D.C.-area dental insurer fined $5,000 for non-compliance

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Group Dental Service of Maryland was ordered to pay $5,000 to Maryland insurance regulators after it failed to comply with all of the terms of a previous agreement.

The Rockville, Md., insurer failed to correct a pre-authorization denial letter, sent out 941 times between Dec. 23, 2009, and June 8, according to Maryland Insurance Administration records.

The letter, which was corrected June 9, was one of several denial letters that had been the subject of violations found in a June 2008 market conduct examination of the insurer, records show. That examination found that the company failed to include proper notice to a member and provider that a Health Advocacy Unit is available to assist in filing a grievance.

In a consent order, signed Sept. 23, 2009, the insurer agreed to pay $50,000 of a $150,000 fine and said it would correct notices sent to members within 90 days. The other letters, records show, were corrected as mandated.

The $5,000 fine was part of the $100,000 that was stayed in the original order. Records show that the $95,000 outstanding will remain stayed, pending compliance with the terms of the original order.

This article first appeared in the December 2010 edition of Insurance & Financial Advisor–Maryland Edition.

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