Some of the violations go back to 2005 when all the data systems we use today were not as sophisticated. One area is in compliance that did not contain all the information required by the state law so the normal fix would be to update the IT infrastructure to either amend or send updates to policy holders and the state sounds like they saw an area of algorithm neglect here. The retirees at Nordstrom were sold 100 dental policies that had not been approved and in another area the company continued to sell a health policy that had been disapproved.
Again with IT infrastructures today those get removed with programming and automated letters are normally sent out to those affected. With automated systems these areas do offer challenge to all. Back in April of this year the company made a mistake in the IT infrastructure automation and sent out letters in error to policy holders stating that their doctors were no longer in network. The algorithm ran without checking all parameters and letters were sent or someone forgot to check a few strings in the SQL that set all of this in motion. This is just a query process but when combined with other algorithms and something is not spelled out exactly in the computer coding, this is what happens. BD
Aetna States Letters Mailed to Thousands of California Customers Were A Mistake–Their Doctors Are Still In Network–”Rogue Algorithms and Flawed Data”–Attack of the Killer Algorithms Chapter 25
OLYMPIA, Wash., Dec. 27 -- The Washington state Office of the Insurance Commissioner issued the following news release:
A Connecticut insurance company has been fined $1 million by Washington State Insurance Commissioner Mike Kreidler for multiple violations over several years.
Aetna Life Insurance Company has agreed to pay the fine.
The violations include issuing unapproved insurance policies, failing to file legally-required documents with the state and charging unapproved rates.
"All insurers must comply with state law, and most of them do," said Kreidler. "I hope that this fine and compliance plan resolves these problems with Aetna."