Department of Insurance: Successes and Looking Forward Karen Weldin - - PowerPoint PPT Presentation

Department of Insurance: Successes and Looking Forward Karen Weldin Stewart, CIR‐ML Insurance Commissioner

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What Does The DOI Do?

Our mission: “Protecting Delawareans through

regulation and education while providing oversight

• f the insurance industry to best serve the public.”

The Department of Insurance exists to:

• Protect insurance consumers
• Regulate companies to ensure ability to pay claims
• Review, approve, and/or disapprove rates submitted by insurance companies
• Prosecute insurance fraud
• License agents and brokers
• Save businesses money on premium costs
• Assist Medicare‐eligible seniors

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About Commissioner Stewart

• Elected Delaware's 25th Insurance Commissioner in 2008, reelected in

2012 and now serving a second term, Karen Weldin Stewart heads the Delaware Department of Insurance (DOI), the largest consumer protection agency in the state.

• Commissioner Stewart contributes to numerous boards and is currently

serving on the State Employee Benefits Committee, Delaware Health Care Commission, the Deferred Compensation Council and the Council on Health Promotion and Disease Prevention.

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How Delaware Ranks Nationally

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• Delaware has the 7th lowest insurance department
• perating budget in the U.S.
• Delaware regulates 151 domestic insurance companies

including 123 multi national and/or multi state companies

• Delaware has maintained its professional accreditation

for 20 years

• Delaware ranks 10th nationally in domestic written

premiums

*All data from calendar year 2014*

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Where it comes from FY14 Actual Premium Taxes $88.3 million Licensing Fees and Fines $6.3 million Gross Receipts – General Fund $94.6 million Where it goes FY14 Actual Fire/Ambulance/Police Pension Fund/Health Fund $35.1 million Fraud Fund $1.0 million Workers’ Comp $3.6 million Net General Fund $54.9 million

Department Contributions

Bureau of Company Examination, Rehabilitation and Guaranty (BERG)

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What We Do FY14 Accomplishments

• Regulate 151 Delaware domiciled companies using financial

analysis and on‐site exams (over $489 billion in assets)

• Monitor the licensing and solvency of approximately 1,800

insurance entities authorized, admitted, or approved to do business in Delaware

• Analyzed and approved approximately 600 filings related to insurance company

dividend requests, affiliate transactions, new company admissions, redomestications, mergers and acquisitions

• Retained national accreditation through comprehensive and timely review of

insurance company financial data

Fraud Bureau

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The Fraud Bureau is charged with investigating allegations of insurance fraud in all lines of insurance, as well as provider fraud (doctors, dentists, chiropractors, clinics, lawyers, etc.) and fraud committed by insurance companies, agents and brokers. According to the FBI, insurance fraud costs each U.S. family an average of $400‐$700 per year!

What Fraud Costs the Consumer

Consumer Services

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Need Help? Contact Consumer Services for Assistance

• Investigate consumer complaints asserting improper treatment by agents and/or

insurance companies.

• Assists consumers in resolving conflicts with insurance companies, health coverage

providers, and agents.

• Educate consumers through focused outreaches
• Connect with community partners to create awareness of the DOI’s purpose
• Help consumers to gain an understanding of their contractual and legal rights
• Provides arbitration hearings as a low‐cost alternative to civil litigation to resolve

disputed consumer claims.

