Volume 2 Issue 1 ● 1st Quarter 2010
Welcome to the fourth issue of The Advocate’s Advice newsletter. The Office of the Insurance Consumer Advocate continues to publish informational articles and advisories on our website (http://www.myfloridacfo.com/ica/) which was recently redesigned. The CFO’s website http://www.myfloridacfo.com/ was also redesigned which makes it more user friendly and easier to navigate. The Advocate’s Advice continues to be a great way for us to communicate directly with the insurance consumers of this state.
Recently, the Office of the Florida Insurance Consumer Advocate hosted an Alternative Dispute Resolution Roundtable which included members of the insurance industry, public adjusters, appraisal umpires and attorneys to work together to improve the appraisal process so that it can once again be a viable, cost-effective claim dispute resolution process. This roundtable will be highlighted herein. Also highlighted are recommendations the office delivered to the Legislature regarding property insurance as a result of this Roundtable meeting and a previous Claims Dispute Resolution Roundtable meeting held in July of 2009.
In addition to the initiatives generated by this office, the office continues to monitor those issues that Floridians are facing. In that vein, Sean Shaw voiced his opposition to a proposed bill which would deregulate the property insurance market in Florida and negatively impact Floridians. Additionally, Sean Shaw wrote an editorial calling on the State's legislators to act on behalf of homeowners experiencing problems with Chinese Drywall. The ICA office has received indications from workers’ advocacy groups that the current workers’ compensation system makes access to medical care difficult to obtain for injured workers. As a result, Sean Shaw approved the preliminary formation of a Workers’ Compensation Advisory Board to look at ways to enhance the worker’s compensation process.
This office remains committed to keeping the citizens of Florida alert and prepared on all potential insurance issues. Thus, we have prepared articles for consumers to be aware of the potential problems in purchasing an extended warranty when buying a new car, explained the expansion of benefits to cover mental health and provided details on new auto insurance products that may soon be available. Consumers are also reminded of the requirements to receive premium assistance under the extended COBRA deadline and are offered advice on health insurance coverage needs when traveling overseas.
Lastly, we recognized Identity Theft Awareness Month (December), National Cervical Cancer Awareness Month (January) and Prenatal Infection Month (February) by publishing consumer alerts on identity theft, cervical cancer and women’s health care coverage and an overview of prenatal infection prevention and maternity benefits. These alerts have been reproduced inside.
I encourage you to subscribe to The Advocate’s Advice newsletter (it's free!) by clicking on the button on the left. Just put the word “subscribe” in the subject line. Once you subscribe, you will continue to receive future newsletter issues. You will be able to unsubscribe at any time in the future, if you wish, by clicking on the “unsubscribe” button on the left.
Sincerely,
![]()
Sean M. Shaw, Esq.
Insurance Consumer Advocate
Insurance Consumer Advocate Sean Shaw Hosts Alternative Dispute Resolution Roundtable
By: ICA Staff
January 20, 2010
TALLAHASSEE- Florida’s Insurance Consumer Advocate, Sean Shaw, hosted an Alternative Dispute Resolution Roundtable to help Floridians affected by property insurance losses. On Wednesday, January 6, 2010, Sean Shaw invited members of the insurance industry, public adjusters, appraisal umpires and attorneys to work together to improve the appraisal process so that it can once again be a viable, cost-effective claim dispute resolution process.
Before the 2004/2005 hurricane season, the appraisal process was a seldom used contractual provision in homeowners’ insurance policies. If the claim could not be settled through mediation either the homeowner or insurance company could request appraisal. Each party would select an appraiser to estimate the cost to repair the damaged property. If the appraisers were unable to reach an agreement, the appraisers would select an umpire. The umpire would review the estimates completed by the appraisers and make a determination on the amount needed to make repairs or replace the damaged property. Agreement by two of the three parties would be binding on all parties with few exceptions.
However, since the 2004/2005 hurricane
seasons, the handling of insurance claims and the alternative
dispute resolution processes; such as mediation, appraisal and
litigation have remained a topic of concern for all parties
involved in the claims process. Currently, there are no
standards for the appraisal process, and this has led several
insurance companies to the belief that the appraisal process is
no longer a viable option.
A viable appraisal process would enable
This roundtable was convened to address the unique problems
represented by the appraisal process that arose during two
Claims Dispute Resolution Roundtables that were held in July and
November. With the conclusion of the Alternative Dispute
Resolution Roundtable, the Office of the Insurance Consumer
Advocate will now review the recommendations provided by the
participants of all three
roundtables. The recommendations of
the first two roundtables regarding the claims process will be
summarized along with the recommendations from the third
roundtable regarding the appraisal process. The Insurance
Consumer Advocate’s office is now in the process of drafting a
report detailing the concerns raised by all parties on each
issue. The report will also include the Insurance Consumer
Advocate’s recommended course of action on each issue. The
report is expected to be finalized in mid-February and will be
presented to Senate President Jeff Atwater and House Speaker
Larry Cretul.
ICA Sean Shaw Delivers Property Insurance Recommendations To The Legislature
By: ICA Staff
March 1, 2010
TALLAHASSEE — Florida Insurance Consumer Advocate
Sean Shaw today delivered a report to legislative leadership detailing the recommendations collected from two property insurance roundtables aimed at improving the property insurance claims process for Florida consumers. Representatives from the insurance industry, public adjusters, property insurance loss appraisers, umpires and attorneys participated in the roundtables.
“These recommendations are designed to create consumer protections, while also promoting a healthy insurance market to serve Florida’s insurance consumers.” said ICA Sean Shaw. “We listened to consumers, consumer representatives, and heard from the insurance industry; I felt that these recommendations offer the best route towards efficient claims resolution.”
The recommendations include:
- Additional education for insurance adjusters
- Open communication and transparency in the claims handling processes
- Standards for the appraisal process along with licensure of property appraisers
- Licensure of umpires and an impartial selection process for umpires
- Ability to purchase comprehensive insurance policies
For additional information, please visit the ICA website: http://www.myfloridacfo.com/ica/
Property Insurance Deregulation: A choice too costly for consumers
By: Sean M. Shaw Esq., Florida Insurance Consumer Advocate
Brad Ashwell, Florida Public Interest Research Group, Democracy & Consumer Advocate
Bill Newton, Florida Consumer Action Network, Executive Director
January 22, 2010
This has been a tough year for property insurance consumers in the State of Florida. 2009 brought Floridians problems from harmful Chinese Drywall to the threatened exit of State Farm. Now, two of Florida’s legislators, Senator Mike Bennett and Representative Bill Proctor, have proposed a bill to deregulate residential property insurance rates. Their legislation, HB 447 and SB 876, would allow residential property insurers to set premium rates without the approval of the Office of Insurance Regulation. They call it “consumer choice”, but we believe it will provide anything but real choice for Florida’s consumers.
