Filed Under:Health Insurance, Individual Health

Maine hits Anthem with complaint-handling fine

Anthem says the action resulted from problems it fixed in 2014

Eric Cioppa, Maine's top insurance regulator, says insurers need to respond to consumer complaints in a timely manner. (Photo: Allison Bell/LHP)
Eric Cioppa, Maine's top insurance regulator, says insurers need to respond to consumer complaints in a timely manner. (Photo: Allison Bell/LHP)

A unit of Anthem Inc. has agreed to pay a $225,000 fine to resolve a complaint-handling procedures investigation in Maine.

Officials at the Maine Bureau of Insurance say they looked at a batch of 106 consumer complaint inquiries the bureau sent Anthem's unit in Maine, Anthem Health Plans of Maine Inc., and found that the unit had responded to only 39 within the state's 14-day deadline.

Related: NAIC "Standard Setting" Becomes an Issue in Maine

The Anthem unit answered 18 of the inquiries 30 or more days late, according to a copy of a consent order posted on the Maine insurance bureau website.

In addition to agreeing to pay the fine, the Anthem unit has agreed to submit a corrective action plan to the bureau within 30 days.

Eric Cioppa, the Maine insurance superintendent, said in a statement that insurers need to respond to issues raised by consumers in a timely and substantive manner.

"Failure to respond to the bureau's inquiries is a serious issue, as it directly impacts our ability to assist consumers and protect their contractual and legal rights," Cioppa said.

The unit fined holds the rights to use the Blue Cross and Blue Shield logos in Maine. Anthem, an Indianapolis-based company, acquired the rights when it bought an independent, Maine-based Blue Cross and Blue Shield carrier in 2000.

Colin Manning, a spokesman for Anthem's Anthem Blue Cross Blue Shield operations, says the problems in Maine occurred because of the actions of one individual.

"Anthem Blue Cross and Blue Shield is committed to providing the highest quality service to our members," Manning said in a statement. "Unfortunately, the actions of one individual did not live up to that commitment."

Anthem took immediate action when it learned about the problems, in 2014, and the "individual involved and the manager are no longer with the company," Manning said.

"Additionally, internal policies have been strengthened to help prevent similar actions by individuals in the future," Manning said.

Related:

Maine Wants $82M From Anthem For Plan

Anthem Plans To Acquire Maine Blues

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Nichole Morford

Nichole Morford
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