I am writing today to announce the closure of the New Mexico Independent. After three and a half years of operation in New Mexico, the board of the American Independent News Network, has decided to shift publication of its news…
While environmental activists played their part yesterday during demonstrations at the capitol building, going so far as to dress up as solar panels and to sing the tune of “You Are My Sunshine,” their counterparts, the anti-cap-and-trade contingency who has…
Roughly one quarter of University of New Mexico students are unimpressed with the state’s flagship public school, according to a survey that questioned college students about their higher education experiences.
Sharp divisions surfaced on renewable energy and insurance rate regulation between Public Regulation Commission (PRC) candidates at an industry-sponsored candidates’ forum Wednesday, with District 4 Republican candidate Gary Montoya defending the use of coal-burning power plants while his opponent, Democrat Theresa Becenti-Aguilar, advocated more use of solar power.
Stephanie DuBois has worked as a dog trainer, bookkeeper and waitress, and managed the Deming Chamber of Commerce for three years. Outgoing Land Commissioner Pat Lyons is a former legislator who has overseen the state Land Office for the past eight years. The two are competing for a seat on New Mexico’s most powerful regulatory agency, the Public Regulation Commission. And each has a different vision on how the agency should be run.
Auditors for a national accrediting organization reviewing the New Mexico Division of Insurance this spring found an inexperienced, marginally trained staff often incapable of performing in-depth analysis of insurance filings, according to a June 24 draft report obtained by The Independent.
The auditors from the National Association of Insurance Commissioners (NAIC) also were sharply critical of how New Mexico regulators have overseen the insurance industry, the report shows.
The findings resulted from visits NAIC auditors paid to the New Mexico insurance division this spring as part of a regular every-five-year re-accreditation process for state insurance regulation agencies.
New Mexico’s insurance division won accreditation in August, but auditors placed the division on “probationary status” pending completion of a corrective action plan to address problems identified during their visits to Santa Fe, Superintendent of Insurance John Franchini acknowledged Thursday.
According to the report obtained by The Independent, auditors found:
The auditors also noted that the division’s financial analysts frequently resorted to surface-level reporting without analyzing underlying factors, when reviewing insurance filings. Their reports frequently identified what happened, but not why, the report states.
The division’s financial surveillance staff suffered significant turnover during the past two years, the NAIC auditors also noted.
The auditors recommended the division provide ongoing training to its financial analysts in, among other things, insurance operations, reinsurance, reserves and other areas to bulk up their expertise in reviewing insurance company filings.
Finding echoes earlier warning
The NAIC’s finding that Division reviews of documents submitted by insurance companies are insufficient appears consistent with similar assessments by an independent insurance rates expert hired by the state Attorney General’s office to review a controversial Blue Cross Blue Shield N.M. rate hike earlier this year.
The draft report did not focus just on insufficiencies, although that appears to have dominated the report. NAIC auditors noted areas of improvement at the division.
The division’s new chief examiner, hired in 2009, had provided “significant oversight,” auditors found. But financial examinations of insurance companies conducted by division contractors prior to the new chief examiner’s arrival frequently contained “no evidence of any involvement by division personnel on the examination.”
Commission might review report in secret
The Public Regulation Commission (PRC), which oversees the insurance division, had scheduled Franchini to present the corrective action plan to commissioners Tuesday. But that presentation was rescheduled for Thursday.
Division officials had learned Tuesday morning that The Independent had obtained a copy of the NAIC report.
At Thursday morning’s public Commission meeting, Franchini asked commissioners for a second delay, saying the corrective action plan would be ready next week. He also suggested the PRC allow him to present the NAIC auditors’ findings and the division’s response in a secret, closed-session meeting, alluding to sensitive personnel matters supposedly discussed in the reports.
But the June 24 version of the NAIC report obtained by The Independent doesn’t name any employees or even specify division staff positions, other than to compliment the division’s chief examiner for improving oversight issues.
“The law is clear,” N.M. Foundation for Open Government director Sarah Welsh told The Independent Thursday. “They can only go behind closed doors to discuss personnel actions, complaints or charges ‘against any individual public employee.’ That means actual people, with names. If they’re discussing some larger departmental issue and they realize they need to fire the department head, fine, they can go talk about that in closed session. But they should specify which limited personnel matter they’re talking about, whether it’s hiring, demotion, dismissal or the investigation of specific charges against a specific person.”
