Humana Insurance Company and Humana Health Plan have been fined $299,000 by the Colorado Division of Insurance.
The division completed market conduct examinations of the two companies that found violations of Colorado insurance laws. The final orders resulted in fines totaling $184,000 for Human Insurance and $115,000 for Humana Health Plan. Both companies are licensed to sell insurance in Colorado and are headquartered in Louisville, Ken.
The exam, which covered July 1, 2007 to June 30, 2009, found a number of issues:
- Missing or incorrect information provided in policy forms, which in some cases related to mandatory benefits coverage.
- Using rates not filed with the Division of Insurance
- Failing to pay claims within time frames required by Colorado law
- Failing to use correct underwriting criteria for small groups
- Using incorrect utilization review procedures
- Failing to use correct procedures when terminating coverage
The final agency orders require both companies to correct the problems listed in the report and report back to the Division of Insurance in writing, documenting changes and corrections within specific timeframes.
The examination reports and Final Agency Orders can be viewed on the Division of Insurance’s website: http://www.dora.state.co.us/insurance/mcexam/MarketRegChron.htm