Community-based health providers working in a carceral setting liability market study work group

The study will include:

  • A review of the state's commitments to facilitating safe transitions of care for incarcerated individuals through Medicaid coverage of health services under the 2023 Medicaid transformation waiver.
  • An analysis of the barriers to accessing liability coverage for community-based health care providers on the private market. 
  • An actuarial analysis of the potential risk to be incurred by providing health care malpractice liability coverage for transition of care services to individuals who are incarcerated and near release.
  • Policy options and recommendations, if any, for consideration by the legislature regarding provision of or increasing the availability of health care malpractice liability coverage or other liability protection options for community-based health care providers delivering these services. 
  • A final report by December 31, 2024.

Work group report

Work group meeting agenda, materials, and recordings

Nov. 13 meeting

Aug. 20 and Sept. 17 meetings

  • The August and September work group meetings are canceled to allow for further research and interviews.

July 16 meeting

  • The July work group meeting has been canceled.

June 18 meeting

Work group members

Community-based health providers working in a carceral setting liability market study work group members
Name Organization
Bryon Welch     
 		 Office of the Insurance Commissioner
Kelly Richburg

Office of the Attorney General
Michael Petterson Department of Corrections
Meghan Regis Health Care Authority
Jason Siems Office of Risk Management, Department of Enterprise Services
Svetlana Sedukhin
 		 Physicians Insurance
Lindsey Hueer Association of Washington Cities
Paul Jewell Washington State Association of Counties 
Brad Banks Washington State Association of Counties
Ric Bishop
 		 Washington Association of Sheriffs and Police Chiefs 
Marc F. Stern Washington Association of Sheriffs and Police Chiefs
 
Alyssa Patrick  Washington Association for Community Health
Penelope Sapp

Kitsap County Sheriff's Office
Joe Vessey  Community Health Center of Snohomish County
Amanda McDade Northwest Regional Council
Brynn E. Felix 
 		 Peninsula Community Health Services
Jennifer Kreidler-Moss Peninsula Community Health Services
Jesus Hernandez Family Health Centers
Melodie White Family Health Centers

Background information

Community-based health providers survey

Comments

Housing providers using housing trust fund insurance market study work group

Providers cannot operate without insurance and Washington communities cannot thrive without these critical providers. The state must keep these housing providers in operation and ensure that they are appropriately insured so that the state can continue to house some of its most vulnerable residents. 

The Legislature has asked the Insurance Commissioner to conduct a study on the insurance market considerations for housing providers receiving housing trust fund resources under RCW 43.185A.130 and serving extremely low-income households as defined in RCW 36.70A.030. It will include:

  • Collect the information required under this section from entities transacting insurance with housing providers described in subsection (1) of this section, and any identified authorized insurers, unauthorized insurers, and risk retention groups, are required to provide the requested information to the commissioner;
  • Obtain data from the previous five years on the number and types of policies in effect, whether and why policies were nonrenewed or canceled, claims activity, and premiums and deductibles; and
  • Investigate and request any other relevant information that may assist the commissioner with analyzing the availability of property and liability coverages for housing providers described in subsection (1) of this section and any other trends that may affect market availability.
  • Provide a report by December 31, 2024.

Work group report

Work group meeting agenda, materials, and recordings

October 23 meeting

August 13 and September 10 meetings

  • The August and September work group meetings are canceled to allow for further research and interviews.

July 9 meeting

June 11 meeting

Work group members

Housing providers using housing trust fund insurance market study work group members
Name Organization
Bryon Welch Office of the Insurance Commissioner
Melodie Pazolt Department of Commerce
Nathan Litchti Department of Commerce
Jason Siems Office of Risk Management, Department of Enterprise Services
Joy Erven Surplus Line Association of Washington
Sarah McDonnell Non-Profit Insurance Program
Duane Leonard Housing Authority of Snohomish County
Kirsten De Simone Volunteers of America Eastern Washington
Brandon Martin Volunteers of America Eastern Washington
Renee Rooker Walla Walla Housing Authority
Margaret Gritten YWCA
Erika Muñoz Tacoma Housing Authority 

Michele Thomas

Washington Low Income Housing Alliance
Flo Beaumon Catholic Housing Services of Western Washington
Lowel Krueger Yakima Housing Authority
Nathan Bartholome Plymouth Housing
Jackie Moynahan Washington State Housing Finance Commission

Background information

Housing provider surveys

Housing provider work group data call

Comments

Learn how to submit a public records request

Find links to commonly requested records that are available online or use our public records request form below to get access to records maintained by the Office of the Insurance Commissioner (OIC). 

