John R. Kasich, Governor Mary Taylor, Lt. Governor/Director. Education Day

Transcription

1 John R. Kasich, Governor Mary Taylor, Lt. Governor/Director Central Ohio Insurance Education Day Catherine Geyerer

2 Introduction Named Deputy Director in February. Previously at Nationwide Insurance in the Office of the Chief Legal and Governance Officer Worked as an attorney for the insurance industry in the private sector Insurance defense and coverage attorney at Rendigs, Fry, Kiely & Dennis in Cincinnati. Worked in the legal department at Motorists Insurance Group 20 year legal career working for the insurance industry

3 Introduction Mary Taylor was sworn in as Ohio s 65 th Lieutenant Governor on January 10. Governor Kasich named her to lead CSI Ohio the Common Sense Initiative to reform Ohio s regulatory policies. Appointed dto serve as the Director of the Ohio Department of Insurance.

4 Introduction First certified public accountant to serve as Auditor of State. Transformed the office into a nationally recognized, 21 st century government accounting firm. Praised dfor fighting and preventing fraud and for recovering millions of misspent tax dollars.

5 Introduction As a state legislator, instrumental in passing Ohio s 2005 tax reform package. Reduced personal income taxes by 21 percent. Eliminated the tangible personal property tax, the corporate franchise tax and the inventory tax imposed on businesses. Member of the House Finance, Ways and Means, and Education committees. Recognized as a watchdog of the treasury.

6 Introduction Recently called a Guardian of Small Business by National Federation of Independent Businesses Called Wicked Smart when being introduced dby Governor Kasich.

7 Dual Role Challenge The Department regulates the activities of approximately 1,600 insurance companies, including 250 domestic companies. These companies write more than $55 billion in insurance premiums and py pay about $435 million each year in premium taxes to the General Revenue Fund. Ohio is the ninth largest insurance state by premium volume in the US U.S. The Department issues licenses and monitors the conduct ofmorethan283,000insurance agentsandoverseesand 20,000 insurance agencies.

8 Dual Role Challenge Insurance industry is a significant contributor to Ohio s employment and economy. Insurance companies, insurance agencies and other insurance related activities employed nearly 110,000 workers and an additional 106,000 indirect jobs in industries that support the Ohio insurance industry. The total payroll contribution of the insurance industry and industries that support insurance is $10.3 billion dollars.

9 Mission Promote a robust, stable and competitive market place. Empower consumers to make informed insurance decisions. Vigorously investigate insurance fraud.

10 Who We Are Jillian Froment, Chief Administrative Officer Steve Martindale, Chief Regulatory Officer (April 25 th ) Mike Farley, Assistant Director of Legislative Affairs Carrie Haughawout, Assistant Director of Health Policy John Charlton, Assistant Director of Communications Sue Real, Assistant Director of Property, Casualty and Life Policy Joe Garber, Chief Counsel (April 11 th )

11 Who We Are The executive team at the Department of Insurance includes 141 years of experience. Theagency of 259 permanent employees consists of 3,519 years of public sector experience. 78 employees with 20 or more years of service. Several employees with nearly 40 years of experience.

12 Who We Are

13 Common Sense Initiative 4 principles: Regulations Should Facilitate Economic Growth Regulations Should be Transparent and Responsive Compliance Should be as Easy and Inexpensive as Possible Regulations Should be Fair (Consistency)

14 Common Sense Initiative Existing Regulatory Reform Asks agencies to do some analysis Seek public input into regulations early in the process Consider alternatives that have less impact on small businesses Establish internal ombudsman function

15 Common Sense Initiative Our goals: More effective regulations understand the purpose for each regulation and measure success Simpler for small businesses get rid of the regulations that don t contribute to our outcomes, make compliance easier Transparency interested parties feel like their views have been heard in shaping the regulation and achieving the balance Customer service

16 Collaborating with CEOs Governor Kasich, Lieutenant Governor Taylor and I met with Insurance Company CEOs in February. Two Task Force Formed Insurance Education Task Force Business Development and Regulatory Reform Rf Task Force

17 Collaborating with CEOs Insurance Education Task Force Met on March 31 to discuss the Insurance Talent Development Plan Funded by the Ohio Board of Regents. Led by Columbus State Community College s Office of Workforce development. The end product will be a set of customized solutions to address the workforce needs of the insurance employers ers in the state.

