Updates from the OIC
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office of the insurance commissioner mike kreidler
Kreidler fines LifeWise, Evolent $225,000 for illegal claim denials
"Media contact: Public Affairs, (360) 725-7055"
Washington state Insurance Commissioner Mike Kreidler fined LifeWise Health Plan of Washington and Evolent Health LLC a total of $225,000 for incorrectly processing, and automatically denying, health insurance claims based on the patient’s gender.
Kreidler fined LifeWise [ [link removed] ] $150,000 and fined Evolent [ [link removed] ] — LifeWise’s health care benefit manager — $75,000 in orders filed on Sept. 12, 2024. Health care benefit managers are third-party professionals or entities who act as intermediaries between insurers, providers and patients, often making determinations on whether services are covered or not by the patient’s plan.
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