The state of Georgia goes head-on against various health insurance companies over various insurance complaints and allegations.
Overview
Several health insurance companies are now facing a head-on collision with the state of Georgia and its investigators after the outpour of complaints and allegations against them. Some of the health insurance companies named in the article are the following: Anthem Blue Cross Blue Shield (Anthem, Inc.), Ambetter of Peach State, and Humana.
Jim Beck, a Georgia Insurance Commissioner, and his staff compiled all the data from all the complaints that those health insurance companies have received in 2018 alone. Those complaints were filed through the department’s Consumer Services Division.
Georgia’s Public Complaint
Georgia is the only state to file a complaint against multiple health insurance companies according to JoAnne Oni, director of consumer services. It was also the first time in Georgia’s history to publicly announce filing a complaint.
According to the consumer services report, most of the compiled reports filed in their office are mainly focused on different types of insurance, namely automotive, life, and homeowner insurance.
To ensure that each complaint filed through them is handled professionally, each complaint type is handled by different department staff. This way, Beck and his staff can fulfill their promises of transparency, consumer protection, and fraud protection while still carrying out their work duties.
How Health Insurance Complaints Work
There are two distinct complaint categories filed when it comes to health insurance: the ratio of complaints filed and the level of confirmed complaints. When both categories are ratioed to each other, any ratio exceeding 1% for any categories is a cause for alarm. This is because higher numbers confirm worse records within the pile of complaints.
In this case, a confirmed complaint is when a) the insurer committed an error, confirmed by the insurance department, or b) the insurer was in error after either the complaint or the company’s response indicates it.
Anthem Blue Cross Blue Shield (Anthem, Inc.), a health insurance company based in Indianapolis, has the largest number of complaints against them. The company received a total of 579 complaints, ratioing to 1.50%. Within that number, 81 complaints were confirmed, giving it a confirmed complaint ratio of 1.87% (the highest among the others previously mentioned). When asked for comments about the issue, their spokesperson said that the company is taking the time to go over all their existing records.
The second company to have the greatest number of complaints is Ambetter of Peach State. Although the exact number of complaints hasn’t been given, their complaint ratio ranges from 1.31% to 1.81%. Centene, the parent company, refused to make any comments about the issue.
Meanwhile, the third company with the most complaints is Humana, with a confirmed complaint ratio of 1.40% to 1.42%. The company has also declined to give comments in regards to the matter.
The data collected has allowed the Georgia Association of Health to continue monitoring health insurance complaints. Commissioner Beck and his team are consistently evaluating records from insurance members and pouring over the data compiled from the complaints. The committee has also vowed to be vigilant in foreseeing new complaints that might be filed in their office in the future.