What you’re looking for may already be available online 

You may not need to submit a public records request for the records you are looking for, we have provided a list of commonly requested records already available online. 

Information we don’t collect or maintain

We do not collect information on individual policyholders. If you are looking for:

Request for a list of individuals

If you’re requesting a list of individuals and it appears that your intended use may be for commercial purposes, we may not be able to fulfill your request. Please read the information regarding requests for list of individuals before submitting your request.

Submit your public records request or contact the public records team

Mental health service cost and use trends

To help policymakers and interested parties better understand how consumers use mental health services and the cost of those services, our office contracted with Onpoint Health Data to create a searchable dashboard of behavioral health-specific claims. 

The data is from the Washington All Payer Claims Database (WA-APCD) and includes claims between 2017-2022 for all state-regulated health plans and Washington’s Public and School Employee Health Benefit Programs (PEBB/SEBB).  

The information in the dashboard will be available to policy experts, legislators and others to get a better understanding of how mental health care services are accessed across Washington state and to propose solutions that improve access and coverage for these critical services. 

Anyone can use the dashboard to find:

  • How often consumers sought treatment for various mental health conditions.
  • The types of services used. 
  • How often out-of-network providers were used and how that varied across the state.
  • How much insurers paid providers for these services.

Key findings include:

  • From 2017-2022, the percentage of insurance claims involving a mental health diagnosis increased from 11.83% to 17.43%. 
  • In 2022, 18% of enrollees in an urban area had a mental health diagnosis compared to 13.55% in rural areas. 
  • In 2022, 7.6% of mental health services were provided by out-of-network providers compared to 4.2% of other medical services. 
  • The cost of mental health services has increased 69% since 2017, driven primarily by the use of services. During the same time, the average amount paid to providers per service has only increased by 4%. 

How to use the dashboard

You can do four types of searches:

  • Cost Driver - Search by the type of mental or medical health service for all health plan enrollees, enrollees with any mental health illness or enrollees with a serious mental health condition.  
  • Conditions Overview - Search by year, mental health condition and diagnosis for various measurements including outpatient facility rate, hospital emergency department visit rate, pharmacy claims and more.  
  • Geographical Overview – Search mental health conditions and diagnosis by region for various services, such as rates of pharmacy claims, primary care visits and inpatient admission rates.
  • Network Analysis – See the types of claims by year and region that were provided either by network or out of network providers.

Example: Find out what’s driving the cost of psychotherapy counseling.

Steps: 

  1. Select the “Cost Drivers” tab.
  2. Select “Psychotherapy/Counseling” from the “Service Type” dropdown menu.
  3. Select “All Members” from the “Member Population” dropdown menu.

Results:

According to the data, use, not price, drove the per member per month increase:

  • Per member per month (PMPM) cost increased 112%.
  • Use per 1,000 members increased by 94%.
  • The average price per service increased by 9%.

Project funding

This project was supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $684,447 with 100% funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government. 

Wildfire Symposium

The OIC's 2023 Wildfire Symposium, part of the Climate Summit Series, highlights the issues the threat of wildfires has on the insurance market in Washington state. What is the risk to consumers? How can we work together to mitigate that risk? Is there a chance home insurers pull out of the market and leave rural residents without any options? 

This series of short presentations and conversations was recorded in November of 2023. Guests and presenters include:  

  • Program managers from the Washington State Department of Natural Resources. 
  • Representatives from Verisk Analytics, a leading risk assessment firm. 
  • The executive director of the Okanogan County Long-Term Recovery Group. 
  • The vice president of the Reinsurance Association of America. 

Note: The Climate Summit Series also featured a presentation from from the Insurance Institute for Business and Home Safety (ibhs.org). IBHS President & CEO Roy Wright discusses the "why" behind wildfire losses and what the IBHS has learned (youtube.com), through its research facility, about how wildfires behave and what homeowners can do to prepare for wildfires and mitigate losses.

Engaging Communities in Wildfire Preparedness 

Guy Giffords from the Washington State Department of Natural Resources’ Community Resilience Program discusses the program, its outreach, and its reception.  

Long-Term Recovery for Communities After Wildfire Loss 

Carlene Anders, the Executive Director of the Okanogan County Long Term Recovery Group, the mayor of Pateros, and a former firefighter with the Department of Natural Resources and the U.S. Forest Service, discusses wildfire mitigation and resiliency after a major fire event. 

