Monthly Archives: February 2014

Missouri regulators lead multistate, market conduct investigation of Humana

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Humana Insurance agrees to $4.5 million settlement and change in business practices

Jefferson City, Mo. – The Missouri Department of Insurance today announced that a regulatory settlement agreement has been reached with Humana Insurance Co. Missouri regulators led a multistate market conduct investigation of Humana in collaboration with regulators in Mississippi and Wisconsin. In the settlement, Humana agrees to pay $1.8 million in fines that will be divided among 10 states and to establish a $2.7 million consumer restitution pool.

The multistate market conduct investigation of the company began in 2012. The investigation was based upon a referral of a single complaint that was filed by a small employer with the Missouri department’s consumer affairs division. The investigation found that Humana Insurance Company was requiring some employers, who purchased small group medical insurance, to also purchase a group life insurance product. In the settlement, Humana agreed to make business reforms to include notifying employers and insurance agents that the additional purchase of life insurance is not required. Humana also agreed to set up a $2.7 million restitution pool to provide refunds for employers who were required to purchase the group life product.

“Policyholders should be able to choose individual insurance products without insurers bundling products together” said Missouri Insurance Director John M. Huff. “I am pleased our team was able to collaborate on a settlement with multiple states to benefit consumers.”

Missouri will receive $390,886, paid to the Missouri State School fund. Other states that will benefit from the settlement and fine are Alabama, Arkansas, Georgia, Mississippi, Montana, North Carolina, Tennessee, Utah and Virginia.

In market conduct exams and investigations, the Department of Insurance reviews insurance company practices regarding the treatment of policyholders. This includes the way premium rates are charged, the way insurers handle claims and other responsibilities under state law. These reviews can result in refunds for consumers, fines and corrections in business practices, as well as other remedies. In the last five years, Market Conduct enforcement actions have generated nearly $20 million in payments from insurance companies. The money goes toward refunds for consumers, general revenue and the Missouri State School Fund.

Consumers who have complaints or questions about life and other types of insurance, can call the department’s Insurance Consumer Hotline at 800-726-7390 or by visiting insurance.mo.gov.

About the Missouri Department of Insurance, Financial Institutions & Professional Registration

The Missouri Department of Insurance, Financial Institutions and Professional Registration (DIFP) is responsible for consumer protection through the regulation of financial industries and professionals. The department’s seven divisions work to enforce state regulations both efficiently and effectively while encouraging a competitive environment for industries and professions to ensure consumers have access to quality products.

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Missouri regulators lead multistate, market conduct investigation of Humana

Humana to pay $1.8 million fine

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February 14, 2014 4:38 pm

Humana Insurance Co. has agreed to pay $1.8 million in fines and $2.7 million in restitution to Missouri and other states resolve complaints about its sale of small group health insurance.

The Missouri Department of Insurance alleged that Humana required small employers to buy group life insurance in order to get small group health coverage. Such bundling violates insurance regulations. Ten states will divide the fine. Missouri regulators led the investigation with regulators from Wisconsin and Mississippi.

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Humana to pay $1.8 million fine

A Whistleblower’s Profile In Courage

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Obamacare threatens to maim and kill innocent people in the name of furthering the bottom line for the insurance companies. Obamacare contains the heinous specter of death panels. We are all at risk and certainly Obamacare represents yet another form of wealth distribution. However, the people should know that help is on the way.

Dr Linda PeenoDr. Linda Peeno contacted me two weeks ago and informed me that she is reinserting herself into her advocacy work on behalf of all patients who are trapped in a corrupt medical system.

If you don’t know who Linda Peeno is, the following profile should inspire all to become a force for positive change. If you remember Dr. Peeno, you will find the following information to be a welcome update on one of America’s most courageous whistleblowers.

Of all the interviews that I have conducted over the years, there is one interview which still troubles me to this day. Almost five years ago, I interviewed managed health care whistleblower, Dr. Linda Peeno, her revelations have haunted me in the years following the interview. I am haunted because Dr. Peeno gave so much to the people of America and lost nearly everything in return.

