West Virginia Offices of the Insurance Commissioner 2009 Annual ...

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STATE OF WEST VIRGINIA Offices of the Insurance Commissioner JOE MANCHIN III Governor JANE L. CLINE Insurance Commissioner November 1, 2010 The Honorable Joe Manchin Governor of the State of West Virginia State Capitol Charleston, WV 25305 Dear Governor Manchin: The Annual Report of the Insurance Commissioner of the State of West Virginia for the calendar year 2009 is hereby submitted in accordance with Chapter 33, Article 2, Section 15, of the Code of West Virginia. An Executive Summary immediately follows this memorandum. The information contained in this report reflects the economic importance and current financial condition of the insurance industry in our State. The included insurance entity statistics are compiled from the December 31, 2009 annual statements filed with this agency by the insurance companies licensed in this State. Respectfully submitted, Jane L. Cline Insurance Commissioner 1124 Smith Street Charleston, WV 25301 “We are an Equal Opportunity Employer” Telephone 304.558.6279 www.wvinsurance.gov
Executive Summary This report to the Governor of West Virginia provides detail about the structure and activities of the West Virginia Offices of the Insurance Commissioner for the preceding year. The report is divided into three major sections. Each section is detailed below. Section 1 of this report highlights the organization of our office and provides detail for its $187.2M in total revenue collected from the previous year. It includes an interdepartmental organizational chart, historical list of insurance commissioners, and then proceeds to identify the individual revenue streams managed by this agency. Section 2 of this report further identifies the functional divisions of this office, and enumerates each division’s individual activities during the past year. A summarization of those activities follows: AccessWV-(West Virginia Health Insurance Plan.), known as the state high-risk health insurance pool, increased its membership from 576 to 734 during 2009 and provided insurance to 846 members during the year. It ended the year with an operational gain of $335,000. The Agents Licensing and Education Division presides over processing and maintaining records on individual producers licensed to transact insurance business in WV, and issued over 11,014 new licenses in 2009, while handling over 136,000 company appointments and appointment cancellations. The Workers’ Compensation Board of Review handles appeals of Workers’ Compensation claims and during 2009 they maintained their goal of operating without a backlog. They received 157 new appeals per month with average dispositions of 174. The Claims Services Division, which oversees management of the workers’ compensation “Old Fund”, successfully transitioned 47,000 active workers’ compensation claims from BrickStreet Mutual Insurance to three independent Third Party Administrators: Sedgwick Claims Management Services, Wells Fargo Disability Management, and American Mining Claims Services. Since that time, through proper claims handling utilizing accepted industry standards and a focused settlement initiative, approximately 48% of the active caseload has been closed. The Office of Consumer Advocacy assisted consumers in 47 complaints during 2009 and also participated in the review of 35 Certificate of Need applications and 34 Hospital Rate Review Applications. The Consumer Service Division assists our insurance consumers with questions and complaints. The division received a total of 2,322 written complaints from insurance consumers in 2009. Over the course of the year, the Division responded to an average of 135 consumer inquiries per day. The Employer Coverage Unit reviews and grants requests for exemptions from statutory Workers’ Compensation Coverage as well as serving as the contact point for employee claimants of uninsured employers. The Unit reviewed 2,938 applications for exemption during 2009, and approved 2,269 of the same. The Financial Accounting Unit is responsible for the preparation of audited financial statements, monthly financial reports, and the budget. In 2009, the unit received a fourth consecutive “clean” opinion on the Audited Financial Statements. The Financial Conditions Division monitors insurance company financial stability and collects premium taxes and surcharges. They oversaw a total of 2,256 separate insurance entities transacting business in West Virginia during 2009 (up from 2,115 in 2008).
Page 1: West Virginia Offices of the Insura
Page 5 and 6: TABLE OF CONTENTS SECTION 1 GENERAL
Page 7 and 8: Admitted Assets, Liabilities, Commo
Page 9 and 10: Organizational Chart Virgil Helton,
Page 11 and 12: FEES AND TAXES COLLECTED DURING THE
Page 13 and 14: WEST VIRGINIA OFFICES OF THE INSURA
Page 15 and 16: APPROPRIATED APPROPRIATED EXPENDITU
Page 17 and 18: SECTION 2 DIVISIONAL REPORTS 17
Page 19 and 20: An applicant must be a resident of
Page 21 and 22: Major Activities in 2009 The Plan
Page 23 and 24: Agents Licensing and Education Divi
Page 25: Workers’ Compensation Board of Re
Page 28 and 29: The focused settlement initiative h
Page 30 and 31: October 2008 November 2008 December
Page 32 and 33: Offices of the Insurance Commission
Page 34 and 35: January 2009 February 2009 March 20
Page 36 and 37: Representing Consumers in First and
Page 38 and 39: FIRST PARTY COMPLAINTS HANDLED BY T
Page 40 and 41: CERTIFICATE OF NEED - March 2009 FA
Page 42 and 43: Hospital Rate Review The Office of
Page 44 and 45: Consumer Service Division The Consu
Page 46 and 47: CONSUMER SERVICE COMPLAINTS CALENDA
Page 48 and 49: CONSUMER SERVICE COMPLAINTS CALENDA
Page 50 and 51: Employer Coverage Unit The Employer
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Financial Accounting Unit The Finan
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Financial Conditions Division The p
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FINANCIAL CONDITIONS DIVISION West
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FINANCIAL CONDITIONS DIVISION West
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WEST VIRGINIA ESSENTIAL PROPERTY IN
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2009 Summary of West Virginia Opera
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American Retirement Life Insurance
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ADP Totalsource, Inc. d/b/a ADP Tot
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FINANCIAL CONDITIONS DIVISION Merit
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FINANCIAL CONDITIONS DIVISION Compa
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FINANCIAL CONDITIONS DIVISION Risk
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National Health Club Purchasing Gro
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FINANCIAL CONDITIONS DIVISION Name
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ADA Risk Purchasing Group, Inc. (Am
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FINANCIAL CONDITIONS DIVISION Liqui
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Office of Inspector General—Fraud
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The following chart depicts statist
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James R. Hiroskey Jr., age 25 of Lo
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Ramona Mack, age 40 of Winfield, pl
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Jennifer Jo & Matthew Nichols, ages
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Senate Bill 284 - Relating to Viati
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Senate Bill 537 - Relating to Worke
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Senate Bill 537 -continued §33-2-2
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House Bill 3047 - Clarifying that t
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114 CSR 42 - Continuing Education f
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09-EO-03 - Emergency Order entered
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DISCIPLINARY ACTIONS Individual Ins
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Market Conduct Unit Four (4) “Agr
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Employer Violator System (EVS) The
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MANAGED HEALTH CARE PLANS: The West
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A Client Reporting process was deve
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Non-Workers’ Compensation Matters
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Rates and Forms Division The Rates
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2009 Filings by Product Commercial
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Approved Rate Change History of Top
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Private Passenger Auto Market Share
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2009 West Virginia Market Share Rep
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Total for Top 10 Insurers 76.87% $4
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Admitted Assets, Liabilities, Net W
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Domestic Property Insurers Common P
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Admitted Assets, Liabilities, Capit
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Admitted Assets, Liabilities, Capit
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West Virginia Offices of the Insurance Commissioner 2009 Annual ...

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