Penn State Geisinger Health Plan fined for 13 violations

Specialties Case Management


Penn State Geisinger Health Plan fined for 13 violations

Following a year-long market conduct examination, the Pennsylvania Insurance Department fined Penn State Geisinger Health Plan $150,000 for 13 violations of state regulations.

Penn State Geisinger, an HMO, services more than 200,000 Pennsylvanians, including large employee groups, individuals, families, and Medicare beneficiaries.

The insurance department administered its market conduct exam from July 1, 1997, through June 30, 1998, and found, among other violations, that Penn State Geisinger failed to pay claims in a timely manner (45 days, according to Pennsylvania guidelines), canceled subscribers' coverage without giving written notice, and overcharged some of its policyholders.

Insurance Commissioner Diane Koken says that the most serious infraction was the HMO's failure to pay claims in a timely manner.

Penn State Geisinger signed a consent order with the Pennsylvania Insurance Department and has agreed to correct its wrongdoings and pay the $150,000 fine. The HMO must file proof with the insurance department that it has reimbursed the policyholders it overcharged. It must send payment and comply with the order by Oct. 13.

Last updated Sept 17, 1999

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