Order 19-0509

Order Summary
$100,000 fine levied with compliance and reporting requirements for failing to timely provide decisions on 5,053 preauthorization requests, for failing to timely respond to an inquiry of the Insurance Commissioner, for misclassifying two (2) appeals and failing to provide the IRO with records, documents, or information relevant to the Independent Review within 3 business days, for failing to timely notify the insured of its review decision in two (2) instances, and for issuing 292 notices to insureds with incorrect language regarding the timeframe allowed for the submission of additional information. WAC 284-43-2050(10)(a)(i); WAC 284-30-650; RCW 48.43.535(4); WAC 284-43-3110(1); RCW 48.43.530(5)(c); WAC 284-43A-140(4)(d); RCW 48.43.535(5).
Entities Named in the Order
Entity Name Location
PREMERA BLUE CROSS MTLAKE TERRACE, WA
Order Documents
Order Type Issue Date Effective Date
Consent Order with Fine 12/10/2019 01/15/2020

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