Senate Bill 876 and House Bill 447 claim to give consumers “greater choice” by allowing property insurance companies to charge unregulated rates to their residential customers. The architects of this legislation believe that these unregulated rates will attract more companies to the state, giving insurance consumers more selection. The proposed legislation also stipulates that no private insurer can be charged an assessment until of all Citizens’ policyholders have been charged a 15% assessment.
While these provisions are similar to the “consumer choice” bill introduced in the 2009 legislative session, unlike the previous bill, this legislation would allow all authorized property insurers in the state to charge any rate, not just a select few.
Citizen Overload
Imagine walking into your insurance agent’s office. Your agent places three policies in front of you. Two are policies with private insurers and one is a Citizens policy. The two private insurer’s policies are close in price, but the Citizens’ policy is significantly cheaper, for essentially the same coverage. Which would most consumers choose? The answer is obvious – the cheaper policy, especially in these tough economic times.
Senator Bennett has stated that he filed this bill in response the perception that Citizens’ legislatively set rates are driving private property insurers from Florida. Unfortunately, this bill does nothing to address Citizens’ rates, either through deregulation of Citizens or through any other mechanism. If this legislation is passed, these provisions would only further exacerbate the growth of Citizens. Allowing property insurers to charge unregulated rates would only serve to increase the divide between Citizens’ rates and what other companies can charge. If Senator Bennett and Representative Proctor are truly concerned about Citizens’ rates, it would make more sense for their legislation to directly address their concerns.
Instead, if passed, this legislation will actually increase the size and exposure of Citizens. Because Citizens is backed by all Florida’s taxpayers, many legislators have been looking to limit the state’s exposure by reducing the size of Citizens. However, if property insurance companies are allowed to raise rates to wherever they wish, Citizens is quite likely to see an increase in policyholders.
Finally, this proposal would allow all insurance companies to “cherry pick” their customers, leaving many Floridians with nowhere else to turn but Citizens. For example, South Floridians who live near the coast would likely see the largest increases in premiums, while Floridians who live more inland and northern counties would see more favorable rates. And when a hurricane hits, not only would Citizens have the majority of the losses, but their policyholders would also be required to pay that 15% assessment before any private insurance money was due.
Does Deregulation Work
Proponents of deregulation claim that deregulation will bring new insurers to the market. However, no insurer has said publicly that they would enter Florida if the property insurance market was deregulated.
Deregulation also strips out a huge layer of consumer protection for all Floridians. Because the average consumer does not have the resources or information to determine when a rate is excessive, the opportunity for the company to abuse consumers exists. However, the State of Florida has the time, knowledge, and resources to judge the fairness of rates contained in insurance policies. The state can provide a warranty of fairness to the insurance consumers of Florida. Under current regulations the state protects consumers against excessive insurance rates. Deregulation would eliminate this protection for our citizens, protection that is desperately needed in these tough economic times.
Another argument for deregulation is that it will end the subsidization of coastal properties by inland property owners. However, significant state revenues are generated from these coastal areas and flow inland. Any current subsidization helps the overall housing market in Florida, which many people believe to be instrumental to helping Florida’s economy rebound. The issue of coastal property insurance rate subsidies has been successfully addressed in other states, such as Mississippi, and the answer has never been deregulation.
Lastly, history has shown the problems deregulation can bring to Florida’s insurance marketplace. In, 1968, Florida politicians attempted to deregulate the auto insurance market based on many of the same arguments that are being submitted by Senator Bennett and Representative Proctor. However, after significant rate increases (some as high as 23%) the citizens of Florida clearly said that deregulation of auto insurance was not a good idea. The legislation was repealed and the auto insurance market has remained regulated since 1971. We should learn from our mistake with auto insurance and not deregulate the property insurance market.
Our View
The sponsors of this legislation mistakenly call this bill the “Consumer Choice” insurance bill. However, the only choice that consumers are given is between higher premiums (based on recent rate filing requests anywhere for 25% to 50%) or a move to Citizens’ property insurance.
As consumer advocates, it is our charge to look out for one thing – what is the best interest of our state’s consumers. Truly, we are always encouraged when any legislator or industry group proposes an idea that seeks to improve the insurance industry in Florida.
However, this bill does not accomplish any improvement – instead it would significantly hurt Florida’s consumers. Deregulation of our property insurance industry rates would allow insurance companies to abuse consumers through excessive rate increases and would hurt Florida financially by overburdening Citizens. We also do not see any hard evidence this bill can achieve its stated goal of attracting new companies to the state.
We call on members of the Florida Legislature to vote against the proposed deregulation bill. If this legislation should pass, we urge Governor Crist to again veto this type of proposal. We encourage the legislature to choose what’s in the best interest of the citizens of Florida.
A Conversation With Sean Shaw
Insurance Consumer Advocate Proposes New Workers’ Compensation Panel
By Joan E. Collier, Editor
Florida Underwriter Magazine
Published January 1, 2010
In December, Florida Insurance Consumer Advocate Sean Shaw convened and facilitated a discussion on the potential creation of an advisory board to help improve the state’s workers’ compensation process. Although representatives of the various stakeholder groups — carrier, legal, health care, governmental, and regulatory — attended, agreement on the need for such a board was far from unanimous. Rehabilitation and health-care companies and claimant’s counsel expressed the most interest in creating the council; support from other quarters was muted, at best.
“In my view, the main question on the formation of a workers’ compensation advisory board is defining its mission and assuring its effectiveness,” said Attorney Rich Fidei, who heads the regulatory division of Colodny, Fass, Talenfeld, Karlinsky & Abate. “Workers’ compensation was substantially reformed by the 2003 Florida Legislature and in a 2009 legislative correction of the Florida Supreme Court’s decision on attorneys’ fees in the Emma Murray v. Mariner Health case. Many believe that these reforms have dramatically improved Florida’s workers’ compensation platform and have served as a model for meaningful, positive change. In this context, are there issues significant enough, and will the advisory board have enough influence, to warrant the expenditure of valuable resources [to create the board]? If so, the advisory board would be a good forum for open dialogue on the issues.”
