DENVER - Two units of Kaiser Permanente have paid a total of $367,000 for 2007 market violations.

The Colorado Division of Insurance, which announced the violations yesterday, conducted two market examinations covering the 2007 calendar year. Kaiser Foundation Health Plan of Colorado and Kaiser Permanente Insurance Co. received fines of $201,000 and $166,000, respectively. Payment was received on July 6.

The Division of Insurance, part of the Colorado Department of Regulatory Agencies, carries out market conduct examinations of insurance companies to ensure compliance with state insurance law and regulations related to rating, underwriting and claim practices.

The Kaiser reports identified a number of issues, many dealing with items in contracts and other forms. The reports also included issues with claims, such as failure, in some instances, to:

  • pay, deny, or settle claims within the time periods required by Colorado insurance law;
  • allow the required time for submission of additional information before denying; and
  • provide notice of appeal rights on denied claims.
"Consumers count on health insurers to provide the services they have purchased," said Insurance Commissioner Marcy Morrison in the announcement. "It's imperative that companies fulfill their responsibilities to the consumers. We have made it clear that our mission is to protect consumers and these market conduct examinations and resulting fines reflect our commitment."
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