18 Collaborating with CEOs Insurance Education Task Force The next step Ask insurance companies to complete a survey about their employees in Ohio and about their recruiting and training practices. Columbus State will identify strategies the insurance industry might undertake. The Talent Development Plan will identify quick wins the industry might undertake. The Task Force meets again in late May.

19 Collaborating with CEOs Business Development and Regulation Reform (BDRR) Task Force The task force will review and organize the suggestions submitted by a wide array of insurance industry sources. Facilitate CEO discussion, development and prioritization of formal business development and regulatory reform recommendations back to Gov. Kasich. Task kforce meets weekly.

20 ODIIS Implementation Computer System to help implement new licensing laws Licenses renewable every two years. Expire on the last tday of your birth month. One month grace period to complete renewal requirements built into the law. $100 late fee charged if you renew during the grace period.

21 ODIIS Implementation License suspended after the month grace period expires. Suspension lifted in the first year if renewal requirements are met and a late fee of $300 is paid. After the year suspension, license is cancelled. In order to obtain a license, have to start the process over as a new agent.

22 ODIIS Implementation New process saves money and time by avoiding the119 hearing process. Continuing education requirement increased by 4 credits to 24. Three of those credits required to be ethics credits.

23 ODIIS Implementation The new system stores all the collected information in one place. The new system increases the speed in which a license is approved by utilizing an automatic approval process. The new system enhances communication with agents potentially saving the Department t$20, per quarter in mailing costs.

24 ODIIS Implementation The new system creates a web portal for agents to access information such as CE credits and appointments. The new system enables agents to print their own license and certification letters. The new system lets lt agents update dt their biographical information.

25 ODIIS Implementation Implementation of the new system is May 3 and May 16. During this time period, there will be no online access to licensing pages on the Department of Insurance website.

26 Maintaining Integrity Monitoring the financial solvency of insurance companies operating in Ohio to ensure they are fiscally sound and stable is one of themost important functions we perform.

27 Maintaining Integrity Analyzes the quarterly financial statements submitted by each of our 250 domestic insurers. Performs streamlined quarterly analysis of over 1,400 foreign insurers. Conducts periodic, on site financial i exams of domestic insurers at least once every five years and more often, where needed, dd for targeted companies.

28 Maintaining Integrity Conducts market conduct exams, to assess complaints and investigate allegations of wrong doing. Examinations comprehensive or targeted on specific issues. Conducted d25 external exams and 112 desk reviews in Investigations can lead to suspension or revocation of licenses or even to criminal prosecutions.

29 Maintaining Integrity Risk assessment reviews of annual statements of our domestic companies. Involves 12 financial examiners and actuaries conducting thorough and comprehensive reviews over a week period to assess the solvency of the domestic companies.

30 Maintaining Integrity Review thousands of rate requests filings to ensure rates meet all state mandated actuarial and financial requirements. Review company forms to ensure compliance with the insurance code. Review new insurance products to determine their compliance with Ohio law. Received 8,461 filing submissions with an average turnaround time of 27 days in 2010.

31 Empowering Consumers The Department empowers consumers to make informed insurance purchasing decisions by providing educational information, training and consultation. We assist consumers who encounter difficulties by answering inquiries and investigating and resolving li complaints. lit We provide seniors, caregivers and other Medicare recipients with information on Medicare products and programs; and works to prevent predatory sales practices directed toward seniors.

