Order 24-0247

Order Summary
$100,000 fine levied by failing to provide timely notice of health care benefit managers on the Company’s initial public notice, website, and evidence of coverage, the Company violated WAC 284-180-325(1) and WAC 284-180-325(2); and by contracting with a health care benefit manager that denied claims based on time and frequency limits that were not filed and approved, and using unclear criteria to deny claims that did not match the benefit information provided to policyholders and the Insurance Commissioner, in violation of WAC 284-43-6560(1), RCW 48.43.733(1), and RCW 48.44.040, the Company is subject to a fine under RCW 48.44.166 and RCW 48.200.050.
Entities Named in the Order
Entity Name Location
DELTA DENTAL OF WASHINGTON SEATTLE, WA
Order Documents
Order Type Issue Date Effective Date
Consent Order with Fine 10/23/2024 11/20/2024

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