United Healthcare Co’s slapped with fines for coverage lapses, other violations

The Colorado Division of Insurance levied two fines against insurance companies that operate in Colorado.

United Healthcare of Colorado received a $211,000 fine and United Healthcare Insurance Company received a $246,000 fine.

Commissioner Marcy Morrison said that conduct examinations for calendar year 2007 found that the companies had provided incomplete information in certificates of creditable coverage, failed to pay claims timely and accurately and failed to comply with the requirement for physician review in some cases.

The exams showed that some individual consumers – whose coverage in a small group plan ended – were not offered coverage under the state mandated basic and standard plans. United Healthcare Insurance Company also had several violations pertaining to information provided in its policy forms.

The companies have paid the fines, Morrison said.

The final agency orders require both companies to document changes made to correct the problem and to report back to the Division of Insurance in writing, documenting changes and improvements.

Copies of the examination and final agency orders are available at www.dora.state.co.us/nsurance/mcexam/marketregchron.html.