Department of Insurance reports PBM compliance work, seeks actuarial and fire‑marshal funding as wildfire risks strain market

Noah Peterson, the Legislative Services Office analyst for the Department of Insurance budget, reviewed the agency’s base budget and enhancement package on Jan. 21. Director Dean Cameron then answered questions from the Joint Finance‑Appropriations Committee about pharmacy benefit manager (PBM) compliance, the state’s 13.32 waiver and wildfire impacts on the insurance market.

Peterson told the committee the Department of Insurance has 75.5 approved full‑time positions, split between the Insurance Regulation Division and the State Fire Marshal; funding comes principally from the Arson, Fire and Fraud Prevention Fund and the Insurance Administrative Fund. The agency’s FY2026 enhancement requests include an ongoing staff actuary position (total request $201,900, $198,900 ongoing), a regulatory compliance/public policy adviser position, compensation increases for the state fire marshal team ($48,100 ongoing), and $162,200 in one‑time capital outlay for replacement equipment including turnout gear, cameras and two medium‑duty pickup trucks.

Cameron told the committee the department received a trailer appropriation to implement House Bill 596, which amended section 41‑349, Idaho Code, and was appropriated one FTP and $132,400 to implement PBM reporting requirements. "Most [PBMs] have complied and have submitted their data," Cameron said, but he added that a few providers had not yet submitted and the department is working to secure the remaining data. The agency hired an analyst to handle PBM complaints; Cameron said the complaints range from dispensing‑fee disputes to contract and responsiveness issues.

On the 13.32 waiver the director said the state applied for and obtained a federal waiver that matches state contributions to reduce individual insurance premiums. Cameron credited the waiver, the state’s high‑risk reinsurance pool and other measures with reducing individual premiums, saying premiums for people buying on the exchange are lower now than five years ago and that participation by carriers on the exchange has doubled since the waiver and pool were used.

Cameron discussed wildfire‑related market stress and proposed a legislative approach to help homeowners and insurers. He described insurers tightening underwriting and reinsurance markets, nonrenewals in some areas and a marked increase in surplus‑lines use. "We had one carrier tell us that reinsurance rates went up by a 1,000% for them," Cameron said. He described draft legislation to create a pool that would fund mitigation to harden homes against wildfire and act as a mechanism to help carriers remain in the market.

Committee members asked for more detail on PBM complaints, compliance and the department’s proposed insurance market legislation. Director Cameron said the department is collecting more data and will provide additional information as it becomes available. No formal committee votes were taken during the presentation.

The director introduced senior staff in attendance and thanked the committee for prior budget support and for the legislature’s role in funding items such as the high‑risk pool.