity. Identity theft happens when someone uses your personal information without your consent to commit fraud or other crimes. Keep this personal information safe:
    • Your name.
    • Your Social Security Number (SSN).
    • Your Medicare number (or your membership card if you’re in a Medicare Advantage or other Medicare health plan).
    • Your credit card and bank account numbers.
  3. Get involved with other seniors with the Senior Medicare Patrol (SMP). The SMP educates and empowers people with Medicare to take an active role in detecting and preventing health care fraud and abuse.
You can find more Medicare fraud tips on our website. If you suspect Medicare fraud or have questions about your bill:

Tuesday, March 8, 2016

Have a quick question? Try our new live chat

This week is National Consumer Protection Week and the OIC is one of the many government agencies that helps protect consumers from financial harm.

A huge part of the work we do is helping and educating consumers about all things insurance, from answering questions to looking into complaints against insurance companies, providing help with filing appeals for claim and coverage denials and everything in between.

We recently launched a live chat feature to help consumers get answers to their quick questions about insurance and their rights. Consumers can chat with one of our consumer advocates Monday through Friday from 10 a.m. to noon and from 2 p.m. to 4 p.m. If your question needs more attention, we will direct you to the right place to get the help you need.

Consumers can reach us:




Monday, March 7, 2016

Helping Washington consumers is our mission

This week is National Consumer Protection Week and the OIC is one of the many government agencies that helps protect consumers from financial harm.

Consumer protection is part of our mission, which is reflected in the way we do business. Our consumer advocates can help:
In 2015, our consumer advocates fielded 6,130 consumer complaints and helped recover more than $9.1 million in insurance billings, refunds and other claims-related issues for Washington citizens. Read more about the ways we helped consumers in 2015.

We share information of interest to insurance consumers on this blog and through our social media channels. Many of our blog posts are generated by questions our consumer advocates receive from Washington citizens.

More resources for consumers:

Monday, February 29, 2016

How to get health insurance if you missed open enrollment

If you missed open enrollment and didn't sign up for health insurance by Jan. 31, 2016, you may have to wait until next year's open enrollment period, unless you have a life event that makes you eligible for a special enrollment or you qualify for Apple Health (Medicaid).
Such events include, but are not limited to:
  • Losing health insurance, including an employer plan or individual health plan
  • Losing Apple Health (Medicaid) because you no longer qualify
  • Giving birth to or adopting a child
  • Permanently moving to a new area where your current plan doesn't provide coverage
  • Your employer not paying your COBRA premiums on time
  • Your COBRA coverage ending or reaching the lifetime limit
  • Your dependent turning age 26 and losing their coverage on your employer plan
  • Getting married or entering into a domestic partnership
  • Getting divorced or ending a domestic partnership
  • Cancelling your Washington State Health Insurance Pool (WSHIP) coverage
  • Your health plan no longer being offered for sale in Washington state

Most special enrollment periods are limited to 60 days from the qualifying event. Keep in mind that you won't qualify for special enrollment if you voluntarily cancel your health insurance or if your insurer cancels you because you didn't pay your premium.

If you don't qualify for special enrollment, here's some resources that may help you afford medical care.

Next year's open enrollment for individual and family coverage starts Nov. 1, 2016.

Wednesday, February 10, 2016

Who determines how much my totaled car is worth?


We hear from many consumers who are trying to resolve their auto total loss claims with their own insurer or another insurer. A total loss is when a vehicle is in a collision and the insurance company determines it would cost more than the vehicle is worth to repair it, so they “total” it.

Once an insurer declares a vehicle a total loss, they owe you the retail market value of your car, plus sales tax. But how do you know if the amount the insurer offers you is a reasonable estimate of the retail market value? Many consumers don’t know they have the right to, and should, ask the insurance company for a total loss valuation report, which shows the comparable auto data the insurer used to calculate your vehicle’s value. Most insurance companies don’t automatically provide the report to consumers and there’s no requirement that they provide it without being asked.

Insurers can either give you cash for your vehicle’s retail value or offer to replace your vehicle with a comparable vehicle in your area.

Read more about auto total loss on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Monday, February 8, 2016

Not sure if we can help you with an insurance problem? Ask us anyway

Recently, a Washington consumer posted a story on Facebook about her brother, who was on the waiting list for a heart transplant but was being put on hold because of “paperwork” issues with the insurance company. She asked her Facebook friends to file a complaint with the Insurance Commissioner, resulting in more than 40 complaints to our office.

One of our consumer advocates looked into the complaint and determined that the insurance provider was Apple Health, our state’s Medicaid program that is overseen by the Washington state Health Care Authority. In other words, we have no authority over the plan. But that didn’t deter our consumer advocate from trying to help.

First, we reached out to the Facebook user and asked her to let people know that they should contact the Health Care Authority with complaints about Apple Health. Then our consumer advocates reached out to the Health Care Authority to make sure this complaint was received and addressed as a high priority. The next day, we got an email from the concerned sister that said, “Thank you so much for your response and directing my complaint to the proper department. Today (my brother) got his insurance straightened out and is back at A1 status. Thanks again!”

