Mavengity — Insurance https://mavengity.com/categories/insurance/ Home, auto, life, and health insurance articles from Mavengity, explained in plain English, checked against the fine print. en-us Wed, 28 Oct 2026 23:35:00 +0000 https://mavengity.com/assets/img/mavengity-yt-logo.png Mavengity — Insurance https://mavengity.com/categories/insurance/ Washington Drops the Frequency Test From Its Insurance Claim Rules https://mavengity.com/articles/insurance/washington-oic-claim-handling-rules-frequency-test/ https://mavengity.com/articles/insurance/washington-oic-claim-handling-rules-frequency-test/ Sat, 03 Oct 2026 00:00:00 +0000 insurance Two orders fining USAA and Allstate a combined $230,000 arrived weeks before new Washington rules take effect that delete the requirement that claim-handling violations be a general business practice before regulators can call them unfair. CMS Gave Itself a Standing Power to Cut Brokers Out of the Exchanges https://mavengity.com/articles/insurance/cms-broker-moratorium-standing-authority/ https://mavengity.com/articles/insurance/cms-broker-moratorium-standing-authority/ Wed, 23 Sep 2026 00:00:00 +0000 insurance The new rule codifies a permanent authority to suspend agent and broker registration, then uses it for the first time on the brokers who joined last year while 315,000 enrollments covering 760,000 people come off the books. Utah Lets the Algorithm Work and Regulates Who Signs the Denial https://mavengity.com/articles/insurance/utah-ai-prior-authorization-disclosure-sb319/ https://mavengity.com/articles/insurance/utah-ai-prior-authorization-disclosure-sb319/ Wed, 23 Sep 2026 00:00:00 +0000 insurance Senate Bill 319 takes effect January 1 and requires Utah insurers to disclose AI use and to base adverse determinations on independent medical judgment rather than a recommendation from any other source. Molina Is Ending the Medicare Drug Plans 80,000 Members Still Hold https://mavengity.com/articles/insurance/molina-medicare-advantage-drug-plan-exit-2027/ https://mavengity.com/articles/insurance/molina-medicare-advantage-drug-plan-exit-2027/ Tue, 22 Sep 2026 00:00:00 +0000 insurance Molina told investors in February it would exit its traditional Medicare Advantage drug plans and members learn from a letter in October, because investor disclosure and member notice run on separate clocks. Five Hospitals Contracted With Blue Cross Texas and Were Paid by Pennsylvania Rules https://mavengity.com/articles/insurance/texas-hospitals-sue-independence-blue-cross-bluecard/ https://mavengity.com/articles/insurance/texas-hospitals-sue-independence-blue-cross-bluecard/ Tue, 22 Sep 2026 00:00:00 +0000 insurance Five HCA-affiliated hospitals are suing Independence Blue Cross over denied claims made under the BlueCard program, where the plan that decides payment is not the plan the hospital signed with. State Farm's Return to California Starts With Five Feet of Clear Ground https://mavengity.com/articles/insurance/state-farm-california-wildfire-hardened-return/ https://mavengity.com/articles/insurance/state-farm-california-wildfire-hardened-return/ Fri, 18 Sep 2026 00:00:00 +0000 insurance The insurer filed to write new homeowners policies again after three years, but only for homes hardened against wildfire, and the regulator says a filing is a starting point. A $14 Million Bet That Employers Can Rebuild Health Plans With AI https://mavengity.com/articles/insurance/nara-health-14m-self-insured-ai/ https://mavengity.com/articles/insurance/nara-health-14m-self-insured-ai/ Tue, 15 Sep 2026 00:00:00 +0000 insurance Nara Health, an AI-native third-party administrator for self-insured employers, raised $14 million led by Khosla Ventures to replace legacy claims infrastructure with direct contracting and reference-based pricing. Senate Asks State Regulators to Explain Private Equity's Life Insurance Bet https://mavengity.com/articles/insurance/warren-private-equity-life-insurers-naic/ https://mavengity.com/articles/insurance/warren-private-equity-life-insurers-naic/ Tue, 15 Sep 2026 00:00:00 +0000 insurance Sen. Elizabeth Warren is pressing the NAIC on how state regulators oversee private equity owned life insurers after the Walter probe revealed a related party restatement from $1.4 billion to more than $17 billion. The $500 Obamacare Refund Is Smaller and Stranger Than It Sounds https://mavengity.com/articles/insurance/500-dollar-obamacare-refund/ https://mavengity.com/articles/insurance/500-dollar-obamacare-refund/ Mon, 14 Sep 2026 00:00:00 +0000 insurance The administration says nearly a million unsubsidized marketplace enrollees in 30 states will get $500 checks in October, drawn from a surplus of HealthCare.gov user fees whose spending authority is unresolved. A Comparison Site Compared Two Insurers and Called It the Market https://mavengity.com/articles/insurance/choosi-two-insurers-called-it-the-market/ https://mavengity.com/articles/insurance/choosi-two-insurers-called-it-the-market/ Tue, 08 Sep 2026 00:00:00 +0000 insurance An Australian Federal Court has found comparison site Choosi misled customers