Commissioners Sandy Jones, David King and Jerome Block, Jr., voiced support for a closed-door discussion of the report.
Commissioners Jason Marks and Theresa Becenti-Aguilar both questioned the need for secrecy. But they appeared outnumbered.
“It’s already been on the agenda (for Tuesday), and has to be discussed publicly,” Becenti-Aguilar said. “This is our new way of open communication and transparency.”
Becenti-Aguilar and PRC Chief of Staff Michael Rivera both took Franchini to task for failing to communicate with commissioners and for delays in the division’s preparation of the corrective action plan, which was originally due this week.
“When we have a deadline from an oversight agency like this, we need to make much effort to meet those deadlines,” said Rivera. “It has been about three weeks since we received notification (from NAIC) and we’ve asked (the NAIC) for an additional week to respond. Mr. Franchini has assured me we will get this done. Part of the reason for the delay was I found out the commissioners were unaware of the situation.”
‘No attempt to hide anything’
Franchini said he had not intentionally kept the audit findings from commissioners.
“There was never an attempt to hide anything – that wasn’t my intent,” Franchini told commissioners. “I’m new at this stuff, just getting my feet wet. But we almost have that plan complete. We’d like to present that to you at a closed hearing. We can do that early next week.”
Commissioners expressed concern to The Independent in July regarding Franchini’s ability to lead the Division. But only Marks voted against Franchini’s appointment.
Jones suggested staffers should have stayed in Santa Fe to continue preparing the corrective action plan rather than take an August trip to the NAIC annual meeting in Seattle, Washington.
“Maybe they shouldn’t have gone to Seattle,” Jones said.
But the purpose of the Seattle trip was for division employees to seek re-accreditation before the NAIC Financial Regulation Standards and Accreditation Committee, staff have said.
Jones acknowledged that he had had the opportunity to read the NAIC report, but had not done so.
“I was offered a copy and said I didn’t want it,” Jones said. He did not elaborate.
The Independent filed a public records request Aug. 17 to inspect all division correspondence with the NAIC. However, the Division has not yet disclosed the final NAIC report and probationary status notice letter, or other related documents.
Asked if the Division’s probationary status was unusual, Franchini could name no other states currently on probation with the NAIC. But two other states, Nevada and New York, had been through the probationary process in recent years, Franchini said.
In the New York case, the problems had to do with insurance regulators’ statutory power, rather than under-staffing or lax oversight, Franchini acknowledged.
NAIC officials could not be reached for comment Thursday.
New Mexico Independent’s previous reporting on this issue:
‘Typo’ was cited as support for Blue Cross N.M. rate hike
Insurance Division approved Blue Cross rate hike without documentation of claimed losses: Regulators are ‘insufficiently skeptical’
‘Musical chairs’ at state Insurance Division: Blue Cross rate hike fight claims three superintendents in two months
Fired Insurance Division compliance director’s lawsuit alleges illegal, improper conduct at PRC
Fireworks over Blue Cross Blue Shield NM rate hike settlement
Former Republican state legislator Ben Hall and former Democratic Doña Ana County commissioner Bill McCamley both want to clean up the powerful and scandal-plagued state Public Regulation Commission. The men, who are fighting over outgoing Commissioner Sandy Jones’s District 5 seat, both told The Independent they want to see increased PRC scrutiny of utility and insurance companies’ rate hikes, and increased accountability at the PRC’s semi-autonomous Division of Insurance. But the candidates differed on how they would achieve those goals.
Blue Cross and Blue Shield of New Mexico attorney Paul Bardacke spent much of his time at last week’s Division of Insurance hearing on his client’s latest health insurance rate hike attacking Allan Schwartz, the Attorney General’s office’s independent expert who testified…
A contentious all-day hearing Wednesday left many Blue Cross and Blue Shield of New Mexico customers saying they see little hope for relief from a controversial 21.3 percent increase in their health insurance premiums. Even though the company’s cash reserves have now reached $7.2 billion, an expert witness for the Attorney General’s office’s, who reiterated earlier testimony that Blue Cross had not sufficiently documented its claimed cost figures, and whose analysis found the insurer’s rate filing had exaggerated company losses, said the 21 percent increase was “reasonable, given the circumstances.”