What started out as an interview with the objective consisting of presenting the listening audience with an expose on the inherent evils of health care, the interview turned into what John F. Kennedy would refer to as a shining example of a “profile in courage.” Yet, it is a profile in courage that has neither been championed or rewarded. Rather, Peeno’s statements and actions have been met with denial, derision, disdain and a highly effective and destructive retaliation.

Certainly, Linda Peeno’s trip down whistleblower lane appeared promising when the her Congressional testimony was prominently portrayed in Michael Moore’s movie, Sicko, as Peeno told Congress the following:

“I wish to begin by making a public confession: In the spring of 1987, as a physician, I caused the death of a man. Although this was known to many people, I have not been taken before any court of law or called to account for this in any professional or public forum. In fact, just the opposite occurred: I was “rewarded” for this. It bought me an improved reputation in my job, and contributed to my advancement afterwards. Not only did I demonstrate I could indeed do what was expected of me, I exemplified the “good” company doctor: I saved a half million dollars. I contend that “managed care,” as we currently know it, is inherently unethical in its organization and operation. Furthermore, I maintain that we have an industry which can exist only through flagrant ethical violations against individuals and the public.”

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A Whistleblower’s Profile In Courage

Former Marine now battling Medicare for life-saving surgery

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Robert Zurheide asking if they are waiting for him to dieTUCSON- A Tucson man and former Marine says his life is in limbo, caught between the need for life-saving surgery and a Medicare Advantage plan that will not cover the procedure. Robert Zurheide went on disability after he was injured in 2002 while working as a corrections officer in Florence. He has been battling chronic pancreatitis for nearly three years and says doctors at UAMC recommended a pancreas transplant as soon as possible. That was more than eight months ago.

“I love my country to the core, it’s in the core of me,” said Zurheide.

Military service is more than a passion for the Zurheide family, it is a way of life. Robert’s son Graham is a 1st Lieutenant in the Marines and his younger son has plans to join. However it is a tradition that claimed the life of Zurheide’s oldest son, 20-year-old Robert Zurheide Jr., who was killed while serving in Iraq in 2004.

“He came over, he gave me that big hug and he went back around to the car, got in and they drove off, and I never saw him again,” Zurheide said.

Nearly ten years after his son’s death, Zurheide says he is now fighting for his own life. He spends hours, even days in the hospital as his pancreas continues to fail.

“Worst pain I’ve ever felt in my life, and it could kill me,” he said.

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Former Marine now battling Medicare for life-saving surgery

Insurance Giant Abruptly Withdraws Cheaper Plan

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Get Gephardt ABoT(KUTV) Natasha Sponbeck runs a small business called Zap Electric. Natasha says the company has always offered health insurance to its employees.

“That is a great benefit to recruit people,” she said. “They want to go work somewhere where they get benefits.”

Zap Electric’s coverage has been through Humana. Natasha says she was concerned about changes coming because of the Affordable Care Act until she got a letter in the mail.

“I got a letter from Humana stating I could keep my grandfathered plan,” she said.

Natasha agreed. But week later, her insurance agent discovered Humana has already switched Zap Electric over to a new, Affordable Care Act approved plan. The new plan will cost roughly $12-thousand more per year.

“It’s a lot more money for way worse coverage,” Natasha said.

Natasha contacted Humana to complain, and was sent an email that said, “…there has been a lot of miscommunication and errors in letters.”

And the email says, indeed “Zap Electric is going to have to change to an [Affordable Care Act] compliant plan.”

But Natasha suspects that the miscommunication may have been deliberate. She says that if she hadn’t been proactive she would not have discovered the error before the bills went up.

“If this was a mistake, why have they not sent all of us letters letting us know this is a mistake?” she asked.

Natasha says she tried to work out a deal with Humana but the insurance giant wouldn’t budge.

Natasha turned to the Utah Department of Insurance to file a complaint but she cannot get a return call.

Frustrated and not wanting to pay for the more expensive plan, she decided to Get Gephardt.

Get Gephardt began our investigation with the Affordable Care Act signed into law nearly four years ago. In the act we found a paragraph that talks about modifications to plans. It says that if a change is made to a plan then the insurance company has to “provide notice” to the customer. The act also says the insurance provider must give a 60 days notice of such changes so the customer can to decide if they want to stay or go.

Full Article, Video & Source:
Insurance Giant Abruptly Withdraws Cheaper Plan