The Florida United Business Association (FUBA) sent a representative to the meeting, but despite participating in a previous statutorily created advisory panel, the organization is not currently in favor of a new one. “At this time, FUBA does not believe the creation of a new panel or advisory group is warranted or needed,” Executive Director Tom Stahl said.
Such boards are not commonplace. National Council on Compensation Insurance (NCCI) State Relations Executive Lori Lovgren reported that an NCCI informal internal survey identified only 17 similar boards in other states. In more than half of these boards, membership is split between business and labor. Less than half also include other stakeholders, such as medical providers.
According to Lovgren, “The purposes of these boards may be limited at one extreme to advising regulatory authorities or legislatures on workers’ compensation matters, or at the other extreme, they may be tasked with developing workers’ compensation legislation or reviewing/endorsing workers’ compensation legislation before it moves on to the legislature.”
As to possible participation by her company, Lovgren noted that, “NCCI only occasionally holds a seat on a board. It is much more common that NCCI would serve as a resource to the board.”
Given the mixed opinions, where does Shaw go from here? In a Q&A with Florida Underwriter, Shaw talked about the advisory board idea and the workers’ compensation market in general.
Q. What was the impetus for considering such an advisory board now?
A. I had been hearing anecdotal evidence from representatives of injured workers that the current system was not working for them. Then I spoke with a provider who voiced concerns from their perspective and he suggested the creation of an advisory board. Our office, after seeing the value of open dialogue among participants in the homeowner insurance issue, felt that there would be merit in bringing the parties together to discuss their interest in and their thoughts on the value of convening an advisory board to address workers’ compensation issues.
Q. The Dec. 3 meeting agenda appeared to focus on medical and claim issues only. Why?
A. The issues cited on the agenda were those issues that my office identified as potential areas needing discussion from a review of the Division of Workers’ Compensation’s 2009 annual report. We examined, in particular, the types of issues addressed by the division’s Ombudsman & Helpline, as well as the reasons cited that claims were totally or partially denied. It was my belief that these issues are the ones that affect the injured worker and would help me determine what negatives exist that are facing the injured worker.
Q. Advisory boards often suffer from a perception of being ineffective or non-relevant. Many considered the oversight board authorized by the 1993 Florida Legislature ineffective, partly because a supermajority vote was required for approval of recommendations. What would you do to make this board more than a paper tiger?
A. That is a worthwhile question and one that does concern me. It is not worth everyone’s time and investment if the group serves no purpose. I have instructed my staff to study the information regarding other state’s advisory boards to determine what works, what doesn’t work, and if possible, why. I am also considering, at the suggestion of a participant, that the advisory board be one simply as an aid to the Insurance Consumer Advocate in my review of issues and potential solutions.
However, that being said, I would like to comment that one problem that appears to drive many of the concerns that insureds and injured workers have voiced deals directly with the element of good communication, and anything that will foster open communication and improved understanding from all stakeholders, I believe has value.
Q. The health-care people at the meeting for the most part seemed critical of the current system. Others were of the opinion that the 2003 reforms may need tweaking, but not a major overhaul. What is your opinion of the current system and the effectiveness of the 2003 reform package?
A. After listening to the discussion of the participants in the meeting, I did walk away with the belief that the system is not working perfectly and could use some tweaking. However, I am not at a point of recommending what those proposed revisions should be. Clearly, the effectiveness of the 2003 reform package as it related to availability and affordability of coverage has been successful. What is not as clear to me is if the reform has truly provided the “self-executing” system it was designed to be, nor is it clear that the intent of the reform “to assure the quick and efficient delivery of disability and medical benefits to an injured worker and to facilitate the worker’s return to gainful reemployment” is being met.
Q. Does your office plan to introduce any workers’ compensation legislation during the 2010 session?
A. At this time, we are considering legislation relating to the loss cost rating system. However, we are not considering any additional legislation for the 2010 session
Q. What is your next step?
A. I will review the information provided by NCCI related to other state advisory boards and evaluate what I believe the value of an advisory board can be — whether it is one that provides input solely to the Insurance Consumer Advocate or one that would need legislative creation.
Editor’s Note: On Dec. 24, Shaw released a letter stating he has approved the preliminary formation of an advisory group. The first meeting is expected to take place prior to the 2010 regular legislative session.
Chinese Drywall Problems Persist—Time for Florida to Help Floridians
By: Sean M. Shaw, Esq., Florida Insurance Consumer Advocate
February 24, 2010
In 2008, Florida became aware of a serious issue that continues to affect many homeowners today - Chinese Drywall. To date, the Consumer Products Safety Commission has received 1,615 complaints about Chinese Drywall, and Florida represents over half of all such complaints filed in the United States. Unfortunately, even though our state was the hardest hit with this issue, state leaders have been slow to respond to this problem wreaking havoc on Florida homeowners.
Currently, the federal government is conducting interagency tests to determine if the presence of Chinese Drywall is causing the many health issues that consumers have reported, as well as the extensive deterioration of personal property located in these homes. The federal government has also conducted trade missions to China in an effort to persuade the Chinese to help finance solutions to the current problem.
However, while all of these plans are in motion, many Floridians have been forced from their homes because of Chinese Drywall. These citizens cannot afford to repair their homes without financial assistance either from their insurance company or the federal government. Consumers also face the prospect of losing their property insurance coverage due to the presence of Chinese Drywall.
Our state legislature seems content to wait for a federal solution to the ever-growing Chinese Drywall problem. Unfortunately, for those consumers affected by Chinese Drywall, a federal solution could possibly take years to reach, and the administration of this solution even longer.
On a positive note, Senator David Aronberg (D-Greenacres) has introduced a bill to create a Chinese Drywall Taskforce that would set remediation standards and study the health risks of Chinese Drywall. Sen. Aronberg has also introduced bills creating licensing standards for those remediating Chinese Drywall and setting minimum inspection requirements for metal corrosion in homes with Chinese Drywall. While these bills are aimed at helping consumers in the future, I believe that we must do something that will immediately improve the lives of consumers who have already been affected by Chinese Drywall.
