Moda will honor health coverage according to current contracts

The announcement this week by Moda Health that it’s withdrawing from the Washington insurance market has understandably raised questions from its current enrollees.


Enrollees should be aware that their current policies will remain in effect according to the terms of the contracts. Moda said it will fulfill its obligations for plans signed on or renewed by Oct. 31, 2015. That includes policies that have already been sold that start on Nov. 1 or Dec. 1, 2015. Policies that start on Jan. 1, 2016 or later will be terminated.

That’s true for individual, small- and large-group employer plans.
Moda this week notified the Washington Health Benefit Exchange of its decision to quit doing business here. The Exchange is reaching out to its customers to let them know.

You can read that notification here.

In Washington state, Moda has:

• About 18,000 people enrolled in the individual market inside and outside of the Exchange.
• About 29,000 people covered through large-group plans.
• Another 900 enrolled in small-employer plans.

Moda said it is withdrawing from Washington to focus on its business in Oregon and Alaska.

By the first week of November, the Oregon-based company is expected to notify all of its enrollees of its withdrawal from Washington.

Do you need flood insurance? Now is the time to do your research

Residents in Eastern Washington are facing increased risk of flooding after extreme wildfires the last two summers destroyed much of the vegetation there that would normally help prevent landslides and mudflows.


Flood damage is not covered by homeowner’s insurance. Consumers who want to protect their property must purchase a policy through the National Flood Insurance Program (NFIP). Most properties qualify for NFIP, as long as it is located in a community that participates in the NFIP.

NFIP has told to us that Okanogan County and most towns within the county will be able to purchase flood insurance.

Typically, there is a 30-day waiting period before your flood insurance policy takes effect. Here is information on how to find an agent near you who sells flood insurance policies through NFIP.

Read more about flood insurance: Are you protected against flood damage?

Eastern Washington fires burned down much of the vegetation that prevents flooding.
Photo courtesy Washington Military Department.

OIC partners with the American Indian Health Commission on Medicare training

Earlier this year, Insurance Commissioner Mike Kreidler signed a contract with the American Indian Health Commission (AIHC) to support providing Medicare and other related training to tribal staff throughout the state.

The Commissioner's State Health Insurance Benefits Advisors (SHIBA) held its first quarterly training on Oct. 21 at Port Gamble S’Klallam tribal facilities in Kitsap County to 35 staff from several Western Washington tribes.

SHIBA will provide training throughout the year to tribes all over the state. Next up is a training in Spokane for tribes in the region.

The goal of the training to provide tribal assisters with information about Medicare eligibility, benefits and coordination with Medicaid for tribal elders and tribal members who need health care.

Dale Ensign with SHIBA provides
training to tribal staff about Medicare.

Mold, mildew, rot typically not covered by homeowner’s insurance

Living in the Northwest, it is not unusual for homeowners to discover mold, mildew or rot damage to their homes as a result of things like a leaking pipe, a hole in the roof, a failing window seal or improper venting.

Such damage is considered wear and tear and is typically not covered by homeowner's insurance. Insurance is designed to cover sudden and accidental damage caused by specific perils, such as a windstorm, fire or explosion. Some policies may cover mold or mildew damage discovered and reported within two weeks of the leak that caused the damage and some insurers offer limited mold coverage. Consumers should check their policies to find out what is covered.


We do hear from consumers who are unhappy to find out this type of damage is not covered by their insurance. If the policy specifically excludes such damage, we can't compel the company to pay for the repairs.


Here are some perils that homeowner's insurance policies typically do not cover:

• Earthquakes
• Floods
• Mold damage
• Damage due to animals or rodents
• Foundation settling

Read about more things insurance doesn't cover.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Do you have a teen driver? Five tips to cover with your teen

This week is National Teen Driver Safety Week, sponsored by the National Highway Traffic Safety Administration (NHTSA). Motor vehicle crashes are the leading cause of death for 14- to 18-year-olds in the United States. In 2013, 2,614 teen drivers were killed in crashes and an estimated 130,000 teens were injured. Yet, a recent survey shows that only 25% of parents have had a serious talk with their kids about the key components of driving.

1. The “5 to Drive” campaign addresses the five most dangerous and deadly behaviors for teen drivers. The idea behind the campaign is to give parents the words to use when they talk with their teens about the rules of the road. NHTSA’s website, has detailed information and statistics about the five rules designed to help save the lives of teen drivers.
2. No drinking and driving: Nearly one out of five (19 percent) of the young drivers 15 to 19 years old involved in fatal crashes had been drinking, even though they were too young to legally buy or possess alcohol.
3. Buckle up. Every trip. Every time. Front seat and back: 64 percent of all the young (13- to 19-year-old) passengers of teen (15- to 19-year-old) drivers who died in motor vehicle crashes in 2013 weren’t restrained.
4. Put it down. One text or call could wreck it all.: The age group of 15 to 19 years old has the highest percentage of drivers who were distracted by cell phone use and involved in a fatal crash. In 2013, 318 people were killed in crashes that involved a distracted teen driver.
5. Stop speeding before it stops you: In 2013, almost one-third (29 percent) of teen drivers involved in a fatal crash were speeding.
6. No more than one passenger at a time: The risk of a fatal crash goes up with each additional passenger.

More resources for teen drivers and their parents:

• Understanding auto insurance
• Washington state Department of Licensing: Teen driver safety

New Medicare pages on OIC's website, including new Advantage plans

SHIBA is happy to announce today's launch of the new and improved Medicare webpages on the OICs website. Last spring, SHIBA staff and OIC's Web Services team conducted a usability study on the agency's Medicare webpages. After several months of research, and writing and editing content, the new section should provide content that is more user-friendly and easier to navigate for consumers.