32 Empowering Consumers In 2010, we received more than 121,000 calls to our consumer affairs staff, which includes calls to our Ohio Senior Health Insurance Information Program (OSHIIP). We investigated and resolved 5,152 insurance complaints and recovered $10.3 million on behalf of Ohio consumers.

33 Empowering Consumers Ohio currently has 1.9 million Medicare beneficiaries. Nearly 100,000 Ohioans turn 65 each year. OSHIIP assists Ohio s Medicare beneficiaries, their families and healthcare professionals acquire greater understanding and use of available health insurance options. OSHIIP disseminates insurance related information i throughout h Ohio via the toll free hotline, publications, speakers, trained volunteers, and a web site.

34 Health Care Reform One of the main focuses of the Department and otherstate Departments of Insurance has been to lay the groundwork for implementation and enforcement of the immediate health care reforms that took effect under the Patient Protection and Affordable Care Act (PPACA).

35 Health Care Reform These provisions include: Prohibition of lifetime benefit limits; Restrictions on annual benefit limits; Prohibition of rescissions; i Coverage of preventive services without cost sharing; Extension of dependent coverage up to age 26; Internal and external review; Prohibition of pre existing condition exclusions for children

36 Emphasis on Fraud A priority at the Agency is to increase efforts to fight fraud. Mary Taylor is uniquely qualified to lead the efforts against fraud because of her legacy in the auditor s office for fighting and preventing fraud and for recovering millions of misspent tax dollars. Substantial ti efforts have been made to combat fraud, but more can be done.

37 Emphasis on Fraud 68 percent of consumers believe insurance fraud happens because people believe they can get away with it (up from 49 percent in 2003) 76 percent of U.S. US consumers say people are more likely to commit insurance fraud during an economic downturn (up from 66 percent in 2003)

38 Emphasis on Fraud 11 percent of U.S. adults knows someone who has inflated an insurance claim. 19 percent ages and 19 percent of people with incomes over $100, percent of U.S. US consumers say poor service by an insurance company is likely to convince someone to defraud the insurer

39 Emphasis on Fraud 56 percent of U.S. consumers say they d likely report someone who has committed insurance fraud. One in fiveis is uncertain whether they d report a fraudster. Nationally, insurance fraud costs insurance companies and consumers in excess of $80 billion dollars a year, while agent misconduct can result in a consumer sustaining a financial loss.

40 Emphasis on Fraud The Department investigates allegations of agent misconduct and insurance fraudandand works with prosecutors to bring criminal charges against insurance agents, consumers, healthcare providers and members of organized crime groups who commit fraud.

41 Emphasis on Fraud The Department investigates Thesaleof bogus insurance products Staged accident rings Arson for hire cases Bogus billings by health care providers False consumer claim filings, misrepresentation, and misconduct issues In 2010, the Department received in excess of 6,000 allegations of insurance fraud and agent misconduct.

42 Emphasis on Fraud The Department opened more than 160 consumer insurance fraudcases, referring approximately 100 individuals for prosecution. The Department handled more than 1,200 agent misconduct cases, taking administrative action in 250. The Department s t Fraud dunit ithas criminal i justice authority to investigate suspected cases of insurance fraud.

43 Goal in 2011: Emphasis on Fraud Investigateand and prosecute a higher percentage of fraud referrals, Educate against fraud and to increase fraud awareness. Insurance fraudadversely adversely impacts theohio insurance market by causing increases in insurance rates for all Ohioans. As such, there is substantial benefit to Ohio consumers in vigorously rooting out fraud.

44 NAIC Ohio is considered a leader in the NAIC. Last week, 12 of our high level employees to a national meeting in Austin, Texas. Lt. Governor Taylor Matt Elston Mike Farley Susan Real Bill Harrington Mary Miller Peter Weber Michelle Brugh Lynette Baker Carrie Haughawout Dl Dale Bruggeman Michelle Brugh

45 NAIC highlights.. NAIC

46 Questions Thank you!