An Introduction to Reinsurance with Dennis Burke 

Dennis Burke, the Vice President of State Relations for the Reinsurance Association of America, provides an introduction to reinsurance. Burke touches on the role of reinsurers, the impact of global property catastrophes, catastrophe bonds, and what the future could hold for the reinsurance market. 

Risk Scoring Tools with Verisk

Roger Grenier and JulieAnna Anastassatos, from Verisk Analytics, discuss the factors at work in their risk scoring tools and how governments and homeowners can improve their risk score.

Requirements for insurers premium change transparency rule

Types of policies impacted

The affected insurance policies are:

  • Private passenger auto policies (this does not include policies that cover boats, motorcycles, off-road vehicles, recreational vehicles, antique or collector vehicles, classic vehicles, and specialty vehicles) (WAC 284-30A-020(2)(a), (4)(a)); and
  • Homeowner’s policies (including mobile and manufactured homeowners, condominium owners and renter's coverage) (WAC 284-30A-020(2)(b)).

The new rules do not apply to surplus lines, commercial auto policies, health plans, life, disability, and long-term care policies, and personal umbrella policies. (WAC 284-30A-020(4)(b, f)).

Phase 1 - June 1, 2024

Premium increase notices

Insurers are required to inform policyholders that they can request more details about their premium increase by contacting their insurer. (WAC 284-30A050(2), (5)). Disclaimer requirements include:

  • Located on the first page or view of renewal notices and renewal billing statements.
  • Bold font with a minimum size of 12 points.
  • Statement with similar language - "Policyholders receiving an increase to their premiums at renewal can request an explanation by contacting their insurer in writing. Please see Chapter 284-30A WAC for additional information on your right to an explanation for your rate increase." (WAC 284-30A-050(1)).
  • Insurer contact information.

Explanation of premium increases

Insurers must provide a reasonable explanation for premium increases when policyholders request, in writing, information about a premium increase that occurred at renewal. (WAC 284-30A) Reasonable explanation requirements include:

Insurers are not required to but may include the policyholder’s producer’s contact information in all premium change notices and explanations. (WAC 284-30A050(2)).

Phase 2 - June 1, 2027

Notices and explanations to consumers

Insurers must provide notice of premium changes at least 20 days before renewing a policy with a 10% or greater increase. (WAC 284-30A-050(4)(b)). They must also provide notice within 20 days of a written request from the policyholder (WAC 284-30A-050(4)(a)).

Insurers are required to give policyholders clear explanations for any premium increases and include the primary factors that caused the increase in premium change notices, as mandated by WAC 284-30A-040(2).

The primary factors must always be included in premium change notices when applicable:

  • Car garaging location, driving record, miles driven, number of drivers, number of vehicles, claims history, discounts, fees and surcharges, age, credit history, education, gender, marital status, occupation, property age, property location, property value, premium capping, and rate changes (including that subject to rate stability rules, transition rules, or premium-capping rules). (WAC 284-30A-070(2)(a)).

Premium change notice templates

The OIC has provided a standard premium change notice template for insurers to use, but they may also create their own version if it meets the requirements described in (WAC 284-30A-060(1)).

Filing requirements

Insurers must file their premium change notice forms with the OIC starting January 1, 2027, through the System for Electronic Rate and Form Filings (SERFF). (WAC 284-30A-060(3)).

Requirements for both Phase 1 and 2

  • A policyholder can request more information after a premium increase explanation. Insurers must respond within 20 calendar days. (WAC 284-30A-050(6)).
  • Insurers can include estimated amounts in the notices if they also explain the accuracy of the estimate for the policy and premium increase. (WAC 284-30A-070(4)).
  • Insurers can use composite rating factors but must specify the premium increase caused by them. (WAC 284-30A-070(3)).
  • Insurers can choose to provide an explanation for the entire premium increase. (WAC 284-30A-070(6); WAC 284-30A-080).
  • Insurers must keep accessible records of premium increase explanations under RCW 48.05.280. (WAC 284-30A-050(10)).
  • Insurers are not obligated to disclose usage-based insurance data, credit-based insurance scoring models, company placement criteria, or trade secrets. (WAC 284-30A-020(4)(c-d)).
  • Violations of Chapter 284-30A WAC constitute unfair trade practices and may result in penalties and remedies. Chapter 48.30 RCW and Chapter 284-30 WAC. (WAC 284-30A-90(1)).
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