html5-img
1 / 17

Texas Department of Insurance Mini-Conference for Chiropractors

Texas Department of Insurance Mini-Conference for Chiropractors. Audrey Selden, Senior Associate Commissioner, Consumer Protection Valerie Brown, Director, Complaints Resolution, Consumer Protection Teresa Carney, Director of System Monitoring and Oversight, Division of Workers’ Compensation

habib
Download Presentation

Texas Department of Insurance Mini-Conference for Chiropractors

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Texas Department of Insurance Mini-Conference for Chiropractors Audrey Selden, Senior Associate Commissioner, Consumer Protection Valerie Brown, Director, Complaints Resolution, Consumer Protection Teresa Carney, Director of System Monitoring and Oversight, Division of Workers’ Compensation Catherine Reyer, Associate Commissioner, Enforcement Dennis Pompa, Associate Commissioner, Fraud Jennifer Ahrens, Senior Associate Commissioner/Provider Ombudsman, Life, Health, and Licensing

  2. Agenda • Welcome and Introductions • Antitrust Statement • Texas Department of Insurance – Key Regulatory Functions • The Complaint Process • Written complaints • How complaints are resolved • Topics and trends • How TDI uses complaint data • Division of Workers’ Compensation – • Complaints • Performance based oversight • Dispute resolution • The Enforcement Process • Regulatory philosophy • Referrals • Sanctions • TDI Fraud Unit • TDI Resources for Chiropractors

  3. Key Regulatory Functions • Licensing, Certification, and Registration • Workers’ compensation self-insured groups (WC SIGs) • Surplus lines carriers (SLs) • Accredited/trusteed reinsurers • Risk retention groups (RRGs) • Purchasing groups (PGs) • Workers’ compensation networks • Life/health companies • Property/casualty • Health maintenance organizations (HMOs) • Multiple employer welfare arrangements (MEWAs) • Continuing care retirement communities (CCRCs)

  4. Key Regulatory Functions

  5. mergers redomestications license amendments charter amendments withdrawal plans cancellation of licenses dissolutions, etc. Key Regulatory Functions • Assists the industry with processing and guidance on various corporate transactions, including:

  6. Regulatory Functions • 24 license types (effective September 1, 2007) • 700,000 filings processed each year • $14.7 million expected in FY 2007 fee revenue collections • 2.2 days average processing time • 370,218 active licenses (as of August 31, 2007)

  7. Regulatory Functions • Fire Alarm, Extinguisher, and Sprinkler • 2,500 businesses registered • 7,000 employees licensed • $1.75 million in revenue generated • Fireworks • 50 firms licensed • 600 public fireworks displays licensed • 800 individuals display operators licensed • 5,000 retail fireworks stands licensed • $250,000 in revenue generated

  8. Regulatory Functions • Review individual insurer form and rate filings and certain advertising • Promulgated form • File and use • Prior approval • Exempt

  9. Regulatory Functions • Complaint and Dispute Resolution • Examination, Monitoring, and Solvency Intervention • Enforcement, Fraud, and Investigations

  10. Regulatory Functions • Education, Outreach and Customer Assistance • Live, face-to-face outreach • TDI website • Print publications, DVDs, and video loans • Telephone assistance • Stakeholder meetings/public hearings • Partnerships

  11. When a fire breaks out in a crowded place, everyone runs to the entrance. The crush of bodies forms a bottleneck. People panic and start pushing. Some fall down. Some even die. When you walk into a public place, do your homework. Plan an exit strategy. And keep in mind, the best way out may not be the way in.

  12. Regulatory Functions • Inspections and Consultations • Commercial property oversight • Loss control inspections • Amusement ride compliance • Windstorm inspection program and engineering • Inspect for fire and life safety hazards • New responsibility – fire-safe cigarettes • Accident prevention programs • Voluntary Occupational Safety and Health Administration (OSHA) Compliance Assistance

  13. Regulatory Functions • Research and Analysis • Evaluates and sets insurance rates • Monitors insurance marketplace • Monitors loss experience and tracks system trends • Checks for compliance with statutes and rules • Conducts studies on special issues • Responds to information requests

  14. Average Medical Cost Per Claim Network and Non-Network Claims, 6 Months Post Injury Source: Texas Department of Insurance, Workers’ Compensation Research and Evaluation Group, 2007

  15. Texans’ Insurance Status - 2005 Source: U.S. Census Bureau, Current Population Survey, 2006

  16. Financial Program Catastrophe Planning • Financial Program tests insurance company catastrophe sensitivity to determine if any solvency concerns exist as the result of a natural catastrophe, specifically hurricanes • Conducts company inquiries to gather additional information • Holds management conferences • Intervenes, as necessary

  17. Financial Program Catastrophe Planning

More Related