A nonprofit publication of the Kentucky Center for Public Service Journalism

Two Jefferson County women plead guilty to multiple felony, misdemeanor counts of insurance fraud

The Division of Insurance Fraud Investigation of the Kentucky Department of Insurance (DOI) has completed a 19-month investigation resulting in the fraud conviction of two Jefferson County women on Oct. 8 by the Jefferson Circuit Court. Former insurance agent Adley Riley, 27, and roommate Kharis Montgomery, 28, pled guilty to multiple felony and misdemeanor counts of insurance fraud, totaling $50,939.99. DOI...

State’s annual worker’s compensation filing rate shows overall decrease for 14th consecutive year

The Kentucky Department of Insurance (DOI) last week announced the approval of the 2019 rate filing used to develop rates for workers’ compensation coverage. For the 14th consecutive year, the filing shows an overall decrease in Kentucky’s loss costs. A loss cost is an average compensation for lost wages based on the level of disability, plus medical benefit payments. The loss cost is a direct...

DOI completes review of individual, small-group health insurance rate filings for 2020 benefit year

The Kentucky Department of Insurance (DOI) has announced that it has completed its review of the individual and small-group insurance rates filed in the Kentucky market. The rates will be used to calculate insurance premiums for the 2020 benefit year. Kentuckians in the individual market will once again experience changes in premiums and plan offerings. Kentuckians will see an average rate increase...

194 Ky. School Boards Insurance Trust members to receive $5 million in reimbursed payments

The Kentucky Department of Insurance (DOI) and Kentucky Employers’ Mutual Insurance (KEMI) received authorization from Franklin Circuit Court to disburse $5 million to 194 members of the Kentucky School Boards Insurance Trust (KSBIT) Fund. KSBIT members include numerous county boards of education, colleges, and cooperatives throughout the Commonwealth. “We are pleased to announce this $5 million...

Kentucky DOI, Life Insurance Policy Locator matches consumers with lost policies and annuity contracts

If you can’t locate a life insurance policy of a deceased relative, the Kentucky Department of Insurance (DOI) has the investigative tool that can help you find both lost policies and annuity contracts. The Life Insurance Policy Locator, introduced by DOI through the National Association of Insurance Commissioners (NAIC), has matched Kentucky consumers with policies totaling $2 million in the past...

Kentucky Department of Insurance issues penalty against CaremarkPCS Health for multiple violations

The Kentucky Department of Insurance has issued an Order of Civil Penalty and Probation against pharmacy benefit manager CaremarkPCS Health, LLC for multiple violations of the Kentucky Insurance Code. As a result, Caremark’s pharmacy benefit manager license has been placed on probation for 12 months, and Caremark has been assessed a fine of $1,551,500. The order cites 454 violations related to reimbursement...

Kentucky’s annual workers’ comp filing approved; loss costs down for 12th consecutive year

The Kentucky Department of Insurance (DOI) announced the approval of the 2017 rate filing used to develop rates for workers’ compensation coverage. For the twelfth consecutive year, the filing shows an overall decrease in Kentucky’s loss costs. A loss cost is an average compensation for lost wages based on the level of disability, plus medical benefit payments. DOI Commissioner Nancy Atkins attributes...

Kentuckians have only one choice on exchange plans as Anthem leaves 61 counties

By Melissa Patrick Kentucky Health News Anthem Blue Cross and Blue Shield will no longer offer Obamacare exchange plans statewide, leaving all Kentucky counties with only one choice in 2018. Anthem offered plans in all 120 Kentucky counties last year, and had earlier planned to do the same, but scaled back to 59 counties in 2018 citing a “shrinking and deteriorating individual market, as well...

Kentucky DOI fraud investigation results in more than $2 million in restitution for 16 victims

Sixteen victims will receive a combined $2 million in court-ordered restitution as a result of an investigation completed by the Kentucky Department of Insurance (DOI) Division of Insurance Fraud Investigation in conjunction with the Lexington Police Department. Robert Lincoln Williamson II was indicted in late 2014 and pleaded guilty to 13 counts of theft in May 2017, after almost three years of...

Preliminary health insurance rates submitted for state market show significant increases for individuals

Insurance carriers have submitted proposed rates to the Department of Insurance (DOI) for 2018 in Kentucky’s individual and small group markets. In a continuing trend tied to market forces, an aging population, and systemic instability and uncertainty injected by the failure of Obamacare, the proposed rates reflect substantial year-over-year increases ranging from 6.5 percent to 47.7 percent, depending...