In an area where Florida should be setting the standard for citizen protection, Louisiana has taken the lead through several acts by its state government. Under Louisiana law:
“Policyholders who have been covered for more than three years by their homeowner’s insurer have the right to continue their coverage while vacating and remediating their home of defective Chinese Drywall, even if the defective drywall constitutes a “material change in the risk,” as long as the homeowner reports the issue to the insurer.”
Also:
“Notification to your insurance company cannot be used against you and your premiums cannot and will not be raised by your insurer for such a report.”
If enacted in Florida, these protections would relieve consumers’ fears of retaining their property insurance should Chinese Drywall be found in their home. In addition, more people would come forward with Chinese Drywall claims as they would no longer worry about being dropped from their property insurance. This would allow Florida to get the full scope of the Chinese Drywall problem before implementing a solution.
While these policies have critics, it cannot be disputed that these initiatives represent an effort by the Louisiana government to find a solution to the problem of Chinese Drywall –it is time for Florida to do the same. As Florida’s Insurance Consumer Advocate, I believe that our legislators should propose legislation that would provide homeowner’s some protections from losing their insurance coverage due to the presence of Chinese Drywall. While this would not solve the problem of who would pay to fix the damage caused by Chinese Drywall, it would provide some relief to consumers who experience loss to their property for other reasons.
Additionally, I encourage the legislature to create an expedited process for resolving disputes concerning Chinese Drywall liability. Currently, there are several cases being filed by consumers seeking damages relating to Chinese Drywall. The legislature should also create mechanisms that would allow the swift remediation of homes once a solution is reached.
Every possible solution has not been outlined in this editorial; the solutions set forth herein will have as many detractors as supporters. As long as we are working toward some action that will benefit Florida’s citizens who have been affected by Chinese Drywall, I welcome this discussion.
Insurance Consumer Advocate in Support of Prescription Drug Insurance Coverage Bills
By: ICA Staff
January 15, 2010
TALLAHASSEE— Florida’s Insurance Consumer Advocate Sean Shaw is urging lawmakers to ensure that Floridians have access to the most affordable and effective medications available through their health insurance policies.
On January 5, ICA Shaw sent letters to Senator Mike Fasano and Representative Denise Grimsley in support of their legislation relating to prescription drug insurance coverage (SB 516/HB 275). The legislation aims to protect consumers by limiting the ability of insurers to make immediate changes to their prescription coverage in the middle of a policy year, such as suddenly changing copayment amounts or only covering generic versions of a drug.
“It is heartbreaking to think of someone going through the process of finding an effective drug for themselves and their condition, only to have their insurance company substitute the drug with a potentially less effective generic substitute,” said ICA Shaw. “This legislation will alleviate this burden so consumers can continue to use the medication that works best for them at an affordable price.”
ICA Shaw has offered to speak on behalf of the legislation when it is presented to House and Senate committees, and has also offered to meet with Senator Fasano and Representative Grimsley to address any prospective amendments or changes to the proposed legislation.
A copy of Insurance Consumer Advocate Shaw’s letter to Senator Fasano is attached
below:
January 5, 2010
The Honorable Mike Fasano
Florida Senate
8217 Massachusetts Ave.
New Port Richey, Florida 34653-3111
Dear Senator Fasano:
I would like to take this opportunity to offer the full support of the Office of the Insurance Consumer Advocate to your efforts in passing Senate Bill 516. While I have some concern that this Bill may result in increased costs of coverage, I believe it will offer much needed protection for consumers by limiting the ability of insurers to make immediate changes in their prescription formularies and their ability to do so without notice to consumers.
As drafted, this bill will help consumers who have gone through the tedious process of finding the most effective drug for them and their condition, only to have their insurer substitute a drug with a different formula that may not be as effective in their particular instance. In some cases, insurers have moved specific drugs from lower tiers to the highest copayment tier, or they have changed the formulary to make the consumer pay the copayment along with the difference in cost between the brand name drug and its generic substitute. Making changes to the formulary in the middle of the policy year places an undue burden on consumers, and it is imperative that this bill is passed so that consumers may continue to use the medication that best works for them at an affordable price. However, I am concerned about increasing the cost of coverage, and I hope that you will consider changes that may mitigate this problem.
My office has some additional ideas regarding formulary legislation that I believe could further aid consumers and would like to discuss them with you at your convenience. I would also be happy to speak in support of the bill, and I welcome the opportunity to meet with you at a mutually beneficial time.
Sincerely,
Sean M. Shaw, Esq.
Insurance Consumer Advocate
Insurance Consumer Advocate in Support of Senate Bill 662 Banning Use of Credit Scores in Determining Rates
By: ICA Staff
February 23, 2010
TALLAHASSEE—Florida’s Insurance Consumer Advocate, Sean Shaw, is urging legislators to ensure that Floridians’ insurance rates are determined fairly, by banning the use of credit scores in determining insurance rate.
On December 2, 2009, Sean Shaw sent a letter to Senator Rhonda Storms thanking her for sponsoring Senate Bill 662. If passed, the bill will prohibit the use of credit reports and credit scores by insurers in making rating determinations. The legislation aims to offer Floridians who have seen their credit scores decline due to no fault of their own, protections that are not currently available under existing laws. Insurance companies have been using credit scores in pricing premiums, thus a reduced credit score may cause insurance premiums for consumers to increase.
“Given the condition the economy is in, now is the time to ensure that Floridians are being treated fairly by their insurance companies,” said Shaw.
A copy of Insurance Consumer Advocate Shaw’s letter to Senator Storms is attached below:
December 2, 2009
The Honorable Rhonda Storms
Florida Senate
313 Robertson Street
Brandon, Florida 33511
Dear Senator Storms:
Thank you for your efforts in sponsoring Senate Bill 662, which prohibits the use of credit reports and credit scores by insurers in making rating determinations. As the Insurance Consumer Advocate, I have not been convinced of the necessity of using credit scores when determining insurance policy premiums. I have been equally unconvinced by arguments for the use of education and employment status in rating auto insurance policies.
Senate Bill 662 offers Floridians, who have seen their credit scores decline often for reasons beyond their control, protections that are not currently available. Credit card companies have reduced their exposure by lowering credit limits, and credit rating agencies have changed their scoring methods. These changes have resulted in lower credit scores for a significant portion of the population despite having paid their bills on time. Thus, if companies use credit scores in pricing premiums, a reduced credit score may cause insurance premiums to increase. At a time when our economy is struggling and unemployment is the highest it’s been in over 20 years, this is the time to ensure that our citizens are being treated fairly by their insurance company. Thank you for initiating this legislation that will protect many consumers who have been disproportionately harmed.
