State Insurance Regulator & Advocate Save Consumers Money
The Office of the Healthcare Advocate saved consumers $1.5 million and the Insurance Department recovered $1.8 million — a total of $3.3 million — in the second quarter of this year.
Most of the savings the Insurance Department recovered for policyholders were related to health insurance, even though that total also includes savings and fines related to accident, homeowners, and life insurance policies.
“The advent of the Affordable Care Act resulted in more people having health insurance – some for the very first time,” Insurance Department Commissioner Thomas Leonardi said in a press release. “Our staff of experts is well versed in the law and handled hundreds of questions from consumers on their new coverage.”
The Insurance Department’s Consumer Affairs Unit fielded more than 1,600 complaints and inquires between April 1 and June 30.
Healthcare Advocate Victoria Veltri’s office handled 2,245 cases in the second quarter.
She attributed the increase in the number of calls to the Affordable Care Act and Medicaid expansion.
“In a time when healthcare is evolving, the demand for the kind of services we provide, which range from real-time consumer education and assistance in selecting a plan to direct advocacy in the grievance and appeal processes, is increasing exponentially,” Veltri said.
She said the $1.5 million in savings during the second quarter included successful appeals of complex mental health treatment denials of medically necessary inpatient psychiatric care for adolescents and several complex medical cases.
She said the case volume her office is handling is “trending at double the volume of calendar year 2013.”
With the second period of enrollment in the Affordable Care Act starting in just three months, both Veltri and Leonardi said they are ready to help consumers with their issues and questions.
Consumer recoveries and industry fines for the Insurance Department have totaled approximately $3.4 million since January 1, 2014. The Office of the Healthcare Advocate saved consumers $1.3 million in the first quarter of this year. Last year, it saved consumers a total of $9.5 million.