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Thursday, September 27, 2012

Missouri Nails Aetna

Previous posts have discussed the insurance mandate in Missouri. Yesterday, the Missouri Department of Insurance issued this release:
State insurance regulators say one of the nation's largest health insurance companies has for years been violating Missouri law in the health plans it offers to employers. Insurance Director John M. Huff has announced a settlement with Aetna Life Insurance Company related to its coverage of health benefits required by Missouri law, including autism, contraception and elective abortion.
In the settlement, Aetna admits to numerous violations of Missouri law, including issuing health insurance policies that:
Excluded coverage for autism spectrum disorders, in violation of Missouri's landmark autism insurance law signed by Gov. Nixon in 2010;
Under the settlement, Aetna will:
Stop issuing health insurance policies that violate Missouri law;
Pay a $1.5 million penalty, the largest in Missouri history for insurance law violations;
Notify customers that they were entitled to coverage for treatment of autism and accept claims for treatments received since the law went into effect. Aetna will pay claims with nine percent interest; and
Donate $250,000 to a Missouri nonprofit organization specializing in the care and treatment of autism spectrum disorders.
Aetna is Missouri's sixth largest health insurance company, with premium sales of $340 million in 2011.
Consumers with complaints or questions about insurance claims or policy provisions can call the Insurance Consumer Hotline at 800-726-7390 or file a complaint at