2009 Orders
Orders posted below are unverified duplicates of official orders actually entered. To get an official version of the order contact:
Renee Molnes
Phone: 360-725-7047
Email: legal@oic.wa.gov
| Orders 51 to 100 of 129 | |||||||||
| Name | Violation | Issue Date | Action | Order | |||||
|---|---|---|---|---|---|---|---|---|---|
| Johannsson, Stefan E., Spanaway, WA |
Failure to respond to numerous requests to replace NSF check used to pay for licensing fees. | 12/11/2009 | Revocation | 09-0153 | |||||
| Comments: Stefan E. Johannsson has requested an administrative hearing to contest this Order. The enforcement of this Order is effective beginning December 31, 2009, and will remain effective until the outcome of the administrative hearing. | |||||||||
| Kaiser Foundation Health Plan of the Northwest Portland, OR |
Use of unfiled forms. | 3/27/2009 | $70,000 Fine with $55,000 suspended | 09-0005 | |||||
| Comments: | |||||||||
| Kaiser Foundation Health Plan of the Northwest & Kaiser Permanente Health Alternatives Portland, OR |
Indications to providers that claims had been denied rather than accepted and applied to the deductible, failure to calculate and track COB savings, failure to ensure that new business contracts were written by licensed agents, assignments of a contract renewal to a Company representative who was not licensed, failure to ensure that its agents had been appointed and those appointments were filed with OIC, attempting to file replacement plans as endorsements to previous plans, sale of a plan without filing it with OIC, use of unfiled rates, use of unfiled rate model, failure to issue Certificates of Coverage. | 3/27/2009 | $10,000 Fine and Compliance Plan | 09-0020 | |||||
| Comments: | |||||||||
| Kamerer, Rebecca L. Tacoma, WA |
Failure to respond. | 2/3/2009 | Revocation | 09-0009 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Kawasaki Motors Corporation, USA Wilmington, DE |
Sale of service contracts prior to being registered. | 9/3/2009 | $20,000 Fine | 09-0105 | |||||
| Comments: | |||||||||
| Kilpatrick, Philip A., II Boardman, OH |
Failure to respond. | 5/20/2009 | Revocation | 09-0068 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Klein, Erika A. Puyallup, WA |
Failure to respond. | 1/16/2009 | Revocation | 09-0004 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Landamerica Home Warranty Co Burbank, CA |
Failure to timely file. | 8/4/2009 | $2,000 Fine | 09-0087 | |||||
| Comments: | |||||||||
| Landamerica Home Warranty Company Burbank, CA |
Meets requirements. | 6/24/2009 | Order Rescinding Prior Suspension of Certificate of Registration | 09-0074 | |||||
| Comments: | |||||||||
| Larsen, Cynthia L. Gig Harbor, WA |
Failure to admit to felony record and failure to respond. | 2/3/2009 | Revocation | 09-0007 | |||||
| Comments: | |||||||||
| Leukemia & Lymphoma Society, Inc. White Plains, NY |
Failure to timely file. | 6/5/2009 | $1,000 Fine | 09-0066 | |||||
| Comments: | |||||||||
| Lewis, Hilary Fredericksburg, VA |
Failure to respond. | 7/28/2009 | Revocation | 09-0098 | |||||
| Comments: Fingerprint replacement card. | |||||||||
| LifeWise Health Plan of Washington Seattle, WA |
Failure to timley file. | 12/30/2009 | $1250 fine | 09-0128 | |||||
| Comments: | |||||||||
| Lunsford, Candice M. Morrilton, AR |
Failure to respond. | 1/16/2009 | Revocation | 09-0003 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Lutheran Church - Missouri Synod Foundation St. Louis, MO |
Failure to maintain sufficent reserve. | 5/11/2009 | Order Suspending Certificate of Exemption | 09-0058 | |||||
| Comments: | |||||||||
| MacLaren-Beattie, Brenda L. and The MacLaren Group DesMoines, WA |
Transacting the unauthorized business of insurance; acting or holding herself out to be an insurance agent, broker, solicitor, adjuster, or producer; soliciting to Washington residents any product requiring a license or other authorization under the Insurance Code. | 9/16/2009 | Order to Cease and Desist | 09-0113 | |||||
