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Life Health > Health Insurance > Health Insurance

New York Imposes Explanation of Benefit Fine

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Two affiliated carriers have paid a $1.9 million fine to address New York State Insurance Department concerns about explanation of benefit forms they sent from October 2003 to September 2008.

The New York department has received the payments from Health Net of New York Inc. and Health Net Insurance of New York, officials say.

The company did not always give consumers complete information about how claims were handled and how to file appeals, and, in some cases, they took too long to pay claims, officials say.

The companies have acknowledged the violations and taken remedial actions, officials say.

A unit of UnitedHealth Group Inc., Minnetonka, Minn. (NYSE:UNH), acquired the Health Net companies in New York from Health Net Inc., Woodland Hills, Calif. (NYSE:HNT), in December 2009.

“Health Net of the Northeast is firmly committed to excellent customer service and providing our members with relevant and clear information about their benefits, coverage and claims,” the company says in a statement. “In 2008, we corrected an issue previously identified by the New York Department of Insurance (DOI) regarding the description of services on members’ explanations of benefits (EOBs).”

Health Net of the Northeast now agreed to pay a fine related to the recently completed financial examination for the period from 2003 to 2008, and it continues to work cooperatively with the New York department, the company says.

- Allison Bell


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