OIC 2025 Overview Presentation to Senate Business, Financial Services, and Trade Committee
Summary
Slides titled OIC 2025 Overview, presented to the Senate Business, Financial Services, and Trade Committee by the Office of the Insurance Commissioner (OIC). They list OIC's primary responsibilities, including consumer protection, premium tax collection, insurer solvency monitoring, and producer licensing, and say OIC regulates over 3000 insurance and risk-bearing entities. They state a 2023-2025 projection of $1.7 Billion to the General Fund, of which $1.65B is from premium taxes, and a biennial appropriation of $91.837 million with 286 FTEs. For state fiscal year 2023-2024 they report almost 10,000 consumer complaints processed, leading to recovery of $45m for consumers, and they report 159 total enforcement orders issued in 2024.
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“OIC 2025 Overview Presentation to Senate Business, Financial Services, and Trade Committee.”
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OIC 2025 Overview
Presentation to Senate Business, Financial Services, and Trade Committee
January 10, 2023
OIC Primary Responsibilities
• Consumer Protection
• Collect premium tax for general fund
• Monitor insurance company solvency
• Producer licensing and oversight
• Rates and forms approval
• Enforcement of federal and state laws
• Implementation of new laws/Rulemaking
OIC 2025 Overview January 15, 2025 2
2023-2025 Revenue
• $1.7 Billion projected to the General Fund
• $1.65B from premium taxes
• $50M from licensing and appointment fees
• $5M from penalties assessed
• $49.9 Million to the Health Benefit Exchange
Account
• $70.6 Million to the OIC regulatory account
• $3.7 Million to the OIC Fraud account
OIC 2025 Overview January 15, 2025 3
2023-2025 Operating Budget
• OIC has no GF-S appropriation
• OIC’s biennial appropriation is $91.837 million with
286 FTEs. It is funded via:
• Regulatory surcharge account
• Fraud surcharge account
• Federal grants ($4.72M)
• Any excess fund balance in the OIC operating
accounts is required to be returned to the
organizations paying into the accounts.
OIC 2025 Overview January 15, 2025 4
Company Supervision 2024
OIC regulates over 3000 insurance and risk-bearing entities.
Financial examinations:
• To ensure insurers are solvent and can pay claims – at least once every 5 years per
insurer/holding company
• 35 domestic insurers- quarterly and annually
• Including 19 in-depth financial examinations
• 1,500 foreign insurers- quarterly
• 300 charitable gift annuities, 100 service contract providers- annually
Market Conduct:
• Market Analysis: Informed by, e.g. consumer complaints and enforcement actions in
other states
• Focus on compliance with all other state and federal laws, other than financial
• 153 reviews of 120 companies – 65 entities had two levels of review
• Market continuum: Investigation to obtain data and information from companies
• 70 continuums; some involve the same companies
• Closed 32 continuums – with 14 with potential violations (could be multiple
violations) referred for legal enforcement
OIC 2025 Overview January 7, 2025 5
Office of the Insurance Commissioner
Types of P&C companies OIC regulates
• Authorized companies (RCW 48.05)
• Licensed (750 P&C companies and another 200 liability only)
• Insurance producers (agent/brokers)
• ~74k producers
• Review and approve policy forms and rates
• ~2000 policy filings and 1500 rate filings per year
• Unauthorized companies (RCW 48.15)
• Unlicensed- About 14% of the market
• Do NOT review and approve policy forms and rates
• Surplus line brokers
• ~4.3k licensed brokers
• Risk Pools (RCW 48.62)
• Allows local governments to individual self insure or jointly create risk pools
• Regulated the state risk manager office within DES
• Risk Retention Groups (RCW 48.92) (liability only)
• Created by the federal govt., file a notice with OIC when doing business in WA.
• OIC cannot reject a notice from an RRG.
