Citing numerous violations, Washington Insurance Commissioner Mike Kreidler has fined Dental Health Services of Long Beach, Calif., $300,000 and ordered it to develop a compliance plan to resolve consumer concerns.
Company officials agreed to the order, which requires it to hire an external auditor that Kreidler approves by Sept. 25.
The commissioner suspended $200,000 of the fine, if the insurer, through its auditor, develops an acceptable plan to correct violations and meets all requirements of a compliance plan. DHS must also make whole all enrollees who experienced a delay in care or out-of-network charges because a provider was not available in their service area and there are no additional violations occur for two years.
Dental Health Services is the second-largest insurer of dental services in Washington with more than 52,000 enrollees, including just over 14,000 signed up through Washington Health Benefit Exchange. It is the largest dental insurer through the public sponsored Exchange.
The insurance provider is charged with failure to resolve consumer grievances in a timely manner. Enrollees with issues sometimes waited hours after calling with complaints.