We want people to be aware of this for two reasons: First, helping consumers access insurance is one of our missions, even if it’s not something we regulate. So even if you’re not sure if we can help you, reach out to us anyway. If we can’t help, chances are that we know someone who can. Second, social media is a powerful tool and is a way to quickly escalate a consumer problem. We have a robust social media presence, so don’t be afraid to reach out to us on Facebook or Twitter. We will make sure to get you to the right person.

Here’s how you can reach us:

Tuesday, February 2, 2016

Insurers should be current on emerging treatments for consumers

A growing concern for consumers and health insurers is the cost of prescription drugs and specifically, treatment for debilitating and life-threatening diseases.

Hepatitis C is a good example. New drugs are now used to cure this life-threatening liver ailment with proven success. But the pills are costly, ranging from $55,000 to almost $95,000 per patient for a standard 12-week treatment period.

Two nationwide organizations, the American Association for the Study of Liver Diseases and the Infectious Disease Society of America, now recommend that most patients receive treatment even if they are in the early stage of the disease versus waiting until it has progressed.

Last November, the federal government encouraged states to ensure that health coverage policies are “informed” by the treatment guidelines noted above. Unfortunately we do not have the authority to mandate that insurance companies abide by the guidelines. However, we do expect insurers to be current on all appropriate guidelines that best serve consumers. That is true for all types of treatments.

We recently asked health insurers in Washington if they were aware of the new guidelines and if they were making any changes to how they were treating patients with this disease. The responses were varied, but there were common themes:

• No company excludes treatment.
• All allow testing to detect the disease.
• All recommend that patients consult their doctors on the best course of action.

What’s also evident is that insurers are trying to manage their claims costs. That’s not unexpected. Future prescription drugs for ailments such as multiple sclerosis and high cholesterol are expected to cost even more than the hepatitis C treatment.

The emphasis for insurers, though, should be on ready access to appropriate treatment that leads to a healthier state and nation overall.

If you believe you’ve not getting access to prescription drugs or other necessary treatment, we can help you understand your rights to appeal and even contact your insurer on your behalf.

Thursday, January 28, 2016

My insurance premium went up. How can I find out the reason for the increase?

Consumers frequently ask us this question. Your agent or insurer should be able to provide you with an explanation other than “there was a general rate increase.” We recommend that you obtain a policy-specific premium breakdown directly from your agent, and that you ask for a rate worksheet comparison between your old premium and your new premium. 

Every policy is priced differently, depending upon the type of coverage you want and what are called underwriting factors.

Underwriting factors for auto insurance may include:

  • Household/family driver records.
  • Driver(s) age(s).
  • Type of vehicle(s).
  • The number of miles you drive per year.
  • Where you live and/or drive your car.
  • Level of coverage being purchased
  • There may be surcharges or discounts unique to your situation.
Underwriting factors for homeowner’s insurance may include:
  • The age of your home.
  • The materials used to build your home.
  • Your home’s value, as based upon its size and features.
  • Your home’s location.
  • Prior claims or losses for the home.
Read more about understanding auto insurance and understanding home insurance.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Friday, January 22, 2016

If you find yourself the subject of an insurance fraud investigation, the best thing to do is cooperate

Our consumer advocates respond to thousands of inquiries from Washington consumers each year. Sometimes, we hear from people who are the subject of an insurance company fraud investigation.

Most consumers we talk to are surprised to find out that insurers have the right and responsibility to investigate potentially fraudulent insurance claims. If an insurance company flags a claim as high risk for fraud, consumers are contacted by the company’s special investigations unit (SIU).

Being the subject of a fraud investigation can be unnerving, and many consumers are bewildered and angered by SIU actions of their insurers. Consumers who contact us generally feel the company is infringing on their rights; however, that is not the case. We advise consumers to cooperate with the company’s investigation; most policies state that consumers are required to cooperate with any investigations, or they forfeit their rights outlined in the insurance policy.

Insurance fraud is a crime in Washington state, so if you are being investigated, it’s best to cooperate and provide any documentation you can to support the facts in your claim.

If an insurance company’s SIU finds evidence that a crime occurred, they forward the case to Commissioner Kreidler’s SIU, which conducts an investigation and works with the state Attorney General’s Office and local law enforcement to prosecute people who are suspected of committing insurance fraud.

In 2015, Kreidler’s SIU received nearly 1,700 fraud referrals and obtained 22 felony guilty pleas or convictions. Approximately 10 cents of every dollar consumers pay toward insurance premiums pays for a fraudulent insurance claim.

Read more about Kreidler’s SIU
Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Thursday, January 7, 2016

Medicare offers weight loss program

A new year has started and many of us have set weight loss as a goal. You may be thinking of looking into one of the many weight-loss programs available to consumers. However, if you’re on Medicare, did you know that it pays for obesity screening in some cases as a preventive service?

For people who qualify for the obesity screening, Medicare pays for up to 22 face-to-face intensive counseling sessions during a 12-month period with a primary care doctor who accepts Medicare. Qualifying clients have a body mass index (BMI) of 30 or higher. 

The Columbian newspaper in Vancouver recently featured a medical clinic that provides this service for Medicare recipients.

If you are interested in this service, first you should contact your primary care doctor to see if he or she offers this type of program. You can read more about the coverage on Medicare’s website.