• Do NOT review and approve policy forms and rates
OIC 2025 Overview January 15, 2025 6
Rates, Forms, & Provider Network review
In 2024, we reviewed and approved:
• 11,360 health, life, and disability forms, which
includes provider contracts
• 7,909 provider contracts
• 294 health care benefit management contracts
• 4,007 health, life, and disability rate filings
• 1,907 property and casualty forms
• 1,429 property and casualty rate filings
OIC 2025 Overview January 15, 2025 7
Producer Licensing and Oversight
July 1, 2023 – June 30, 2024
• Processed 62,704 applications
• Directly assisted 34,715 callers
• Responded to 26,198 email inquiries
OIC 2025 Overview January 15, 2025 8
Producer Licensing and Oversight
July 1, 2023 – June 30, 2024
With 5 FTEs, the Compliance Team:
• Reviewed 3,483 applications with felony convictions revealed
• Requested 11,418 FBI & WSP background checks on applicants
• Reviewed 2,811 Administrative Actions reported to the OIC
• Contacted 4,439 Licensees to correct issues of non-compliance
• Referred 291 cases to OIC Legal Affairs division for action
• Approved 1,057 continuing education courses, and denied 107
other courses
OIC 2025 Overview January 15, 2025 9
Consumer Advocacy
During State Fiscal Year 2023-2024, OIC:
• Processed almost 10,000 consumer complaints,
leading to recovery of $45m for consumers.
• 93,700 contacts with consumers through:
• Calls to the OIC consumer hotline
• Live chat sessions
• Written consumer inquiries
• Distributed 3,065 insurance-related publications
to consumers.
OIC 2025 Overview January 7, 2025 10
Top reasons consumers contact us
• Claim denials, delays,
and disputes
• Coverage issues and
appeals
• Network access issues
• Cancellations and
renewals
• Rate Increases
• Help navigating their
insurance policy and
benefits
OIC 2025 Overview January 15, 2025 11
0 500 1000 1500 2000 2500 3000
2014 Q3
2014 Q4
2015 Q1
2015 Q2
2015 Q3
2015 Q4
2016 Q1
2016 Q2
OIC 2025 Overview
2016 Q3
2016 Q4
2017 Q1
2017 Q2
2017 Q3
2017 Q4
2018 Q1
2018 Q2
2018 Q3
Life and Health Complaints
2018 Q4
2019 Q1
2019 Q2
2019 Q3
2019 Q4
2020 Q1
2020 Q2
2020 Q3
2020 Q4
2021 Q1
2021 Q2
Property and Casualty Complaints
2021 Q3
2021 Q4
2022 Q1
2022 Q2
2022 Q3
2022 Q4
2023 Q1
Complaints per quarter 2014 to 2024
2023 Q2
2023 Q3
January 15, 2025
2023 Q4
2024 Q1
2024 Q2
12
Consumer recoveries per year by unit
$35,000,000.00
$30,000,000.00
$25,000,000.00
$20,000,000.00
$15,000,000.00
$10,000,000.00
$5,000,000.00
$-
2020* 2021 2022 2023 2024
Property & Casualty Life & Disability
* Excludes Single Anomalous Recovery
OIC 2025 Overview January 15, 2025 13
Regulatory investigations completed in 2024
9% Dishonest or untrustworthy
15% Fraud
42%
105
Incompetent or Negligent
4%
Other
Unauthorized activity
19%
Unlicensed
11%
OIC 2025 Overview January 15, 2025 14
Enforcement orders issued 2024
159 total enforcement orders
• Revocations
• Consent order with fine
• Cease and Desist
105 enforcement orders with fines
• Companies
• Licensees
• Unlicensed
All fines recovered are distributed into the state general fund
OIC 2024 Overview January 15, 2025 15
Criminal Fraud referred to OIC
3,720
3,490
3,246
2,657
2021 2022 2023 2024
ISO NAIC Contact CIU
OIC 2025 Overview January 15, 2025 16
Criminal cases opened
70 31
Companies
Cases opened in 2024
represented
15 61%
Property Crimes, 17%
Counties in
- medical providers,
Washington State
22% - other
OIC 2025 Overview January 15, 2025 17
Questions?
Rory Paine-Donovan
Legislative Director
Rory.Paine-Donovan@oic.wa.gov (564) 250-5124
David Forte
Senior Policy Advisor, Property & Casualty
David.Forte@oic.wa.gov (360) 725-7268
Connect with us!
• Facebook: https://www.facebook.com/WSOIC
• Twitter: https://twitter.com/WA_OIC
• www.insurance.wa.gov
OIC 2025 Overview January 15, 2025 18
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