October 23, 2018
OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler has imposed a $200,000 fine on Dental Health Services of Seattle for failing to substantially improve its process for identifying and responding to member grievances and consumer complaints, and its oversight of third-party vendors.
In September 2017, Kreidler fined the company $300,000 (order 17-0272) and suspended $200,000 of the fine as long as the company completed the terms of Kreidler’s compliance plan. Kreidler extended the compliance deadline to Sept. 28 after the company did not meet the original March 31 deadline.
Issues the company still needs to address include:
- Failure to identify, document and monitor consumer complaints
- Failure to monitor vendor performance and train employees on how to use vendor’s software
- Failure to have a clear process to identify consumer compliant trends
- Failure to timely respond to and resolve consumers’ complaints and appeals
- Failure to deliver enrollment and membership materials to enrollees
As a result of the 2017 order, Dental Health Service stopped selling dental plans inside the Washington Health Benefit Exchange in 2018 and 2019. The company was previously the largest dental insurer inside the Exchange.
Kreidler will revisit the company’s compliance with state insurance laws and may take additional action based on the findings.