| Comments: | |||||||||
| Markert, Justin P. Cleveland Heights, OH |
Failure to respond. | 2/13/2009 | Revocation | 09-0014 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Mercury Select Mgmt Co., Inc. Oklahoma City, OK |
Failure to timely file. | 7/28/2009 | $1,000 Fine | 09-0083 | |||||
| Comments: | |||||||||
| MGA Marketing, Inc. Vancouver, WA |
Failing to preserve inviolate the integrity of insurance; failing to promptly account for and pay the insurer premium funds; failing to account for and maintain in an account separate from all other business and personal funds, premium funds; sharing or allowing commissions or other compensation with a person not licensed; collecting a sum as premium for insurance which insurance was not provided by an authorized insurer; submitting to OIC a license application that failed to reveal information about MGA; obtaining or attempting to obtain its licenses through misrepresentation; showing itself to be incompetent, untrustworthy, and a source of injury and loss to the public; willfully and knowingly facilitating the transaction of insurance by an unlicensed agent. | 6/5/2009 | Order Revoking License | 09-0078 | |||||
| Comments: | |||||||||
| Ministry Advance Foundation Portland, OR |
Failure to maintain minumum requirements. | 5/29/2009 | Order Suspending Certificate of Authority | 09-0070 | |||||
| Comments: | |||||||||
| National Union Fire Insurance Company of Pittsburgh, PA Harrisburg, PA |
Issuing blanket coverage policies to groups that are not eligible, selling disability insurance to individuals under a group policy delivered to a policyholder outside of the state, and selling disability insurance coverage to residents under a group policy delivered to a policyholder outside of the state. | 2/5/2010 | $150,000 Fine with $50,000 suspended and Compliance Plan | 09-0151 | |||||
| Comments: | |||||||||
| National Union Fire Insurance Company of Pittsburgh, PA Harrisburg, PA |
Issuing, delivering, or using insurance policy forms as to which the Commissioner’s approval did not then exist. | 2/5/2010 | $110,000 Fine with $55,000 suspended and Compliance Plan | 09-0150 | |||||
| Comments: | |||||||||
| National Union Fire Insurance Company of Pittsburgh, PA Harrisburg, PA |
Issuing policies with effective dates of coverage prior to approval of the forms. | 2/5/2010 | $50,000 Fine with $10,000 suspended and Compliance Plan | 09-0152 | |||||
| Comments: | |||||||||
| Nationwide Life Insurance Company Columbus, OH |
Issuing, delivering, and using an insurance policy form, application form, and riders which had not been filed; failing to file copies of all certificate forms and any other related forms; failing to provide that the policy’s lifetime limits apply to chemical dependency benefits in the same manner as medical and surgical benefits; failing to make an offer of home health care and hospice care coverage; failing to make an offer of coverage for treatment for temperomandibular joint disorders; requiring that charges for accident expenses benefits in incurred within 90 days of the date of accidental bodily injury; including an “expense incurred” accident benefit in conjunction with fixed payment insurance; failing to provide the disclosures required for the Plan; and failing to include the statement on its application and claims forms warning consumers against filing fraudulent claims. | 11/20/2009 | $20,000 Fine | 09-0037 | |||||
| Comments: | |||||||||
| Newman, Nancy A. Brillion, WI |
Failure to respond. | 3/12/2009 | Revocation | 09-0027 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Ngoc, Ho Toan aka Ho, Toan Seattle, WA |
