Navigating Insurance Commissions

What is a State Insurance Commission?

State insurance commissions are generally a pision or department within the state government that helps regulate insurance within their respective state. While the specific responsibilities of state insurance commissions/regulators can vary by state, they generally include but are not limited to:

• Ensuring insurers follow state laws,
• Protecting consumers’ interests,
• Resolving complaints about insurers,

The state insurance commissioner (the head of insurance commission) is generally appointed by the Governor. Only 11 states elect their commissioner.

How Can My State’s Insurance Commission Help Me and/or My Clients?

If you are having a problem with a state-regulated insurer, you can contact the state insurance commission for support. State insurance commissions generally allow the public to file a complaint, ask questions, and view educational materials.

State insurance commissions investigate the complaints, but the process, timeline and outcomes may vary by state. For instance, some states have a more aggressive approach toward insurance regulation than others. Additionally, some states have more developed mental health parity laws, which may provide further tools for regulating insurers and protecting providers and clients.

Please note that the United States uses a patchwork of regulatory oversight for insurance. The Department of Labor has oversight of self-funded insurance plans, and the Centers for Medicare and Medicaid Services (CMS) oversees Medicare and Medicaid. States provide primary oversight for fully insured plans as well as work with the federal government to administer Medicaid. So, when submitting a complaint about an insurer, be sure to check the insurance plan.

If it is a Medicare or a self-funded insurance plan, use the appropriate federal channels to file your complaint. If you have difficulties with federal regulators, you can still reach out to the state for additional support. “Many states have Consumer Assistance Programs [link added] that help you navigate insurance problems, including those with self-funded plans” (KFF).

How Do I Contact My State’s Insurance Commission?

Check out the National Association of Insurance Commissioners’ Insurance Departments page to find your state’s insurance commissioner and/or file a complaint with your state insurance department. You can also go directly through your state’s website to find your insurance commissioner.

For additional support navigating insurance barriers, check out our Insurance Parity Resources page and our Tips for Handling Claims Denials article.