ICAE – Savannah, GA – Spring 2000 Exchange – Regulators Breakout Session

Regulators Session

We discussed the different systems that the states were using for tracking purposes and tried to glean information from other states as to what worked best for them.

We discussed the white paper and determined that most states do not generally accept oral complaints.

States were questions concerning complaints received since introducing prompt pay legislation (HMO).

Ohio has seen an increase in provider complaints since their prompt pay legislation and these are handled in Market Conduct. New York is hoping to have providers enter their complaints through the internet and they have also seen an increase in complaints.

We discussed the different systems that states use to report complaints to NAIC.

We discussed the staffing of the different department’s consumer sections.

Illinois will be introducing a system which will allow companies to access a complaint directly in their (IL)tracking system. They will be scanning all documents and companies will be able to place their response directly into the complaint file. They are planning on implementation sometime the first of next year.

There was a quick discussion of complaint ratios and justifying complaints, most states don’t justify complaint however they do publish some type of ratio.

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