Controversy has surrounded the state’s approval of a 21.3 percent rate hike on 40,000 Blue Cross and Blue Shield of New Mexico health insurance policyholders, but the state Division of Insurance approved Presbyterian Insurance Company’s even larger, 24 percent health…
The Public Regulation Commission (PRC)’s Division of Insurance will hold a public hearing Wednesday in Santa Fe on Blue Cross and Blue Shield of New Mexico‘s controversial health insurance rate hike.
Blue Cross will be asked…
The state’s new Superintendent of Insurance, John Franchini, began work Monday — just two days ahead of a public hearing scheduled for Wednesday on the controversial Blue Cross and Blue Shield of New Mexico health…
In light of public outrage over a controversial 21 percent increase in Blue Cross Blue Shield’s health insurance premiums — and revelations the increase may have been based partly on exaggerated losses — the New Mexico Division of Insurance is moving to require insurers to submit more information, including rate histories, when filing new rates.
New hearings on an insurance company rate hike will continue after The New Mexico Supreme Court decided on Wednesday to deny Blue Cross and Blue Shield of New Mexico‘s petition to stop them.
The company had asked the court to halt new Insurance Division hearings to review a previously-approved but controversial health insurance rate hike.
“This paves the way for the public vetting of the factors underlying the rate increase,” Public Regulation Commission (PRC) Commissioner Jason Marks told The Independent at the Supreme Court. “The public can’t help but benefit from hearings.”
Blue Cross Blue Shield NM had petitioned the Supreme Court to reverse acting superintendent Johnny Montoya‘s order suspending the rate hike
After hearing oral arguments from Blue Cross attorney Paul Bardacke, Attorney General Gary King and Insurance Division attorney David Barton, justices retired to chambers for approximately 25 minutes Wednesday morning. They briefly emerged for Justice Petra Jimenez Maes to announce the court was denying the company’s petition.
Insurers should not be subject to repeated hearings after a rate hike has been approved by the insurance superintendent, Bardacke argued.
“Where is the finality for consumers, first of all?” he asked in oral arguments before the court.
But the Supreme Court was not the appropriate venue for the case, Maes stated Wednesday morning, echoing Barton’s oral argument that the high court’s intervention would only be appropriate if Blue Cross had no other recourse to appeal the Division’s decision. Under state law, Blue Cross can appeal a withdrawal of any rate hike approval in district court.
“We respect the finding of the Court and will be at the hearing August 25,” Bardacke, who represents Blue Cross Blue Shield NM, told The Independent. “We were pleased Attorney General Gary King indicated the (rate hike) settlement was fair and equitable, and in the best interest of all New Mexicans.”
The Attorney General’s office had helped negotiate and stood by the controversial rate hike settlement, but Gary King appeared before the Supreme Court to defend the Insurance Superintendent’s authority to hold public hearings and review the justification for the rate hike.
The Insurance Superintendent has discretion under state law to hold the scheduled hearings, Gary King argued.
“A final order reversing approval would not be discretionary,” Gary King clarified to The Independent after the Court’s decision. “There would have to be some reason for rejecting the rate increase. There would have to be some different or additional evidence presented at the hearing” to reverse the rate hike approval.
“It’s a new day for consumers in New Mexico,” PRC chair David King told The Independent, adding that Legislature should now empower the PRC to hear appeals of future rate hikes. Currently, appeals must be filed in district court.
“I’m happy New Mexicans will get a chance for new hearings and we’ll do things now that should have been done orginally,” PRC Commissioner Jerome Block Jr. said. “Hopefully the surpluses prove that the rate increases are not justified and New Mexicans can be spared this increase. They have a lot of nerve to come ask for an increase, frankly.”
The Public Regulation Commission (PRC) voted 4-to-1 Tuesday afternoon to appoint John G. Franchini as the state’s newest superintendent of insurance. Commissioner Jason Marks cast the dissenting vote.
Franchini has worked in the insurance industry for more than 35 years, since he joined his father’s insurance brokerage as a salesman, according to a letter to commissioners that accompanied his resume. He worked as vice president for government affairs at New Mexico Mutual, the state’s workers’ compensation underwriter, from 2002 until January 2010, according to his resume.
