Insurance questions: Does my homeowners policy cover lightning?

In most cases, yes. Lightning is a covered peril in standard homeowners policies. Typically, both direct physical damage -- like burns, shattered windows, melted wiring -- would be covered. And if the lightning sets your home on fire, your fire coverage would also kick in.

How about lightning-caused damage to your electronics, like a TV or computer? Also typically covered.

And what about your car? If that gets hit by lightning, is the damage covered? Again, in most cases yes -- IF you have comprehensive coverage. (A man riding his motorcycle near Chehalis yesterday was struck by lightning, but is apparently doing well, other than a partly melted helmet. Really.)

Health care reform questions: Where can I get help?

Q: Will there be health care advocates for people who are not able to understand the complexities of the health care process? I have a family member who cannot work and is in dire medical need and struggling with doctor and drug costs. What help will they get from the health care reform?

A: Yes, there definitely will be advocates to help people navigate the complexities of finding the right health coverage. Health care reform includes a network of navigators and other people to help, and many insurance agents and brokers can help as well. Here's a list of the organizations that have received grants to provide in-person assistance here in Washington state.

Here in Washington state, you can sign up with the Washington HealthPlanFinder to be contacted by assistance staff within the first two weeks of October. They can answer your questions and help with enrollment in the exchange, if that's the best option for you. The coverage would start in January 2014.

In this particular situation, with your relative struggling today to pay for medical care and prescription drugs, feel free to give our consumer advocacy staff a call. They can walk you through the options, including free or low-cost medical, vision and dental clinics, help paying for drugs, and how to appeal when a health insurer won't pay for a treatment or prescription.

The hotline number is 1-800-562-6900. (Don't live in Washington state? Here's how to find your own state's insurance regulator.) You can also email us at AskMike@oic.wa.gov.

WA: Two more Exchange health plans approved for King, Pierce, Spokane counties

From a press release we put out this morning:

FOR IMMEDIATE RELEASE – Sept. 4, 2013

Media contact: Public Affairs (360) 725-7055

Kreidler settles with another health insurer – approves two more Exchange plans for King, Pierce, Spokane counties

OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler has reached a settlement with Molina Healthcare of Washington, Inc. (Molina) and approved its two plans for sale in Washington’s Health Benefit Exchange, the Washington Healthplanfinder.

Consumers in Washington will now have 43 choices in the Exchange when open enrollment begins Oct. 1. Molina’s two plans will be available in three counties: King, Pierce and Spokane.

Previously, Molina only participated in the Medicaid market. Its approval to sell inside the new Washington Healthplanfinder guarantees Medicaid enrollees continuity of care and creates even more competition in the marketplace.

Molina was one of five companies Kreidler disapproved for sale in Washington’s new Exchange. Molina, Coordinated Care Corp., Kaiser, and Community Health Plan of Washington (CHPW) all appealed Kreidler’s decision. Molina later dropped its appeal, but reactivated it Aug. 29.

The reactivated appeal allowed a settlement. Specifically, Molina corrected information in its provider contracts to gain approval.

Kreidler began discussions with only those companies he believed could make the necessary fixes in time before the federal deadline of Sept. 5. Ten plans from Kaiser and Community Health Plan of Washington were approved Aug. 30.

The Executive Board of the Health Benefit Exchange is schedule to certify the final list of approved plans today at 1 p.m. It is scheduled to submit its final list to the federal government Sept. 5.

“I made the tough decision to disapprove some plans on July 31 because I didn’t believe they were good for consumers,” said Kreidler. “I’m pleased that we’ve reached a settlement with some of these companies to bring more quality plans to the Exchange and that consumers will be protected.”

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Kreidler achieves settlement with health insurers - approves 10 more Exchange plans

Insurance Commissioner Mike Kreidler has reached settlements with Community Health Plan of Washington and Kaiser Foundation Health Plan of the Northwest and approved their 10 plans for sale in Washington’s Health Benefit Exchange, the Washington Healthplanfinder.

 Consumers in Washington will now have 41 choices in the Exchange when open enrollment begins Oct. 1. Community Health Plan of Washington (CHPW) will have three plans available in 26 counties.

 Kaiser will offer an additional seven plans in Clark and Cowlitz counties.

 Kreidler said the additional 10 plans meet the same high standards held for the other approved companies. They also ensure continuity of care for Medicaid enrollees and create more competition in the marketplace.

 The Exchange set an initial July 31 deadline for the Insurance Commissioner’s review and approval of plans for inclusion in the Exchange, where subsidies for health coverage will be offered as part of the federal Affordable Care Act.

“We had 31 health plans approved by the Exchange’s deadline. Washington consumers now have an additional 10 quality plans to choose from,” Kreidler said.  “We took the initial deadline seriously, but we also followed our own legal process and it worked. The Exchange cannot delay any further. It must take action and approve these plans by Sept. 5.”

