STATE OF WASHINGTON OmCE OF THE INSURANCE COMMISSIONER In the Matter of NatioBwide Life Insurance Company, Authorized Insurer. Order No. 15-0192 WAOlCNo. 909 NAIC No. 66869 This Consent Order ("Order") is entered into by the Insurance Commissioner of the state of Washington ("Insurance Commissioner"), acting pursuant to the authority set forth in RCW 48.02.060, RCW 48.05.140 and RCW 48.05.185, and Nationwide Life Insurance Company. This Order is a public record and will be disseminated pursuant to Title 48 RCW and the Insurance Commissioner's policies and procedures. BASIS: 1. Nationwide Life Insurance Company (hereinafterreferredto as "Nationwide" or 'ihc Company") is an authorized insurer domiciled in Columbus, Ohio and duly authorized to engage in the business of insurance in the state of Washington. 2. Nationwide intends to issue student blanket plans to students at the following colleges and universities: (1) Walla Walla University; (2) St. Martin's University; (3) Washington Communit>' Colleges; (4) Eastern Washington University - international students only; (5) Eastern Washington University - domestic students only; (6) Central Washington University - international students only; (7) Central Washington University - domestic students only; (8) Western Washington University - graduate students only; and (9) Western Washington University - undergraduate students only, all for the.2015 school year, which in their current filed form do not comply with 45 GFR 147.102 and therefore cannot be approved. To minimize disruption to the students on a pressing timeframe, the Insurance Commissioner agrees with Nationwide that the students need coverage and have 1 Office of the Insurance Commissioner ORDER NO. 15-0192 PO Box 40255 Olympia,WA 98504-0255
few options and therefore. Nationwide will be allowed to issue the plans based on Nationwide's representation that it willfixthe student blanket plans by September 30,2015. 3. Use of disapproved rates would constitute the use of unfiled rates in violation of RCW 48.19.040(6). 4. RCW 48.05.140(1) provides the Insurance Commissioner authority to refuse, suspend, orrevokean insurer's certificate of authority, in addition to other grounds therefor in this code, if the insurer fails to comply with any provision of this code other than those for violation of whichrefusal,suspension, orrevocationis mandatory, or fails to comply with any proper order orregulationof the Insurance Commissioner. 5. RCW 48.05.185 provides that after hearing or with the consent of the insurer and in addition to or in lieu of the suspension,revocation,or refusal torenewany certificate of authority the Insurance Commissioner may levy a fine upon the insurer in an amount not less than two hundred fif^ dollars and not more than ten thousand dollars. Nationwide's sale of disapproved plans (rates and forms) would constitute a violation(s) of 45 CFR 147.102 and RCW 48.19.040(6) that would justify the imposition of a fine on Nationwide under RCW 48.05.140(1) and RCW 48.05.185. CONSENT TO ORDER: The Insurance Commissioner of the state of Washington and the Company agree that the best interest of the public will be ser\'ed by entering into this Order. NOW, THEREFORE, the Company consents to the following in consideration of its desire to resolve this matter without further administrative or judicial proceedings. The Insurance Commissioner consents to settle this matter in consideration of the Company's agreement to the temis and conditions of this Order as are set forth below: 1. The Company acknowledges its duty to comply fully with the applicable laws of the state of Washington. 2. The Company consents to the entry of this Order, waives any and all hearing or other proceduralrights,and further administrative or judicial challenges to this Order. 3. The Company can use the rates and forms as currently filed imtil September 30,2015 at the latest 2 Office of the Insurance Commissioner POBox40255 OIyrapia,WA 98504-0255
