Wyoming insurance regulator describes small, self‑funded agency, PBM oversight and local market differences

Cheyenne — The Wyoming Department of Insurance told lawmakers on June 24 that it remains a small regulatory agency that is self‑funded through industry assessments while overseeing insurers, licensing, market conduct and a newly established pharmacy benefit manager (PBM) unit. “We are the Department of Insurance. We regulate everything about insurance, all aspects,” Deputy Commissioner Tana Howard said as she introduced the department’s functions to the Labor, Health & Social Services Committee. Howard told the committee that the department has 27 employees and manages licensing (about 215,000 active licenses, mostly nonresident), financial examinations of domestic carriers, policy form and rate reviews in narrowly required lines, a consumer complaints division and an inspection/market conduct function. The department conducts accreditation work with the National Association of Insurance Commissioners (NAIC) and uses NAIC model law guidance. Howard and senior health policy analyst Jill Reinking outlined several programs: the Wyoming Health Insurance Pool (WIP), a high‑risk pool that serves about 700 enrollees (largely older and disabled Medicare supplement customers); a public service announcement requirement under Wyoming statute that historically required print publication (Wyoming Statute 26‑3‑126); and a recently funded PBM compliance position that investigates PBM practices and conducts outreach to rural pharmacies. Howard said Medicaid and federal plans drive much of the health market structure and that Wyoming’s market differs from larger states because of low population density and provider shortages, which affect network adequacy and costs. On rates, she noted Wyoming does not require property/casualty insurers to file rates but does require filings for certain lines such as long‑term care and Medicare supplements. “We currently the enrollment is steadily dropping in, in the health insurance pool as more options become available,” Howard said of WIP, and added that the pool is partially funded by insurer assessments and partially by general fund appropriations. The department also collects a premium tax (described in testimony as 0.0075) and surplus lines tax revenue that contribute to the general fund. Reinking told the committee the department prepared a provider credentialing form ahead of the new provider enrollment standards that take effect July 1 and said the form would be available online; she also said the department expected no rulemaking was required because the statute established most requirements. On PBMs, Howard said the department established a program manager position to accept complaints, do outreach and investigate practices affecting rural pharmacies and consumers. She said the PBM unit had created a complaint process, forms and an outreach plan. Consumer assistance and market conduct: the division handled roughly 1,500 complaints or inquiries last year and the market conduct staff (one person) conducts deeper pattern and practice investigations. Howard emphasized the department’s role as a consumer intermediary — it can investigate and recommend but cannot act as private counsel for a consumer. Why it matters: Committee members asked about the rising costs and availability of home/mobile‑home insurance and trends in health coverage related to federal premium tax credits. Howard said the department expected some enrollment and rate shifts if federal premium tax credits for the ACA marketplace change but did not predict immediate large increases in Wyoming because of differences in the state market. The department said it posts monthly public service announcements on its website and circulates them through NAIC and stakeholder channels despite the statutory print requirement. The department said it would follow up with committee requests for data, including a provider credentialing form and additional market surveys on rates and coverage availability in ZIP codes where insurers are limited.