In addition, the 2016 Medicare Advantage and Special Needs plans by county are now available on the OIC's website. Medicare open enrollment started today and ends Dec. 7. Read more about Medicare open enrollment.

OIC joins Great ShakeOut drill – are you prepared for an earthquake?

The OIC is joining the Great Washington ShakeOut drill tomorrow, along with more than 1 million other participants in Washington state. 

In addition to practicing drop, cover and hold, in what other ways are you prepared for an earthquake? Here are some tips from the OIC to help you think about ways you can protect yourself and your home in the event of an earthquake:

• Standard homeowner’s policies do not cover earthquake damage. If you want to protect your investment in your home, you should contact your agent or broker about purchasing earthquake insurance. The coverage typically carries a deductible of up to 25 percent of the value of your home and pays if your home is destroyed by a quake. The time to buy it is before a quake strikes … the coverage is typically not available for a period of time after an earthquake hits. Watch Commissioner Kreidler explain earthquake insurance in a short video.
• Earthquake insurance does not cover damage that results from floods or tsunamis. You must purchase flood insurance, available through the National Flood Insurance Program, to be covered for flood damage. Read more about flood insurance.
• Make claims easier by creating an inventory of the contents of your home by filling out this PDF list. There are also apps that allow you to create a home inventory using your mobile device.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Use extra caution when driving in areas near wildlife

October and November are the months with the most collisions between vehicles and deer, which is compounded by fewer daylight hours and animal mating seasons and migrations. The National Highway Safety Administration (NHSA) reports there are about 1.5 million deer-related auto accidents each year. In Washington, more than 1,100 collisions with deer and other wildlife are reported to State Patrol each year, and result in an average of nearly 1,200 human injuries.

 


Hitting a deer or other large animal at highway speeds can, at best, damage your vehicle and at worst, injure or kill drivers and their passengers. The Washington state Department of Transportation (WSDOT) reports it removes nearly 3,500 deer and elk carcasses from state highways each year.

Our consumer advocates recommend that consumers check their insurance policies or contact their agents or brokers to find out if wildlife collisions are covered by the insurer. Most auto insurance policies cover such damag­e under the optional comprehensive portion of the policy. If you only have collision coverage or liability coverage, your insurer may not cover damage to your vehicle resulting from a collision with an animal. Comprehensive auto insurance also includes coverage for fire, theft, vandalism or malicious damage, riot, flood, earthquake or explosion, hail, windstorm and falling or flying objects. Filing a claim for an accident covered by your comprehensive coverage means you'll still need to pay a deductible. After that, your insurer will cover the costs of the claim up to your policy limits.

WSDOT reports the following areas of the state have the highest number of collisions with wildlife:

• Spokane and surrounding areas, where highways intersect with white-tailed deer wintering grounds.
• Methow River Valley, which is home to one of the state’s largest mule deer herds.
• Wenatchee and vicinity, also home to a large number of mule deer.
• Interstate 90 near Easton/Cle Elum has the highest number of collisions with elk.
• Whidbey Island has a high number of deer collisions
• Packwood/Randle off Highway 12 and North Bend off Interstate 90 have a high number of elk collisions.

Here are some tips to avoid hitting a deer or other wildlife:

• Deer tend to travel in herds, so if you see one, watch for more.
• Keep an eye out for deer signs, which are placed at known deer-crossing areas. Reduce your speed when you see a sign.
• Animals tend to be active during dawn and dusk, so be extra-aware during those times and watch your speed.
• Make sure your headlights are in working order to ensure you see well at night. Using high beams can help you spot wildlife, but be considerate of other drivers when using them.
• Stay focused while driving. Do not text, talk on your phone or allow passengers to distract you.
• Always wear your seat belt. This won't prevent a collision, but it can save your life depending upon the severity of the accident.

If you are involved in a collision with wildlife:

• If you can, move your vehicle to a safe place and turn on your hazard lights. This may mean pulling over to the shoulder of the highway.
• Stay away from the animal. A frightened or wounded animal can hurt you.
• If you can't move your car, or the animal carcass is blocking traffic, call 9-1-1 so emergency responders can clear the roadway.
• Document the collision by taking photos of your vehicle damage, the roadway and any injuries.
• Check to see if your vehicle is safe to operate. Check for leaking fluid, damaged lights, loose parts or other safety hazards. When in doubt, call a tow truck.
• Report the collision to your insurance as soon as you safely can.

Read more about auto insurance on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Homeowners, insurers have responsibilities in repair claims

We often hear from consumers who are concerned about their home repair or rebuild insurance claims and have questions about their insurer's role in overseeing the contractors' work.


 

 

Your insurance company is responsible for paying the claim, as laid out in your homeowner policy. Typically, it is your responsibility to oversee the project with your contractor, and when applicable, your lender. The exception would be if your insurance company has given you assurances or if your policy contains a provision that obligates the insurer to manage a covered home repair or rebuild.


However, if you are using an insurer’s recommended (sometimes called “preferred”) contractor, you should expect assistance from the insurer in answering your questions about the contractor’s actions and performance.

Many insurers also require the homeowner to stop the damage from getting worse--this is called loss mitigation in your policy. If you don’t mitigate the loss, you could be on the hook for paying for any resulting additional damage. For example, if you have water damage in your home, you must control it as soon as you discover it. If you let it go until you get around to calling your insurance company, you will be responsible for any resulting damage, including rot, mildew or mold. Even if you use an insurer's preferred contractor, you are still responsible for mitigating the loss prior to the contractor showing up and starting the repairs.

More information:

• Read about homeowner insurance.
• Make sure your contractor is licensed and bonded at suspectfraud.wa.gov.

Questions? You can contact our consumer advocates online or at 1-800-562-6900.