WA: Kaiser, CHPW Appeals Settled with OIC; Coordinated Care TBD

At today’s Navigator Technical Advisory Committee meeting, it was announced that the Office of the Insurance Commissioner (OIC) has reached a settlement with Kaiser and Community Health Plan of Washington (CHPW) in their appeals of the OIC’s recent disapproval of their Exchange applications.   CHPW and Kaiser are now ready for certification by the Exchange Board at their special meeting on Sept. 4.

CHPW, if approved by the Exchange Board, will be offering three individual Exchange plans in 26 counties.

If Kaiser is approved by the Board, they will offer individual Exchange plans in both Clark and Cowlitz Counties.

In addition, Coordinated Care has finished its appeal hearing and is now waiting for the judge’s ruling. The Qualified Dental Plan up for appeal is awaiting a hearing. Molina has also revisited its appeal.

Stay tuned to State of Reform as more information becomes available.

CORRECTION: An earlier version of this posting stated that the Office of the Insurance Commissioner disclosed that the three carriers in the appeals process have completed their appeals and that the Administrative Law Judge ruled that Community Health Plan of Washington (CHPW) and Kaiser are now ready for approval by the Exchange Board at their special meeting on Sept. 4. This post has been updated to reflect that the Administrative Law Judge did not rule on the plans in the appeals process, a decision was made through a settlement agreement. The Insurance Commissioner made settlements with these firms after they appealed the initial disapproval in July; there was no ruling by the judge.

We received the following clarification to the contents of the original post from the OIC’s Steve Valandra:

Your site today notes that an administrative law judge approved appeals by Kaiser and Community Health Plan of Washington. That is not the case.

The insurance commissioner made settlements with these firms after they appealed the initial disapproval in July. There was no ruling by the judge.

Coordinated Care appealed the July disapproval and completed a hearing with the OIC this week before the administrative law judge. A decision by the judge is pending. The OIC decided not to attempt a settlement with Coordinated Care because of too many issues to correct.

I am hoping you will correct the statement about Kaiser and CHPW soon to avoid any confusion for your readers.

Thanks.

Steve Valandra

Deputy Commissioner, Public Affairs

Washington State Office of the Insurance Commissioner