I would be happy to speak in support of your bill if you deem it helpful. In addition, I am available to assist in any other way that I can.
Sincerely,
Sean M. Shaw, Esq.
Insurance Consumer Advocate
Are Extended Warranties Keeping You Safe?
By: Sean M. Shaw, Esq., Florida Insurance Consumer Advocate
December 14, 2009
Most people don't buy a new car without hearing “how foolish it would be” to not protect their new investment from unexpected repairs. What soon follows is a sales pitch for an extended warranty.
Our analysis indicates that extended auto warranties (also known as extended service agreements) are a bad deal for consumers because of excessive sales commissions. In fact, extended warranties are the most profitable product car dealers sell. Therefore, if you choose to purchase one, we recommend you make it part of a package deal. Generally, about 60% of the cost of the warranty is paid to the auto dealer as commission for selling the warranty to the consumer. You should use this knowledge about the dealer’s sales commission to negotiate a lower price for your car. Remember, make it part of the deal up-front before you go into the dealer’s finance and insurance office to complete the paperwork. If you wait until then, you may not be able to renegotiate a lower price for your car.
Auto warranties in Florida are a huge business. As of December 31, 2008, consumers in Florida spent $3.1 billion on active auto warranty contracts. Yet a review of auto warranty financial filings made with the Florida Office of Insurance Regulation shows that for every dollar spent on the purchase of an auto warranty in Florida in 2008, 61 cents went to sales commissions and only 17 cents went to cover the cost of auto repairs. If you contrast this with your auto insurance policy that covers liability, medical payments, comprehensive and collision only 8.5 cents was paid in sales commissions and 67 cents was paid for repairs and other claims.
Auto warranty companies in Florida, and nearly every other state in the United States, are not subject to the same close regulation and oversight as other insurance companies. Consequently, the Florida Office of Insurance Regulation does not have the same authority over auto warranties that it has over other lines of insurance, i.e. it cannot make auto warranty companies reduce their rates if they are found to be excessive. Current law simply requires auto warranty companies to maintain their rates on file with the Office of Insurance Regulation (OIR). The OIR does not examine the rates to determine if they are excessive, inadequate or unfairly discriminatory, or if expenses are reasonable in comparison to services rendered.
In the U.S., auto warranty dealer commissions averaged $795 per new-car extended warranty in 2008, according to Superior Integrated Solutions, a dealer management consulting firm. Such sales contributed 14 percent to dealerships' bottom lines, according to CNW Marketing Research, which covers the automobile industry.
If you feel you must have an extended warranty, get copies of the various contracts offered by the dealer before you go in to negotiate the price of the car. These contracts are too complicated to try to review at the last minute after you’ve gone through the difficult process of purchasing your car. Also consider buying a warranty direct from the auto warranty company. Extended warranty contracts purchased directly from a warranty company may be more affordable and more comprehensive than the dealer’s offerings.
Do not make a decision to buy an extended warranty or service agreement based on price alone. The coverage offered under the various plans available in the marketplace varies widely. Be sure you understand the exclusions and limitations of the contract. Most contracts exclude damage for normal wear and tear. In some states, extended warranty contracts consider depreciation when paying a claim. For instance, if the company is paying a claim on a part that has a life expectancy of four years and it failed at the end of two years, the company may only provide coverage for 50% of the replacement part. However, under Florida Law, the Office of Insurance Regulation will not approve an extended warranty contract that contains any provision for reducing claim payments due to depreciation of parts. The only exception is for warranties on marine engines.
We recommend that you research the many extended service contracts available. Determine what will and will not be covered. What type of maintenance records must you have in order to verify that your vehicle has received proper maintenance in the event of a claim? Will you be able to obtain service at a dealership or service center of your choice? Will you be required to pay for repairs up-front and wait to be reimbursed later?
Since contracts vary, there may be many deductibles to choose from. Be sure you understand when the deductibles apply. Make sure the contract can transfer to the new owner if you sell your car. The ability to transfer ownership may help you sell the vehicle faster or for more money.
Research the make and model of the vehicle you are purchasing to determine the common types of repairs for the age of the vehicle at the time the repairs are typically needed. Review the warranty contract to make sure the most common repairs are covered. Is it likely that repairs will be covered by the manufacturer’s warranty instead of the extended warranty you are considering purchasing? What is the average cost of the repair? Consider these questions in evaluating the cost of the warranty compared to the odds that you will use the coverage. Be an informed consumer before you buy. Understanding the coverage and the options available will allow you to make a better decision.
You can also purchase an extended warranty after the vehicle has been purchased. However, please use caution when responding to a mail or telephone call solicitation from an extended warranty company. The Federal Trade Commission (FTC), the nation’s consumer protection agency, urges consumers to be skeptical of mail solicitation and phone calls warning that the warranty on your car is about to expire. The company sending the solicitation may give the impression they represent your car dealer or manufacturer. They use phrases like “Motor Vehicle Notification,” “Final Warranty Notice,” or “Notice of Interruption,” when trying to make the offer seem urgent – and to get you to call a toll-free number for more information.
These solicitations are from unrelated businesses that want to sell you an extended warranty. If you respond to one of these, you are likely to hear high-pressure sales tactics, as well as a request for your personal financial information and a down payment, before you get any details about the service contract. The best practice is to never provide your financial information to anyone until you have verified the license of the warranty company and have reviewed the product to make sure it fits your needs.
Always check with the Department of Financial Services to verify the warranty company is licensed in Florida. They can also tell you how long the company has been in business and if consumers have filed complaints. The Division of Consumer Services is available to assist you with these questions and can be reached by calling 1-877-693-5236.
What is mental health parity and when does it begin?
By: Sean M. Shaw, Esq., Florida Insurance Consumer Advocate
January 1, 2010
For several years, professionals and advocates in the mental health and substance abuse community have championed changes in the way insurance companies administer these benefits. Their efforts were rewarded in 2008 when the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act passed Congress and was signed into law by President Bush on October 3, 2008. Congress delayed the effective date of this new law until January of 2010 in order to give health plans time to implement the changes. This new law expands on the limited Mental Health Parity Act of 1996.
The Mental Health Parity and Addiction Equity Act amends the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act to prohibit employers’ health plans from imposing any caps or limitations on mental health treatment or substance abuse benefits that aren’t currently applied to medical and surgical benefits. This law requires that insurers treat mental health and substance abuse benefits the same as medical - surgical benefits.