4. By agreement of the parties, the Insurance Commissioner will not impose a fine for the use of unfiled rates on the unapproved student blanket plans from August 1, 2015, through September 30,2015. 2015: 5. The Company will implement the following Conditions by September 30, a. Each enrollee on Nationwide's (1) Walla Walla University; (2) St Martin's University; (3) Washington Community Colleges; (4) Eastern Washington University - international students only; (5) Eastern Washington University - domestic students only; (6) Central Washington University - international students only; (7) Central Washington University - domestic students only; (8) Western Washington University - graduate students only; and (9) Western Washington University - undergraduate students only, student blanket plans will initially receive a copy of the appropriate Student Brochure. b. The following disclosure statement will be added on the FIRST PAGE of each Student Brochure. The only changes that will be made to this disclosure statement are to include the applicable information in the bracketed sections. IMPORTANT DISCLOSURE: This is not the fmal version of your health coverage policy. You are entitled to all benefits listed in this current version of your policy. Yon are also entitled to some additional benefits that have not been included in this version of your policy. In addition^ some of the exclusions listed in this version of the policy do not appl>'. You will be provided with thefinalversion of yoar health coverage policy prior to October 30,2015. Until then, if you require care that is not listed in this policy as covered, you should contact us to find out whether that care is covered. Tofindout whether the care you need is covered, please call us at [TELEPHONE NUMBER] or email us at [EMAIL ADDRESS]. At all times yon are covered under this policy, all of the benefits to which you are entitled will be provided according to Washington and Federal law, even if this version of your policy form says something different c. By September 30, 2015, Nationwide must make all necessary changes to the forms and rates that support this plan, including the Student Brochures, to make those forms compliant with state and federal law as determined by the OIC. 3 Office of ihe Insurance Commissioner POBox40255 Olympia, WA 98504-0255
d. If the approved rates are higher than the currently filed rates, Nationwide will not pass the extra charge along to enrollees. If the approved rates are lower than the currently filed rates. Nationwide will providerefundsto enrollees. e. Approved form documents will be provided to all enrollees by October 30, 2015, with a disclosure: This is the final version of your health coverage policy. This policy ' form supersedes any previous version of this policy you have received. Please dbcard any previous versions of this policy. f. Beginning January 1, 2016, Nationwide will file all student health plans in accordance with WAC 284-170-870, under which the Commissioner sets a annual deadline for the filings of rates and forms for the individual market which isrequiredto be announced by the Commissioner no later than March 31. Student health plans are individual market products under 45 CFR section 147.145 (a). 6. The Company understands and agrees that any failure to comply with the statutes and/orregulationsthat are the subject of this Order constitutes grounds for penahics, which may be imposed in directresponseto further violations. 7. This Order and the violations set forth herein constimtc admissible evidence that may be considered in any future action by the Insurance Commissioner involving the Company. However, the facts of this Order, and any provision, finding or conclusion contained herein does not, and is not intended to, determine any factual or legal issue or have any preclusive or collateral estoppel effects in any lawsuit by any party other than the Insurance Commissioner. EXECUTED this // day of,2015. NATIONWIDE LIFE fi NjSURANCE COMPANY By:. 0 Office of the Insurance Commissioner PO Box 40255 OI>-mpia, WA 98504-0255
AGREED ORDER: [Hirsuant to the foregoing factual Basis and Consent to Order, the Insurance Commissioner of the state of Washington hereby Orders as follows: 1. The Company will implement the Conditions of this Order, set forth in detail in the section entitled "Consent to Order." by September 30,2015. 2. This Order and the violations set forth herein constitute admissible evidence that may be considered in any future action by the Insurance Commissioner involving the Company. However, the facts of this Order, and any provision, finding or conclusion contained herein does not, and is not intended to, determine any factual or legal issue or have any preclusive or collateral estoppel effects in any lawsuit by any party other than the Insurance Commissioner. ENTERED at Tumwater, Washington, this 1^ day of ^(^IS^^^^ 2015. MIKE KREIDLER Insurance Commissioner By and thromgh his designee AWNALISAU3E Deputy for Legal Affairs Legal Affairs Division Office of the Insurance Commissioner PO Box 40255 Olympia, WA 98504-0255