Kaiser Fined For Conduct Violations In Colorado

Thursday, Jul 23,2009, 11:09:37 AM Click:

Kaiser Permanente Insurance Company and Kaiser Foundation Health Plan of Colorado have been fined for several conduct violations.

Kaiser health plan was fined $201,000, and the insurance company was fined $166,000.

"The violations were pretty typical for a large insurance company," said Carol O'Bryan, director of market regulation for the Division of Insurance. "We have some very Colorado-specific statutes and those were where most of the violations occurred.

The examinations covered calendar year 2007 and both companies submitted payment for the fined last week, according to a release from the division of insurance.

O'Bryan said the companies had corrected most of the problems found in the report.

Failures listed in the report include:

* maintaining and providing records

* roviding coverage for newborn or adopted dependents

* poviding coverage for maternity care

* ncluding certain provisions in a contract

* giving correct information about termination and continuation of coverage

including correct co-pays and co-insurance requirements in basic membership agreements

* providing accurate information regarding coverage for emergency services

* providing written notice of the availability of basic standard health benefit plans to businesses that were denied coverage

* paying, denying or settling claims within the time periods required by Colorado law

* adjudicating claims resulting in erroneous denials