Insurance Commissioner fines Dental Health Services $300k: 5 takeaways

Insurance Commissioner Mike Kreidler fined Dental Health Services $300,000 and order the provider to develop a compliance plan to resolve customer concerns, according to the seattle pi.

Here are five takeaways:

1. Dental Health Services agreed to the order and plans to hire an external auditor by the end of the month.

2. The Insurance Commissioner will suspend $200,000 of the fine if the provider:

• Develops an acceptable plan to correct violations
• Meets all requirements of a compliance plan
• Makes whole all enrollees who experienced a delay in care or out-of-network charges because a provider was not available in their service area
• Has no additional violations for the next two years

3. The fines came after Dental Health Services failed to resolve consumer grievances and failed to deliver enrollment and membership materials to enrollees in a timely manner.

4. In addition to the fine, Mr. Kriedler required Dental Health Services to fix its provider contracts with dentists due to the frequent inadequacies.

5. Dental Health Services is the second largest insurer in Washington with more than 52,000 enrollees.

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