Unfortunately, this act does not require health insurance plans to offer mental health and substance abuse coverage. However, those plans that do offer these benefits are required to do so in an equitable fashion. Additionally, the new law applies primarily to large group plans, those with 51 employees or more. For large group health plans that include mental health and substance abuse disorder benefits, the Act does require parity with medical - surgical benefits. The new law will allow plans that provide mental health and substance abuse benefits to be exempt from the federal law if it can demonstrate actuarially that implementing parity has increased costs by more than two percent in the first year or one percent in subsequent years.
Under the provisions of this act, plans are prevented from placing limits on the number of visits along with a fixed dollar limit per visit unless such limits are similarly placed on medical – surgical coverage in the same manner. The application of benefits must be no more restrictive than the financial requirements or treatment limitations that apply to substantially all medical - surgical benefits. The act also establishes an oversight mechanism to determine if insurers are discriminating against certain conditions or failing to cover certain treatments. Another important change is that if a plan offers out of network benefits for medical - surgical care, they must also offer out of network benefits for mental health and addiction treatment.
Since current statutes do not apply to small group plans, those groups of 50 or less, individual states must pass their own mental health substance abuse legislation for such groups. To remedy this situation, legislation is under consideration for the 2010 Legislative Session of the Florida Legislature. The proposed bill would increase the current minimum of 30 days for inpatient benefits with $1,000 outpatient benefits per year, to 45 days inpatient and 60 visits outpatient per year and strengthen small group mental health and substance abuse law.
Health plans of all sizes often subcontract with firms to monitor and review mental health and substance abuse benefits and companies may require consumers to contact the subcontracted firm for approval prior to beginning any treatment. Most health plans reserve the right in their contract to determine medical necessity as it relates to being a “covered service” not your treating physician. The health plan, not your doctor, determines whether or not the prescribed treatment will be paid for by your plan. Thus, consumers should be prepared to pay for unapproved or unauthorized services.
For more information on mental health parity you may contact the Department of Financial Services, Division of Consumer Services at 1-877-693-5236. Also, be sure to read your Certificate of Coverage from your insurance plan so that you understand the coverage that you have.
Pay-As-You-Drive Insurance ----Will It Save You Money?
By: Sean M. Shaw, Esq., Florida Insurance Consumer Advocate
January 7, 2010
Beginning April 1, 2010 Floridians will have a new choice when it comes to auto insurance. On that date, Progressive American Insurance Company (Progressive) will be the first company to offer a new product called Pay-As-You-Drive auto insurance. Pay-As-You-Drive (PAYD) or “usage-based” auto insurance, in its simplest form, bases insurance cost on the number of miles driven incorporated with existing rating factors, such as a driver’s accident history or geographical location. The fewer miles you drive the lower your premium. Policies may be based on estimated miles, verified miles and prepaid miles. For mileage verification policies, insurers could verify the driver’s miles through various methods, including periodic certified odometer readings, which can be obtained during inspections, self-reporting by the policyholder or by data transmitted by a technological device (telemetric) that connects to a vehicle’s OnBoard Diagnostic (OBD-II) port.
PAYD insurance will be offered in Florida by Progressive through their MyRate program which will go into effect on April 1, 2010 for new business and May 11, 2010 for renewal business. Upon enrollment in the MyRate program, Florida consumers (as in other states) will be mailed the telemetric device that easily plugs under the dash of your vehicle and will transmit mileage and driving behavior information to Progressive. The MyRate device does not contain global positioning satellite (GPS) technology and does not track vehicle location or whether you are exceeding the speed limit. There is also no way to determine driver identity. The program is purely voluntary on the part of each insured and insureds may continue their current rating basis without any penalty.
New products are always exciting and many consumers are curious to try out the latest product in the auto insurance world. However, PAYD insurance may not be the best choice for certain consumers. As the Insurance Consumer Advocate, I am going to help outline what types of drivers will benefit from PAYD insurance and which drivers may be best served by maintaining their current plan.
Some features of PAYD insurance will provide benefits to all drivers regardless of age and driving style. Particularly, all drivers will appreciate the environmental benefits from more responsible driving and a reduction in unnecessary driving. That means fewer accidents and less congestion, carbon emissions, local pollution and a decrease in fuel consumption, hence, less dependence on foreign oil. In addition, because PAYD insurance offers incentives for safer driving the state may experience a decrease in accidents which may result in lower premiums for all consumers. Lastly, PAYD may result in less driving which could save taxpayers money on roadwork by decreasing road-related costs. Thus, if PAYD insurance achieves its goal of inspiring more responsible driving and a reduction in unnecessary driving all Floridians may experience some benefits from this new program.
While the broad social effects of PAYD insurance may not be enough to convince everyone to switch insurance, for some consumers, additional factors may make changing to PAYD insurance very desirable. Young drivers who are responsible would benefit greatly from PAYD insurance. Rather than paying for their irresponsible peers, young safe drivers will pay less according to how well they drive. Thus, their safer driving habits could equate to lower premiums as long as they maintain a clean driving record. Again, these benefits would be available only to those younger drivers who drive safely and do not exhibit the characteristics normally attributed to younger drivers. For those young drivers who exhibit more traditional behavior, they may find that their rates may increase. Since younger drivers typically spend more time driving during unsafe hours and may be more aggressive drivers PAYD insurance would likely increase their rates.
On the other end of the spectrum more mature drivers will see a reduction in benefits if they exhibit the typical attributes associated with older drivers. Older drivers who don’t drive very often will see lower premiums as a result of fewer miles driven and safe driving habits. Retirees who no longer commute during peak driving hours will experience lower premiums as insurance companies may use the time of day one commutes as a factor in determining premiums. However, as many drivers become older many factors such as decreased vision and reflexes lead to many minor accidents. For these consumers, any decrease in premium due to decreased drive time or distance may be offset by the frequency of minor accidents.
Now that we have discussed the two extremes lets turn our attention to the average driver. Because individual behavior varies greatly from person to person each consumer must honestly evaluate what type of driver they are in order to determine if PAYD insurance is a good option for them. Drivers with long commutes, aggressive drivers and nighttime drivers may not see any benefits as premiums most likely could be higher. If these characteristics don’t describe you then PAYD is probably going to be an insurance option that will benefit you greatly.