Franchini was appointed one day before the state Supreme Court is scheduled to hear a Blue Cross Blue Shield NM petition to reverse acting superintendent Johnny Montoya‘s order suspending the rate hike. More …
Blue Cross and Blue Shield health insurance plans across the U.S. have raised policyholders’ rates while accumulating billions of dollars in surpluses – much more than necessary to protect the companies, according to a Consumers Union study released Thursday.
Theresa Becenti-Aguilar‘s top priority on the Public Regulation Commission (PRC) will be empowering PRC employees, she told staffers this week — but protecting consumers will be a close second, she said.
The Insurance Division’s negotiation of a controversial…
A planned public hearing on Blue Cross and Blue Shield of New Mexico‘s controversial health insurance rate hike may be delayed until September.
The company filed a motion July 2 with the state Insurance Division, saying the public hearing and division review of the rate hike should be delayed until the Supreme Court has ruled on the matter, because preparing for the public hearing would be time consuming and the court may toss the PRC’s decision to reverse approval of the hike. More …
Aetna has become the second health insurance company in California since April to scrap planned rate hikes, following revelations last week that “math errors” in the company’s application exaggerated justification for the proposed rate increase.
The company had sought a…
Blue Cross Blue Shield has asked the state Supreme Court to block the PRC’s decision to suspend a controversial 21 percent health insurance rate hike. The company says it complied with all regulations in pursuing the rate hike and negotiated with the Attorney General’s office and Insurance Division in good faith to arrive at the settlement. That settlement came after the state’s expert concluded the rate hike was unjustified and the company had “inflated” its losses.
Acting state insurance superintendent Johnny Montoya has suspended a controversial April 26 Blue Cross and Blue Shield of New Mexico health insurance premium rate increase settlement and ordered an Aug. 25 public hearing to review evidence in the case. But his order allows Blue Cross Blue Shield NM to continue to charge the higher rates until the August hearing.
Insurance Division officials fired former compliance director Aaron Feliciano after he refused to hire an unqualified candidate as chief investigator and complained to the Attorney General’s office about “unlawful or improper” acts by Division officials, Feliciano alleges in a…
The state Insurance Division will this week vacate its controversial April approval of a Blue Cross Blue Shield of New Mexico health insurance rate hike settlement, Public Regulation Commission (PRC) chairman David King told The Independent Monday morning.
The move expected this week does not represent a formal rejection of the request or a final decision; it will simply restart the process.
Commissioner Jason Marks had condemned the settlement as “a back room deal.” Angry commissioners voted May 13 to order the Division to reverse its approval of the settlement, which was negotiated over a weekend without public hearings.
But former acting superintendent Tom Rushton, who had helped negotiate the 21.3 percent rate hike, resigned the following day without issuing an order to vacate the agreement.
Rushton was replaced May 20 by Craig Dunbar, who could not vacate the agreement because a technicality prevented him from staying in the job; State law requires the insurance superintendent to have lived in New Mexico for three years, but Dunbar returned to New Mexico from Texas only last year.
Blue Cross Blue Shield attorneys had threatened to sue the PRC if the Division withdrew its approval for the rate hike. But concerned that Dunbar’s appointment might be challenged in court if he vacated the rate hike, because of the residency issue, commissioners decided to replace him, they told The Independent.
Dunbar was replaced last week by Johnny Montoya
Incoming interim superintendent Johnny Montoya will vacate the Division’s approval this week, Dunbar and King said.
If that happens, the division will also clear a separate request to reverse the approval submitted by the original complainant in the case, Blue Cross Blue Shield NM policyholder and Albuquerque Attorney Jody Neal-Post. Jones defected from the settlement agreement May 27.
Describing Blue Cross Blue Shield as “a corporation with apparently endless litigation resources,” Neal-Post noted in a filing submitted to the Division Monday that the company had hired yet another attorney to fight her request that the settlement approval be vacated.
The PRC’s selection committee will begin reviewing candidates Tuesday for the permanent superintendent, King said. A “permanent” superintendent should be appointed by late summer, King said.
King questioned the constitutionality of residency requirements, noting that “many” candidates for the permanent superintendent position could not apply because they had not lived in New Mexico during the past three years.