by claiming to survey a range of insurers while overwhelmingly comparing policies from one. The ruling draws a legal line around the word range. North Carolina Covers GLP-1s in Medicaid but Not for Teachers https://mavengity.com/articles/insurance/nc-medicaid-covers-glp1-teachers-dont/ https://mavengity.com/articles/insurance/nc-medicaid-covers-glp1-teachers-dont/ Mon, 07 Sep 2026 00:00:00 +0000 insurance Two state programs reached opposite answers on weight-loss drug coverage, and the difference traces to who writes the check: the General Fund for Medicaid, the health plan's own budget for teachers and state employees. A Populist Health Movement and the Insurance Industry Have Landed on the Same Device https://mavengity.com/articles/insurance/maha-insurers-landed-on-the-same-device/ https://mavengity.com/articles/insurance/maha-insurers-landed-on-the-same-device/ Fri, 14 Aug 2026 00:00:00 +0000 insurance RFK Jr.'s push for wearables and insurers' wellness programs want the same continuous body data for opposite reasons. What happens next depends on insurance rating law, not the hardware. The Surprise-Billing Fight Now Turns on a Number One Side Gets to Calculate https://mavengity.com/articles/insurance/surprise-billing-fight-moved-to-the-benchmark-qpa/ https://mavengity.com/articles/insurance/surprise-billing-fight-moved-to-the-benchmark-qpa/ Wed, 12 Aug 2026 00:00:00 +0000 insurance A federal appeals court just handed doctors another win in the fight over the No Surprises Act's payment benchmark, the QPA. The law pulled patients out of surprise-billing disputes, but the underlying cost didn't disappear, it moved into a formula insurers calculate and providers keep suing over. A Popular Law Capped Drug Costs. Ending This Subsidy Shows Where the Cost Went https://mavengity.com/articles/insurance/medicare-part-d-subsidy-cost-relocation-who-pays/ https://mavengity.com/articles/insurance/medicare-part-d-subsidy-cost-relocation-who-pays/ Thu, 30 Jul 2026 00:00:00 +0000 insurance CMS is ending the Part D Premium Stabilization Demonstration. The out-of-pocket cap it was masking didn't eliminate drug costs, it relocated them, and ending the subsidy moves that cost back onto seniors' premiums. A Bank Lost $600,000 to Fraud. Its Insurer Paid $100,000. The Policy Covered All of It. https://mavengity.com/articles/insurance/cyber-insurance-sublimit-characterization-gap/ https://mavengity.com/articles/insurance/cyber-insurance-sublimit-characterization-gap/ Tue, 28 Jul 2026 00:00:00 +0000 insurance A Minnesota bank's cyber policy technically covered its full loss. The insurer characterized it as social engineering instead of computer fraud and paid the smaller sublimit. That characterization fight, not a coverage denial, is where cyber claims actually get decided. Iowa Banned Spread Pricing. An Audit Suggests PBMs Just Moved It to a Different Timescale. https://mavengity.com/articles/insurance/iowa-medicaid-pbm-spread-pricing-audit/ https://mavengity.com/articles/insurance/iowa-medicaid-pbm-spread-pricing-audit/ Tue, 21 Jul 2026 00:00:00 +0000 insurance A state auditor found one PBM collected about $100 million in back-end value from Iowa Medicaid over three years, through year-end recalculations. You Can Lose Your ACA Subsidy Without Your Income Changing at All https://mavengity.com/articles/insurance/aca-priced-out-consumer-verification-trap/ https://mavengity.com/articles/insurance/aca-priced-out-consumer-verification-trap/ Sat, 18 Jul 2026 00:00:00 +0000 insurance A verification rule can suspend ACA tax credits over a database mismatch, while the full premium comes due. It has nothing to do with whether you can afford coverage. Should Medicaid Pay Your Rent? California Says Yes, and the Waiver Expires This Year https://mavengity.com/articles/insurance/calaim-medicaid-social-services-debate/ https://mavengity.com/articles/insurance/calaim-medicaid-social-services-debate/ Sat, 18 Jul 2026 00:00:00 +0000 insurance California has spent nearly $12 billion routing Medicaid money into housing and food. Republicans call it waste. The real question is what Medicaid is for. Insurers Promised to Fix Prior Authorization. The Fine Print Excludes the Drugs People Depend On. https://mavengity.com/articles/insurance/humana-prior-authorization-drug-pledge-gap/ https://mavengity.com/articles/insurance/humana-prior-authorization-drug-pledge-gap/ Sat, 18 Jul 2026 00:00:00 +0000 insurance Insurers pledged to honor prior authorizations for 90 days when patients switch plans. A Missouri woman switched, got denied, and landed in the hospital. Humana's defense: the pledge only covers medical services. Medicaid's New Work Rule Doesn't Require Anything of Employers. It Will Still Land on Their HR Desks. https://mavengity.com/articles/insurance/medicaid-work-requirements-employer-verification/ https://mavengity.com/articles/insurance/medicaid-work-requirements-employer-verification/ Sat, 18 Jul 2026 00:00:00 +0000 insurance There's no employer mandate in the new Medicaid work rule, but the proof enrollees need has to come from payroll, on a 30-day clock.