If you have decided that PAYD insurance would benefit you and are interested in signing up there are some final factors that you should consider before making your decision. If you are a private person you may not be comfortable with your insurance company monitoring your behavior. Some consumer groups oppose the collection and use of any information other than mileage, claiming driving behavior would be captured in the driving safety record rating factor already being used. Monitoring driving behavior or location raises privacy and fairness concerns among some consumers. Also, some mileage verification requirements could be overly burdensome or not feasible for some consumers. For example, you may have a vehicle older than 1996 (those without an OnBoard Diagnostic (OBD-II) port) or live too far from an odometer reading site. Thus, even if you are the type of driver who would benefit from PAYD insurance these other factors may make this type of insurance less desirable.
The advantages of PAYD insurance far outweigh the disadvantages for some consumers. An obvious benefit is that you will have options that will allow you to save money by only paying for the insurance you use. Ensuring a closer connection between miles driven and premiums provides a financial incentive for drivers to reduce their mileage and rewards those who choose to drive less. Reducing mileage will benefit consumers by saving them money and benefit insurers by reducing their risk; all the while making our streets safer and cutting down on congestion, as well as government infrastructure costs.
If you are considering switching to PAYD insurance I recommend that you review your mileage history and review your current policy before switching. Any questions about PAYD insurance can be directed to the Office of the Insurance Consumer Advocate at (850) 413-5923. I also encourage all consumers to be responsible drivers and obey all traffic laws.
COBRA Premium Assistance Expiration Alert
By: Sean M. Shaw, Esq., Florida Insurance Consumer Advocate
December 10, 2009
On February 17, 2009, President Obama signed the American Recovery and Reinvestment Act. This legislation provided COBRA premium assistance to help those who lost their jobs by offsetting the costs of continuing health insurance. The premium assistance program will continue for nine months from the March 1st passage date through December 31st of this year. Individuals who are eligible for COBRA during this time period will receive nine months of assistance upon applying for their benefits, even if it extends beyond the end of the year.
Individuals who have been involuntary terminated are eligible for nine months of COBRA premium assistance as long as they have applied for their COBRA benefits by December 31st of this year. Individuals currently receiving COBRA benefits at a reduced rate because of the assistance will continue to receive the assistance for the duration of the statutorily granted nine month period. The premium assistance program also applies to state continuation coverage, also known as mini-COBRA.
Any individuals who have questions regarding the process for receiving COBRA benefits should contact their employer. Consumers should also be aware that the rules for applying for COBRA and mini-COBRA are not identical. Thus, individuals should confirm what type of COBRA they are eligible for before applying. If you have any questions, you should contact the Division of Consumer Services at the number below.
Also, if you are about to lose the premium assistance, do not cancel your COBRA coverage - instead shop around for an individual policy with the benefit level you want and a premium you can afford. Watch for Congressional changes and if you have any questions, contact the Division of Consumer Services at 1-877-693-5236 or http://www.myfloridacfo.com/Consumers/.
Insurance Consumer Advocate Offers Advice For Consumers Traveling Overseas On Their Health Insurance Coverage Needs
By: Sean M. Shaw, Esq., Florida Insurance Consumer Advocate
February 19, 2010
As spring time and travel season rapidly approach, the Office of the Insurance Consumer Advocate would like to share with the citizens of Florida some information on purchasing health insurance for overseas travel.
While most health insurance policies cover emergency services rendered within the United States, Canada, Mexico, and U.S. territories, it is important to note that most policies exclude coverage beyond those boundaries. Becoming seriously ill or injured overseas could leave consumers personally responsible for their medical expenses. In the event a patient needs to be evacuated back to the United States, evacuation costs can easily rise to $50,000.
Some health insurance polices may cover “usual and customary” emergency hospital costs overseas, but most policies exclude such coverage. Further, Medicare and Medicaid also exclude emergency medical treatment overseas.
To prevent any issues regarding health insurance coverage while overseas, there are some steps consumers should take prior to traveling abroad to ensure they don’t find themselves saddled with exorbitant health care fees:
- Consumers should review their health insurance policies before traveling abroad to see if their policies cover emergencies. It is also vital that consumers review how they can access their benefits.
- Buying short-term emergency health coverage is a good idea for travel overseas; short-term coverage can be obtained by purchasing a travel insurance policy from a reputable health insurance agent.
- Consumers should not confuse travel insurance that covers health with insurance that covers the cost of the trip.
- Also, in the event emergency services are rendered overseas, consumers should obtain a copy of any medical records before leaving the overseas treating facility.
Short-term emergency health coverage available through a travel health insurance policy is beneficial and may include other coverage, including trip cancellation coverage and lost luggage coverage. While travel insurance policies can offer travelers peace of mind, there are some guidelines that should be considered prior to purchasing this type of insurance.
- Consumers should make sure that the insurance policies that they are purchasing are from a company that is licensed in Florida.
- Be aware of the coverage that is being offered and what might be excluded from such coverage.
- If consumers are purchasing travel insurance from a travel agent, ask the agent if he or she sells policies from different insurers. This will allow the consumer to compare policies and prices.
If you have any questions regarding health insurance while traveling abroad you should contact the Division of Consumer Services within the Department of Financial Services on-line at http://www.myfloridacfo.com/Consumers/ or by phone at 1-877-MY-FL-CFO (1-877-693-5236), toll-free in Florida, and (850) 413-3089 from out of state.
Identity Theft Awareness Month - Can You Insure Your Identity?
By: Sean M. Shaw, Esq., Florida Insurance Consumer Advocate
December 16, 2009
As Insurance Consumer Advocate, I would like to share some information regarding identity theft insurance with consumers in recognition of December as Identity Theft Awareness Month. Identity theft has become a national concern affecting an estimated 10 million consumers in the United States in the last year. Because restoring your credit history and correcting information is a slow and time-consuming process, consumers are being inundated with offers for identity theft insurance, credit monitoring plans, and other services.
If you are a victim of identity theft, it can be very costly to reestablish your credit and identity. Several companies are now offering identity theft insurance, which generally costs between $120 and $180 per year. Identity theft insurance cannot protect you from becoming a victim of identity theft and does not cover direct monetary losses incurred as result of identity theft. Instead, identity theft insurance provides coverage for the cost of reclaiming your financial identity, such as the costs of making phone calls, making copies, mailing documents, taking time off from work without pay (lost wages) and hiring an attorney.
