Insurance Claims Comment

[loss adjusters]

He said the county has been overpaying on insurance premiums for the past five years. “That is your opinion that we have been overpaying,” said Supervisor Terry Durby, noting he believes the fees charged by Two Rivers are justified. Under this year’s contract, the county’s insurance costs are going up 8 percent. Durby said there are no other significant changes. The county’s insurance plan is under the Iowa Governmental Health Care Plan, a trust with other counties, school districts and cities who receive insurance coverage through Wellmark. In 2014 the Iowa Insurance Division began investigating allegations that Two Rivers was overcharging IGHCP clients for administrative fees and not fully disclosing those fees. Two Rivers representative Denise Ballard told the Winnebago supervisors this week the investigation is nearly over, and at that time all the information will be released to the public. “We at no time felt that we were deceptive,” she said. Ballard admitted that when the IGHCP was formed in 2005, the commission Two Rivers built into the Wellmark premium was not disclosed. “But at that time disclosure wasn’t a thing in the insurance industry,” Ballard said. When reforms began, Two Rivers went to Wellmark and asked how to disclose on IGHCP because Two Rivers wasn’t An Analysis Of Modern Insurance Adjusters receiving any commissions from Wellmark. She said Wellmark told her IGHCP was excluded because the only one getting a commission on the trust was the Two Rivers general agent. Winnebago County was actually paying less before disclosure, according to Ballard. Under the old system, each county was charged a fee that was a percentage of the premium, which meant each one paid a different fee as premiums were all different, she said. Today Two Rivers is charging a consulting fee of $10 for single insurance coverage plans and $25 for family plans. Ballard said before disclosure, those fees could have been lowered if Two Rivers was trying to get a new county to join the IGHCP and the competition was charging less. When Stensrud asked if Two Rivers receives a fee from Wellmark, Ballard replied, “not one cent comes from Wellmark to us.” She said this is stated in the contract with the county.

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[insurance adjusters]

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