Washington insurance regulator fines for violations amounted to $828,500 in July, August, September, and early October of 2025, according to the office of Washington Insurance Commissioner Patty Kuderer.
That tally included a $100,000 fine for Regence BlueShield, which reportedly incorrectly denied 954 claims for treatment, and a $550,000 fine against Premera for violations of the Health Parity and Addiction Equity Act and Washington’s provider directory regulations.
Kuderer’s office fined Regence Blueshield for incorrectly denying claims for treatment based on a lack of preauthorization. The denials occurred between June 11, 2020, and May 25, 2022, and included chiropractic, physical therapy, occupational therapy, acupuncture and Eastern medicine, massage therapy, and speech and hearing therapies.
Regence reprocessed the claims, after which Regence’s amount paid rose from $11,139 to $85,982. The patient portion also increased from $6,114 to $31,724 after reprocessing because policyholder cost-shares and deductibles were now applied, according to Kuderer’s office.
Other fines and reported violations Kuderer’s office handled include:
Jonathan Ayers, Vancouver, Wash.; fined $3,000
Ayers lowered the deductible on a policy for his own travel trailer from $1,000 to $250 and misrepresented the date of the loss on a claim filed under the policy. Ayers received two years of probation and is barred him from acting as the agent on his own policies for two years. It also requires Ayers to complete 10 hours of ethics training.
Dentegra Insurance Company, Wilmington, Del.; fined $75,000
Dentegra failed to timely file its 2026 dental network access plan and GeoNetwork reports, placing roughly 11,000 enrollees at risk of coverage disruption or loss. Dentegra was fined $75,000 and agreed to cover at least $25,000 in basic dental care and services.
PacificSource Health Plans, Springfield, Ore.; fined $25,000
A system coding error caused PacificSource to adverse benefit determinations that didn’t disclose members’ appeal rights on prescription drug denials for 116 members.
Midvale Indemnity Company, Madison, Wis.; fined $5,000
Midvale incorrectly applied rating factors on 233 business policies in effect in 2023. The company returned the $461 in resulting overcharges with interest and waived $6,619 in resulting undercharges.
Heartland Dental LLC, Wilmington, Del.; fined $15,000
Heartland failed to timely report health care benefit manager credentialing contracts with 17 carriers.
KeyCorp Insurance Agency USA, Inc., Brooklyn, Ohio; fined $10,000
KeyCorp failed to timely resolve an identified annuity issue, failed to competently oversee two of its affiliated producers and conducted business under something other than its legal name.
Premera Blue Cross, Mountlake Terrace, Wash.; fined $550,000
Premera was fined for violations of the Mental Health Parity and Addiction Equity Act and Washington’s provider directory regulations.
Prestige International Insurance Group, Tamarac, Fla.; fined $1,000
Prestige failed to notify an insurer, and required an additional form to be signed upon receiving a customer’s request to cancel their policy.
The Corporation of Haverford College, Haverford, Penn.; fined $12,500
The college issued five charitable gift annuities in Washington from 1993 to 2021—with an aggregate value of $501,317—before obtaining a certificate of exemption from the OIC and issued annuities that didn’t comply with state law.
Eagle West Insurance Company, Monterey, Calif.; fined $5,000
Eagle West used incorrect base rates for its 680 Washington commercial farm and ranch policies in the first five months of 2023. The company waived $261,673 in undercharged premiums on 315 policies and refunded $559 in overpayments on nine policies.
Accredited Surety and Casualty Company, Orlando, Fla.; fined $15,000
The company issued ocean marine insurance policies without being authorized for that line of insurance in Washington.
Grange Insurance Association, Seattle, Wash.; fined $5,000
The company applied incorrect protection classification codes to an estimated 149 farm policies in 2023 and 2024, resulting in an estimated $133,206 in undercharged premiums.
Ying Sun, Bellevue, Wash.; fined $5,000
Sun made false statements on 12 submitted applications for life insurance policies, stating the applications were signed in various California cities when they were signed in Washington. The consent order also imposed two years of probation, including a requirement that Sun have a mentor review their insurance work in Washington during the probation.
Bankers Fidelity Life Insurance Company, Atlanta, Ga.; fined $2,000
The company filed its annual Medicare Supplement Premium Rates and Experience form and its annual Medicare Supplement Refund Calculation form after the deadline of May 31, 2024.
The third-quarter total fines bring the amount collected to more than $44 million since 2001. The funds are sent to the state’s general fund to pay for state services.
Topics Washington
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