Kentucky extends deadline for insurance companies to submit new rates a second time

By Melissa Patrick Kentucky Health News Uncertainty continues to surround the Patient Protection and Affordable Care Act’s market for individual heath-care policies. Kentucky has extended for a second time the deadline for insurance companies to file plans and rates for next year, Anthem has pulled out of Ohio’s marketplace, and states are making deals with insurers to keep them from leaving. The...

Atkins appointed commissioner of state Department of Insurance; O’Connor named deputy commissioner

Nancy G. Atkins has been appointed Commissioner of the Kentucky Department of Insurance (DOI), and Patrick O’Connor has been named Deputy Commissioner of Policy. Atkins is a 33-year veteran of the insurance industry, working as both a licensed agent and employee benefit manager. She previously served as the Deputy Commissioner for DOI, an appointment she held since February. Prior to joining DOI,...

Dept. of Insurance to return $1m each to member schools, KLCIS related to failure of company

The Franklin Circuit Court has approved an agreed judgment to return funds from the defunct Kentucky School Board Insurance Trust (KSBIT) to nearly 200 Kentucky schools, colleges and education groups and to the Kentucky League of Cities Insurance Services Association (KLCIS).  Under the terms of the settlement negotiated by Department of Insurance Commissioner Brian Maynard, who serves as court-appointed...

Court orders former adjustor, associates to repay nearly $400,000 from KFB insurance scheme

An investigation led by the Fraud Division of the Kentucky Department of Insurance (DOI) has resulted in $388,803.80 in court-ordered restitution for one business. Charles Benson, a former insurance adjustor, pleaded guilty to 41 counts of insurance fraud and was sentenced earlier this month in U.S. District Court in Covington. Benson was the mastermind behind a fraud scheme that involved recruiting...

Department of Insurance Fraud Division recovers $3 million in court-ordered restitutions

The Fraud Division of the Kentucky Department of Insurance (DOI) said that it has increased the amount of court-ordered restitution payments this year by more than 800 percent. The increase—from $369,762 in 2015 to more than $3 million this year—accompanies 113 criminal convictions that have been secured through October. “This is great news for Kentucky’s citizens who have been squeezed by...

State sues failed Kentucky Health Co-op’s former chief executive board, alleging mismanagement

By Melissa Patrick and Al Cross Kentucky Health News The former president and directors of the Kentucky Health Cooperative, created under federal health reform, are facing a lawsuit from the state as liquidator of the failed, not-for-profit health insurer. “Years of mismanagement by co-op administrators and contractors forced the co-op into liquidation, leaving Kentucky’s citizens and their health-care...

Baptist Health Plan announces intension to withdraw from Kentucky’s individual insurance market

Baptist Health Plan, Kentucky’s fourth largest health insurance provider, has informed the Kentucky Department of Insurance (DOI) that it will withdraw entirely from the individual health insurance market for the 2017 plan year. Approximately 7,000 Kentuckians will have to find a new insurance provider. In a letter to Insurance Commissioner Brian Maynard, Baptist Health Plan president James S....

Annual workers’ compensation costs see overall decline for 11th straight year, Maynard says

An annual filing most insurance carriers will use to develop rates for workers’ compensation coverage shows the eleventh consecutive overall decrease in loss costs, Department of Insurance Commissioner Brian Maynard announced Friday. The 2016 filing, approved by the Kentucky Department of Insurance and effective Oct. 1, was submitted by the National Council on Compensation Insurance Inc. (NCCI),...

State approves nearly all health insurers’ rate hike requests for plans on exchange

Health insurers get almost all of the rate hikes they requested for plans on exchange; some get more than requested. The state Department of Insurance has largely approved the rate increases that health-insurance companies requested for individual and small-group plans that will be sold through the federal health-insurance exchange for 2017. The major exceptions were a 5.6 percent hike for individual...

Health-insurance companies seek rate increases averaging 17 percent; failure of non-profit blamed

From Kentucky Health News Health insurers want rate increases averaging 22.3 percent in 2017 for individual policies in Kentucky. Counting small-group plans, the overall increase would be 17 percent, “continuing a national trend of hefty hikes as insurers adapt to a market reshaped by President Barack Obama’s signature health care law,” Adam Beam reports for The Associated Press. “But...