Transacting the unauthorized business of insurance; seeking, soliciting, pursuing, and/or obtaining any insurance business in the State of Washington and from participating directly or indirectly, in any act of an insurance agent or insurance company in seeking, soliciting, pursuing, and/or obtaining any unauthorized insurance business in the State of Washington; soliciting Washington residents to sell or purchase any plan or policy or coverage for any form of insurance; soliciting Washington residents by e-mail, facsimile, telephone, mail, or any other means to induce them to purchase any form of insurance product; offering to Washington residents a plan, contract, trust, annuity, policy, or coverage for any form of insurance without submitting to examination by the Insurance Commissioner. | 9/28/2009 | Order to Cease and Desist | 09-0090 | |||||
| Comments: | |||||||||
| Nichols, Andrew T. Mauldin, SC |
Failure to respond. | 3/12/2009 | Revocation | 09-0028 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Old American Insurance Company Kansas City, MO |
Failure to timely file. | 10/26/2009 | $1,000 fine | 09-0124 | |||||
| Comments: | |||||||||
| PacifiCare of Washington, Inc. Vancouver, WA |
Failing to undertake the annual true-ups required by the OIC Management Agreement during the period of 2003 to 2006 and failing to submit reports substantiating the fact that true-ups took place and failing to submit reports of the results of the true-ups as required by OIC. | 10/30/2012 | Consent Order Levying A Fine Fined $400,000 | 09-0010 | |||||
| Comments: | |||||||||
| PacifiCare of Washington, Inc.; PacifiCare Life Assurance Company, and UnitedHealthcare Insurance Company Mercer Island, WA |
Failure to file provider contracts and material changes to provider contracts. | 10/26/2009 | $100,000 Fine with $60,000 suspended | 09-0118 | |||||
| Comments: | |||||||||
| Physicians Insurance A Mutual Company Seattle, WA |
Issuing or renewing policies in situations where the producing broker had failed to maintain its Washington broker license and was not acting as the issuing Company’s agent and failure to give policyholders premium credits to which they were entitled under the Company’s rate filings then in effect. | 3/10/2009 | $2,500 Fine, which total amount is suspended | 09-0018 | |||||
| Comments: | |||||||||
| Powell, Nancy C. Cape Coral, FL |
Failure to respond. | 5/15/2009 | Revocation | 09-0060 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Premera Blue Cross and LifeWise Health Plan of Washington Mountlake Terrace, WA |
Inability to locate and produce underwriting files for all in-force business, misleading advertising, failure to identify the source of statistics used in advertisements, failure to ensure agent was appointed, inability to verify that agents were licenses for the appropriate lines of business and appointed by the Companies, use of unfiled or unapproved contracts, use of unfiled or approved rates, failure to provide the “Guide to Health Insurance for People with Medicare” to each applicant and obtain and retain a copy of the acknowledgements of receipt, failure to provide copies of signed acknowledged applications to all Individual Medicare Supplement members, failing to attach or make a true copy of the application part of each Medicare Supplement policy when it was issued and delivered, failing to notify providers of there responsibilities regarding administrative policies and programs when the grievance procedure changed, failing to file a report of participating providers or monthly updates for their Global Network, filing Geographic Network reports that did not meet the requirements of WAC 284-43-220(4), failing to file required Geographic Network report for the MSC preferred individual network or the MSC Traditional Participating Individual Network. | 3/2/2009 | $80,000 Fine with $50,000 suspended and Compliance Plan | 09-0015 | |||||
| Comments: | |||||||||
| Puget Sound Health Partners, Inc. Lakewood, WA |
Proposed Acquisition of Control. | 9/21/2009 | Acquisition granted | 09-0032 | |||||
| Comments: | |||||||||