• Consumer Services recovered $1,259,634.92 on behalf of Delaware consumers

$843,034.96 was awarded to policy holders through arbitration

• $2,102,669.88 Total amount that the DOI helped recoup for consumers in FY2014.
• Phone: 1‐800‐282‐8611 (toll‐free in DE) or 302‐674‐7310
• E‐mail: consumer@state.de.us

What We Do

Workplace Safety Program

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What We Do

• Provide participating Delaware employers a

discount (up to 19%) on workers’ compensation insurance premiums

• Establish testing/inspection procedures to

determine qualification

FY14 Accomplishments

• Saved Delaware businesses $9.3 million in premium expenses
• Served 1,496 participating Delaware businesses
• Brought 78 new businesses into the program in CY’14

Delaware Medicare Assistance Bureau

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What We Do FY14 Accomplishments

• Provide free health insurance counseling to Medicare population
• Empower Medicare population to better understand their options related to

Medigap (Medicare supplement insurance), Medicare Part D, Medicare Advantage plans, financial assistance programs, and more

• Assisted approximately 6,500 Medicare Beneficiaries
• Performed 94 outreach activities in all three counties, and provided DMAB

materials via direct‐mailing efforts to more than 27,000 beneficiaries, caregivers, and service providers.

• Provided Part D counseling approximately to 2,800 Medicare beneficiaries
• Maintained effective partnership with Delaware Medicaid & Medical

Assistance (DMMA) which resulted in Medicare beneficiaries saving approximately $609,000

Market Regulation and Enforcement

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What We Do FY14 Accomplishments

• Perform Market Analysis reviews and Market Conduct examination on

companies and producers

• Review premium rate and form filings
• License agents, adjusters, surplus lines brokers, and Discount Medical

Plans

• Performed 160 Market Analysis Reviews
• Agent Market Conduct: 332 investigations with restitution totaling $209,000

in calendar year 2014

• Processed 74,451 producer appointments and issued 25,797 licenses
• Unit reviewed, certified Qualified health plan applications and established

monitoring procedures for the Quality Health Plan Issuers consistent with the Affordable Care Act (ACA)

Captive Bureau

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• Captive Insurance is Delaware’s fastest growing industry. When the

Commissioner formed the Captive Bureau in July 2009 it had 38 captives

• The Bureau licensed its 1000th active captive entity in October 2015
• Delaware is the world’s 6th largest and the 3rd largest U.S. captive domicile
• Increased calendar year captive premium

from $2.4 billion in 2012 to $6.6 billion in

• 2013. Delaware is the 3rd largest U.S.

domicile in terms of premium.

About the Program Accomplishments

Bureau of Captive and Financial Insurance Products

Q: What is captive insurance? A: A captive insurer is generally defined as an insurance company that is wholly owned and controlled by its insureds; its primary purpose is to insure the risks of its owners, and its insureds benefit from the captive insurer’s underwriting profits. Captive insurance is utilized by insureds that choose to:

• put their own capital at risk by creating their own insurance

company,

• working outside of the commercial insurance marketplace,
• to achieve their risk financing objectives.

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2014 Achievements:

 The growth in the number of captive insurers results in a steady increase in the amount of annual premium taxes and fees.  During Commissioner Stewart’s tenure, the Captive Bureau has generated more than $11 million in revenue.  Gross expenses for 2014 are $1.2 million – gross revenue is $4.4 million.  The Captive Bureau is fulfilling Commissioner Stewart’s promise of being a profit center!

Captive Bureau

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$‐ $500,000.00 $1,000,000.00 $1,500,000.00 $2,000,000.00 $2,500,000.00 $3,000,000.00 $3,500,000.00 $4,000,000.00 $4,500,000.00 $5,000,000.00

Annual Captive Revenue

DOI Successes in 2014

• Transferred $54.9 Million to General Fund FY’ 14
• Saved $9.3 Million in workers compensation insurance premiums for

Delaware businesses through the Workplace Safety Program

• Recovered approximately $2.1 Million for Delaware consumers
• Restructured the Consumer Services Division in to Life & Health and

Property & Casualty sections to better serve consumers

• Exceeded all expectations with the growth of the Captive Bureau

ranking us 3rd in the nation and 6th globally

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Delaware Insurance Department Questions?

(302) 674‐7300 www.delawareinsurance.gov

“Like” us on Facebook at www.facebook.com/Delawareinsurance.gov Follow us on twitter @Delaware_DOI

Thank you for your time!