THE Hartford Life Insurance Co. agreed to issue credits totaling $24 million to about 30,000 customers of accidental death and dismemberment services, Benjamin Lawsky, superintendent of the New York Department of Financial Services (DFS) announced last month.
The company will provide premium credits to currently insured individuals in the form of a 35% discount for 36 months and also agreed to reduce premium rates for existing and new enrollees by 45%.These aggregate credits will equal $24 million, so the action does not result in a payout.
At issue is the medical loss ratio (MLR) threshold required under New York law.
The Hartford will issue the credits because it did not comply with the 60% MLR required under New York law for plans such as the company’s accidental death and dismemberment (ADD) coverage, according to the DFS.
The period in question predates Lawsky’s stewardship. A review conducted by the New York State Insurance Department for the period of January, 2007 through December, 2010, revealed that The Hartford did not achieve the 60% loss ratio as provided in 11 NYCRR 59.5(b), according to the stipulation.
The DFS said that The Hartford had failed to meet the 60% level because it overestimated the amount of money that would be spent to pay claims when the policies were priced by the insurer.
The policies in question were sold via telemarketing and other forms of mass marketing targeted to members of associations and customers of banks and other financial institutions.
“We worked closely with the New York Department of Financial Services throughout the review to determine an appropriate corrective action. We are pleased the matter is resolved,” The Hartford said in a statement.
The Patient Protection and Affordable Care Act (PPACA) covers the MLR in comprehensive health care plans, of which The Hartford’s ADD coverage is not included. It is considered long term care.