Bright Health has entered into an agreement with the regulator to address the issues, according to an April 8 Colorado Division of Insurance news release.
The complaints against Bright Health were focused on four areas:
1. Failure to pay provider claims according to Colorado law
2. Failure to communicate with members
3. Inability to accurately process consumer payments and accounts
4. Untimely process of claims for physical and behavioral health problems
Of the $1 million penalty, $500,000 must be paid now, according to the news release. Bright Health might not have to pay the remainder, depending on improvement and compliance with various metrics. Those include accurately paying past claims, providing reasonable resolution times for complaints, resolving claims disputes from healthcare providers and a significant reduction in complaints.
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