All five major Connecticut health insurers — Aetna, Anthem, Cigna, Connecticare and UnitedHealthcare — were fined for failing to provide mental health parity to policyholders
The Insurance Department never disclosed the fine amounts, which are capped at $625,000 per carrier for non-compliance
Sens. Lesser and Cabrera urged the department to go beyond financial penalties and require formal corrective action plans with reimbursement to affected enrollees
Just days after the state Insurance Department issued a report saying it has fined five Connecticut insurance companies for short-changing customers seeking mental health treatments, state Senators Matt Lesser (D-Middletown) and Jorge Cabrera (D-Hamden) have written a letter asking the insurance commissioner: How much did you fine them?
Last week, less than 10 months after Democrats passed a new law requiring state insurance companies to provide mental health parity to their policyholders or face steep fines, the first report on their compliance was issued – and all five of the major Connecticut health carriers were fined.
The Insurance Department found that all five Connecticut insurance carriers – Aetna, Anthem, Cigna, Connecticare and UnitedHealthcare – failed to adequately connect policyholders with mental health treatment in the same way they do for medical and surgical treatment.
“It has long been a fact that insurance companies are delaying and denying care for people who are paying for, and who need, mental health treatment,” said Senate President Martin Looney (D-New Haven). “Now we have documentation in a damning report that proves insurance companies are still not fully compliant with state law, and that they are being fined for their recalcitrance.”
But the Insurance Department never specified its penalties, which are capped at $625,000 if an insurance company fails to file its annual mental health compliance certifications.
Lesser and Cabrera are now arguing not just for tough fines, but also for tougher follow-up enforcement actions to prevent future occurrences.
“Several carriers refused to provide adequate comparative analyses… even after multiple follow-up interrogatories from the Department. This conduct reflects non-cooperation that, in our view, warrants serious consideration in determining the appropriate scope of penalties,” Lesser and Cabrera wrote. “We respectfully urge the Department to ensure that this enforcement action goes beyond financial penalties alone.”
Lessser – who is Senate Chair of the Human Services Committee – and Cabrera – who is Senate Chair of the Insurance and Real Estate Committee – suggest the Insurance Department adopt the “Kennedy Forum’s Gold Standards for Corrective Enforcement Actions” which includes formal corrective action plans with clear timelines and measurable benchmarks and reimbursement to enrollees for out-of-network costs incurred as a result of the insurance company’s violations.
The Kennedy Forum document can be found here.
In the meantime, Lesser and Cabrera have asked the Insurance Department to answer four questions:
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What are the specific fine amounts assessed against each of the five carriers, and how were these amounts calculated?
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What is the Department’s process and timeline for finalizing enforcement actions and making penalty determinations public?
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Does the Department intend to require formal corrective action plans from the cited carriers, and if so, what elements will those plans be required to address?
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What is the Department’s plan for ensuring that the violations identified in this report result in durable changes in carrier practices?
By Lawrence Cook
