A survey of market conduct exams conducted by insurance trade groups among their member companies found the number of examinations has changed little, despite efforts to streamline the examination process.
The findings were discussed during the market conduct uniformity working group at the summer meeting of the National Association of Insurance Commissioners, Kansas City, Mo., here.
Groups that participated in the study were the American Council of Life Insurers, the American Insurance Association, America’s Health Insurance Plans, Blue Cross and Blue Shield Association, all in Washington; the National Association of Mutual Insurance Companies, Indianapolis; and the Property Casualty Insurers Association of America, Des Plaines, Ill.
According to statements from representatives of these groups, aggregate results show on-site targeted exams and on-site multistate exams declined slightly, while on-site single state comprehensive exams increased slightly. Desk audits, which are regulatory exams from an office, increased.
The respective results for 2003, 2004 and 2005 were as follows:
On-site single-state targeted examinations: 127 in 2003, 108 in 2004 and 111 in 2005;
On-site single-state comprehensive exams: 116 in 2003, 99 in 2004 and 122 in 2004;
On-site multistate exams: 5 in 2003, 7 in 2004 and 4 in 2005;
Desk audits: 58 in 2003, 64 in 2004, and 84 in 2005.
The duration of regulatory activity seemed to show a decline in longer market conduct examinations, the studies showed.
For instance, the number of exams that were less than a day increased from 1 each in both 2003 and 2004 to 7 in 2005.
Examinations that were 1 day to 1 week were 27 in 2003, 18 in 2004 and 23 in 2005.
Those more than a month dropped from 199 in 2003 to 157 in 2004 before jumping slightly to 163 in 2005.
Examinations with no examiners on site grew from 291 in 2003 to 317 in 2004 before declining to 250 in 2005.
More expensive type of examinations did seem to drop, according to the trade groups.
The number of exams costing up to $1,000 grew from 9 in 2003 to 11 in 2005, from 11 to 12 in the $1,000 to $5,000 range, from 19 to 23 in the $5,000 to $15,000 range and from 11 to 20 in the $15,000 to $25,000 range.
The higher expense categories experienced a drop. In the $50,000 to $100,000 range, examinations declined from 41 to 27 companies between 2003 and 2005, and in the $200,000-plus range, it plummeted from 30 to 4 in the same time period.
ACLI received responses from 107 of its 370 members. Linda Lanam, ACLI vice president-annuities and market regulation, says that there is much that the numbers still don’t tell, but they do provide a perception and direction.
“The vast majority feel that they are no better and maybe worse off, Lanam said. “People are not feeling an improvement.”
Betsy Pelovitz, AHIP’s regional director-state advocacy, said that 27 health insurers, representing the largest national companies with direct premium that exceeded $86 billion, had responded to the survey.