Read the full release.

New online tool shows you what individual health insurance costs next year in WA

We've built a new online tool to help you find out what health care plans will cost next year. Simply click on the map -- premiums vary by where you live -- and it will tell you which insurance carriers are offering coverage in your area. You can click on each company to see its rates, which vary based on your age.

A couple of caveats: These rates are mainly for the individual market, meaning people who have to buy insurance for themselves, and don't get it through an employer, Medicare, etc.

Also, the rates do factor in the subsidies that will be available to some people. Those subsidies will reduce the cost of coverage substantially for many people. You can estimate how much you'll pay, with subsidies taken into account, by using this online calculator from the Washington HealthPlanFinder.

Lastly, the list of health plans is likely to grow over the next couple of months. We are still reviewing plans, for example, for multiple insurance carriers that have filed to sell coverage outside the state exchange. And some plans that were rejected for the Exchange have filed appeals. So stay tuned.

An open letter from Mike Kreidler about insurance plans filed for Washington's exchange

An open letter from Insurance Commissioner Mike Kreidler

In January, the biggest changes under health care reform – or “Obamacare” – will take effect. Many health plans, which now have to comply with federal standards, will be significantly better. And hundreds of thousands of low- and middle-income Washingtonians will qualify for subsidies to help pay for coverage.

This fall, Washington’s new Health Benefit Exchange will open for business, giving consumers an easy way to compare health plans, sign up, and see if they qualify for the subsidies.

Many kinds of insurance policies, before they can be sold, must be reviewed and approved by my office. This is a very important consumer protection, designed to ensure that prices are fair and that insurers can deliver on their promises.

I’m pleased to report that based on state and federal law, we were able to approve 31 health insurance plans, from four carriers, for the Exchange. People shopping on the Exchange will have broad choice and significantly better coverage, starting Jan. 1, 2014.

Unfortunately, we had to reject applications from five other insurance carriers. These were not decisions I made lightly. I am a strong supporter of competition and consumer choice, and a longtime supporter of health care reform.

As the state’s insurance regulator, however, I have a duty to protect consumers and to hold all insurers to the same standards. There were substantial problems in the plans we rejected.

Health insurers must have adequate networks of doctors and other health care providers. And there were major problems with the networks of most of the rejected plans. One didn’t offer any pediatric hospital.

Another had no approved retail pharmacy. Certain plans didn’t have adequate access to transplant surgeons, or to HIV/AIDS specialists.

One network would have required people to drive more than 45 miles to see a cardiologist, and more than 120 miles to see a gastroenterologist. That would be like living in Tacoma but having to see a doctor in Bellingham.

These were not minor technicalities. They were major problems.

Some people have pointed out that three of the carriers whose plans were rejected are currently serving people on Medicaid. They worry that people whose incomes rise, making them ineligible for Medicaid, will have difficulty moving to a regular commercial plan, or would lose important continuity of care offered by the community clinics. Many of these community clinics offer important services, such as language assistance or transportation.

Rest assured: The plans I approved for the Exchange include a substantial number of community clinics throughout the state. In many cases, Medicaid patients who want to remain with the same clinic will be able to.

The Affordable Care Act requires all carriers participating in the Exchange to contract with an adequate number of “Essential Community Providers,” or ECPs. These are defined as health care providers that serve high-risk, special needs and underserved individuals. Many Sea Mar clinics, for example, have contracts with the commercial carriers who were approved for the Exchange.

My staff and I worked very hard to try to get all carriers and all plans across the finish line in time. We had dozens of meetings, and 14 webinars to try to walk them through the process. I called one CEO after another, laying out the key issues and timelines. On the final night, July 31, we had staff waiting at their desks until midnight, in order to give the companies every possible minute to succeed.

But some carriers – particularly those new to the commercial insurance market -- simply couldn’t meet the standards this time.

We knew this first big year of health reform implementation would be a bumpy ride, and it has been. But I remain optimistic about the future. We will continue to work with all carriers to help them get ready for the next year, when I fully expect more insurers to succeed.

In the meantime, consumers have a broad number of choices. The insurance is meaningful, the networks robust, the subsidies significant. Again, the process has been bumpy. But it’s a very promising start.

Mike Kreidler

Insurance Commissioner

Auto insurance and pizza delivery

We get a lot of calls from parents -- and usually those calls are after the fact, unfortunately -- about whether their child delivering pizzas needs additional auto coverage.

Sorry, but the answer's usually yes. Most personal auto insurance policies won't cover you if you're getting paid to use your own car to transport people or property for business purposes.

In general, you'll need to buy a business or commercial auto insurance policy if you are a health care worker who occasionally uses your own car to take clients to appointments. The same is true if you use your own car to deliver flowers, newspapers, pizzas, etc.

If you have questions about your coverage -- and policies do differ -- contact your agent or insurance company directly.