Consumers who are interested in purchasing identity theft insurance should inquire about policy limits, deductibles, and other policy terms. Most identity theft insurance policies have policy limits of $5,000 for lost wages. Consumers should also inquire about deductibles. Some policies require you to pay the first $100 - $500 of costs incurred for reclaiming your financial identity. Remember, identity theft insurance does not cover direct monetary losses. If the policy covers lost wages, verify what limits apply and what is required to trigger this coverage. If you are a salaried employee or are required to request vacation time in the event of a work absence associated with reclaiming your financial identity, you may not have unpaid leave and lost wages. If the policy covers legal fees, verify what limits apply and if legal work needs to be pre-approved by the insurer.
Consumers should also check to see if their current homeowner’s insurance includes identity theft insurance. If not, you may be able to add identity theft insurance to your homeowner’s policy for a small fee or purchase a stand-alone policy from another insurer, bank or credit card company.
As with any insurance product, consumers should understand what they are purchasing and compare the product’s price, coverage and deductibles among multiple insurers.
If you have any questions regarding identity theft insurance you should contact the Division of Consumer Services within the Department of Financial Services on-line at http://www.myfloridacfo.com/Consumers/ or by phone at 1-877-MY-FL-CFO (1-877-693-5236), toll-free in Florida, and (850) 413-3089 from out of state.
National Cervical Cancer Awareness Month & Women's Health Care Coverage
By: ICA Staff
January 28, 2010
In recognition of National Cervical Cancer Awareness Month, the Office of the Insurance Consumer Advocate would like to share with you some information on women’s health care coverage.
Currently, cervical cancer is one of the most fatal forms of cancer. According to the Centers for Disease Control (CDC), cervical cancer was once the leading cause of death for women. Though preliminary screening has assisted in the prevention and early detection of the disease, last year more than 11,000 women were diagnosed with cervical cancer in the United States. In addition, about 4,000 women died from the disease last year alone.
Although this disease can be fatal, as with other forms of cancer, early detection is key. Annual Pap Tests and regular checkups from a primary care physician can lower the likelihood of the disease going undetected. Recently, a vaccine was released that protects against the human papillomavirus (HPV). This vaccine protects against two forms of the virus which cause 70% of cervical cancer cases. The CDC recommends routine vaccinations for girls 11 to 12-years-old. Further, the vaccine is also recommended for young women ages 13-26 who have not yet been vaccinated or completed the vaccination series.
Though cancer screenings and pap smears are covered by health insurance providers, there are some important issues consumers should consider before receiving preventative care for cervical cancer:
- Most policies cover one annual pap smear exam, as well as additional exams if requested by a physician.
- While some health insurance providers cover the vaccine, levels of coverage varies. Consumers should contact their health insurance provider to find out if the vaccine is covered under their plan.
- Consumers should review their policy and inquire about potential differences in price based on the test location.
- Consumers should contact their insurer to confirm the extent of coverage based on the existing policy.
Cervical cancer can be prevented with proper screening. Consumers can reduce their risk of receiving unexpected fees by reviewing their policy, and contacting their provider prior to receiving preventative care.
If you have any questions regarding cervical cancer coverage you should contact the Division of Consumer Services within the Department of Financial Services on-line at http://www.myfloridacfo.com/Consumers/ or by phone at 1-877-MY-FL-CFO (1-877-693-5236), toll-free in Florida, and (850) 413-3089 from out of state.
Insurance Consumer Advocate Honors Prenatal Infection Prevention Month
By: ICA Staff
February 11, 2010
In recognition of February as Prenatal Infection Prevention Month, the Office of the Insurance Consumer Advocate would like to provide consumers with an overview of prenatal infection prevention and maternity benefits.
According to the U.S. Centers for Disease Control and Prevention (CDC), group B strep, or GBS, is on of the most common life threatening infections and one of the leading causes of blood infection in newborns. This bacterial infection can occur in babies during the first week after delivery. It can lead to respiratory distress, pneumonia, shock, apnea and meningitis in babies.
GBS is very common and is present in up to 40 percent of all pregnant women. Many women do not know they have the bacterial infection because it can be asymptomatic. The best means of combating GBS is through proactive prenatal care. Pregnant women should have urine culture tests in the first and third trimesters testing for GBS and other bacteria. If symptoms of an infection do manifest, see your physician immediately.
For more information in preventing infections during and after pregnancy, visit the CDC’s website at http://www.cdc.gov/ncbddd/pregnancy_gateway/infections.html.
Effective treatments are available if infected and a healthy baby can be delivered. Care should be taken for the first three months of a newborns life since they are still susceptible. Fevers and trouble breathing should be treated by a physician immediately.
Though prenatal screenings and immunizations are covered by most health insurance providers, there are some important issues consumers should consider before receiving preventative care:
- Most policies cover the insured; changes in coverage may be required to cover newborns.
- Some individual and small group plans do not have maternity benefits, or they must be added at extra cost.
- While some health insurance providers cover the tests and vaccines, levels of coverage may vary. Consumers should contact their health insurance provider to find what is covered under their plan.
- Consumers should review their policy and inquire about potential differences in price based on the test location.
- Consumers should contact their insurer to confirm the extent of coverage based on the existing policy.
GBSGBS is preventable with proper care and testing, and can be treated if discovered. Be proactive and protect yourself and your newborn baby.
Under Florida Statutes, all health plans including HMOs issued or delivered in Florida, must provide for child health supervision services delivered or supervised by a physician. Coverage must include periodic visits which shall include a history, a physical examination, a developmental assessment and anticipatory guidance, and appropriate immunizations and lab tests. Such services and periodic visits shall be provided in accordance with prevailing medical standards consistent with the Recommendations for Preventive Pediatric Health Care of the American Academy of Pediatrics. You can access their website at http://www.aap.org/.
If you have any questions regarding your health insurance coverage you should contact the Division of Consumer Services within the Department of Financial Services on-line at hhttp://www.myfloridacfo.com/Consumers/ or by phone at 1-877-MY-FL-CFO (1-877-693-5236), toll-free in Florida, and (850) 413-3089 from out of state.
The Insurance Consumer Advocate is appointed by Florida Chief Financial Officer Alex Sink and is committed to finding solutions to insurance issues facing Floridians, calling attention to questionable insurance practices, promoting a viable insurance market responsive to the needs of Florida’s diverse population and assuring that rates are fair and justified.
