BLOG: Protecting Pennsylvania’s Consumers
By: Teresa Miller, Insurance Commissioner
January 13, 2016
Since taking office, Governor Wolf and I have set consumer protection as the Insurance Department’s top priority. A big part of helping consumers is letting them know that we are here as a resource for them, and under Governor Wolf’s direction, we have substantially increased our consumer outreach.
There were many times throughout 2015 where Governor Wolf and I took an active stand in order to put consumers first and protect them from future harm.
Keeping Rates Low
I’m also very proud of the work done by my department in reviewing individual and small group health insurance rates this year to ensure that we balanced the needs of the companies involved without placing too much burden on consumers through drastic rate increases. My department was able to save Pennsylvania’s consumers nearly $81 million – an outcome that wasn’t the case in all other states. I’m glad we can tell that story here.
Shortly after taking office, we addressed an issue where families enrolled in the full-cost CHIP program were facing tax penalties, because these plans did not meet minimum essential coverage standards dictated by the Affordable Care Act. We worked quickly to bring these plans up to MEC standards and obtained waivers so these families would avoid the tax penalty. Under the direction of Governor Wolf, we brought the remaining CHIP plans up to MEC standards so that more than 150,000 Pennsylvania children enrolled in the program could enjoy improved benefits and coverage standards.
The Insurance Department is also continuing to play a role in protecting consumers affected by the consent decrees signed by Highmark and UPMC in 2014. My department supported Governor Wolf’s decision to go to court in order to protect the access of more than 180,000 seniors in western Pennsylvania to the doctors and hospitals of their choice, by requiring UPMC to stay in Highmark’s Medicare Advantage program, consistent with the terms of the consent decrees.
Saving Consumers Money
Away from the health side, we’ve taken a stand against unfair pricing tactics like the “widow’s penalty” and price optimization – a practice that occurs when insurers consider factors unrelated to expected losses and expenses, such as a customer’s likelihood to shop around for a better price, when setting rates. I issued notices to insurers to remind them that these practices are unfairly discriminatory and my department will not authorize rates that impose costs where additional risk can’t be proven.
We’re also continuing to pursue other consumer protection issues, including surprise balance billing, which occurs when patients receive a bill for a service received at an in-network facility with an in-network provider but encounter an out-of-network provider at some point during care.
These accomplishments demonstrate the Wolf Administration’s strong commitment to putting consumers first through increasing access to health insurance, ensuring consumers are treated fairly by companies, and educating the public on issues so consumers have the information they need to make the best decisions for themselves and their families.
As we move into 2016, we’re going to continue to focus on finding solutions to issues that affect consumers every day.
Find Us Online
Over the summer, we revamped the Insurance Department website to make it much more user-friendly, and we’re making good use of this new platform to reach and educate consumers. We regularly update it with consumer alerts focused on seasonal tips or issues we hear of from consumers, and we’re producing more educational content, such as our videos and shopper’s guide to using and purchasing health insurance, to help consumers make educated and empowered choices.
We’re going to work to become a more visible force in communities around the commonwealth. I want Pennsylvania consumers to know that we’re here as a resource and to connect with consumers in their own environments, and I strongly encourage you to contact us if you have any issues or concerns via our Consumer Services Bureau at 1-877-881-6388 or through our contact form at insurance.pa.gov
Read more agency year in review blog posts.
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