| Puget Sound Health Partners, Incorporated Federal Way, WA |
Failure to timely file. | 1/20/2010 | $1250 fine | 09-0156 | |||||
| Comments: | |||||||||
| Regence BlueShield Seattle, WA |
Failing to notify enrollees of appeals decisions within 14 days of receipt of their appeals without notifying enrollees that an extension is necessary and failing to notify enrollees of appeals decisions within 30 days of receipt of their appeals without obtaining the enrollee’s informed, written consent to an extension. | 2/24/2010 | $100,000 Fine with $50,000 suspended and Compliance Plan | 09-0120 | |||||
| Comments: | |||||||||
| Regence BlueShield, Asuris Northwest Health, and Regence BlueCross BlueShield of Oregon Seattle, WA |
Failing to provide coverage from prostate cancer screening, failing to file fully-negotiated health plan contract forms and rate scheduled within thirty working days, and failing to send amended benefit certificates. | 1/13/2010 | $200,000 Fine with $75,000 suspended and Compliance Plan | 09-0116 | |||||
| Comments: | |||||||||
| RiverSource Life Insurance Company Minneapolis, MN |
Using unfiled, increased rates for the tax-qualified form. | 10/5/2009 | $25,000 Fine with $10,000 suspended | 09-0039 | |||||
| Comments: | |||||||||
| Rowe, Jr., Larry E., Spokane, WA |
Failure to respond. | 8/25/2009 | Revocation | 09-0107 | |||||
| Comments: Complaint generated. | |||||||||
| Ryals, Scott A. Niagara Falls, NY |
Failure to respond. | 2/12/2009 | Revocation | 09-0013 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Sabatke, Emily A. Stevens Point, WI |
Failure to respond. | 8/4/2009 | Revocation | 09-0099 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Seattle Symphony Foundation Seattle, WA |
Violation of RCW 48.38.010(6). | 5/11/2009 | Order Suspending Certificate of Exemption | 09-0052 | |||||
| Comments: | |||||||||
| Sierra Club Foundation, The San Francisco, CA |
Issuing Charitable Gift Annuities without a Certificate of Exemption. | 5/20/2009 | $3,075 Fine | 09-0048 | |||||
| Comments: | |||||||||
| Smith, Libbie L., Vancouver, WA |
Failure to comply with Department of Social and Health Service support order. | 8/4/2009 | Suspension | 09-0100 | |||||
| Comments: | |||||||||
| Smith, Libbie L., Vancouver, WA |
Reinstatement of License | 12/9/2009 | Licensee complied with DSHS support order - reinstate license. | 09-0100 | |||||
| Comments: Complied with DSHS Support Order | |||||||||
| Spokane United Methodist Homes Spokane, WA |
Failure to meet minimum requirements. | 5/11/2009 | Order Suspending Certificate of Exemption | 09-0053 | |||||
| Comments: | |||||||||
| Standard Life Insurance Company of Indiana, The Indianapolis, IN |
Capital & Surplus below minimum | 12/4/2009 | Suspention of Certificate of Authority. | 09-0143 | |||||
| Comments: | |||||||||
| State Farm Mutual Automobile Insurance Company Bloomington, IL |
Failure to timely file. | 12/16/2009 | $750 Fine | 09-0140 | |||||
| Comments: | |||||||||
| Sullivan, Jeffrey A., West Richland, WA |
Probationary License Granted | 12/17/2009 | Probationary License Granted | 09-0148 | |||||
| Comments: | |||||||||
| Szmyd, Katarzyna Chicago, IL |
Failure to respond. | 9/30/2010 | $500 Fine | 09-0059 | |||||
| Comments: Fingerprint replacement card | |||||||||
| Orders 51 to 100 of 129 | |||||||||
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These enforcement actions taken by Mike Kreidler, Washington state Insurance Commissioner, are a primary tool in protecting the people of Washington.
| Type of Entity | Authority to Suspend or Revoke | Authority to Fine |
|---|---|---|
| Agent or broker | RCW 48.17.530 | RCW 48.17.560 |
| Insurance company | RCW 48.05.140 | RCW 48.05.185 |
| Health care service contractor | RCW 48.44.160 | RCW 48.44.166 |
| Health maintenance organization (HMO) | RCW 48.46.130 and RCW 48.46.135 | |
Updated 05/02/2013
See also
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