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Humana Fined For Misleading Missouri Policyholders

Humana Insurance has agreed to pay a $161,800 fine for misleading policyholders, the Missouri Department of Insurance said Tuesday.

It’s the second time in less than a year that the department has slapped Humana with a penalty.

The latest fine stems from notices Humana sent to 1,618 policyholders, according to the department. The notices stated that, due to Missouri legislation, Humana was required to terminate their policies on Dec. 31, 2013, and replace them with new ones with 2014 benefits under the Affordable Care Act.

There is no such Missouri legislation.

The department also said Humana told policyholders that its rates were subject to insurance department approval.

In fact, health insurance rates are not subject to the department’s approval.

Humana representatives could not immediately be reached for comment.

In a statement, department director John M. Huff said, “Residents in other states throughout the country have the benefit of rate transparency and regulatory protection from health insurance rates that are excessive, inadequate or discriminatory. Insurance companies may not mislead Missourians into believing they have the same regulatory protections that other states provide.”

Humana will pay its fine to the Missouri state school fund.

Earlier this year, Humana agreed to pay $1.8 million to 10 states, including Missouri, and to establish a $2.7 million consumer restitution pool. The insurance department said Humana had required some employers who purchased small group medical insurance to purchase a group life insurance product as well.

Missouri collaborated on that investigation with regulators in Mississippi and Wisconsin. Missouri received $390,886, which also was paid to the Missouri state school fund.

The investigation of the company began in 2012, based on a referral of a single complaint that was filed by a small employer with the department’s consumer affairs division, the department said.

Dan Margolies, editor of the Heartland Health Monitor team, is based at KCUR.

Dan Margolies has been a reporter for the Kansas City Business Journal, The Kansas City Star, and KCUR Public Radio. He retired as a reporter in December 2022 after a 37-year journalism career.
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