Department of Insurance seeks actuary, outlines wildfire and PBM pressures on insurers

The Joint Finance-Appropriations Committee on Jan. 21 reviewed the Department of Insurance budget and heard Director Dean Cameron describe regulatory and market pressures tied to pharmacy benefit manager enforcement, the state’s high‑risk reinsurance program and wildfire-related insurance market disruptions.

The agency requested four enhancement items for fiscal 2026: one staff actuary (about $201,900 ongoing), a regulatory compliance specialist to serve as an internal legal resource, compensation increases for the state fire marshal and deputies ($48,100 ongoing from the Arson Fire and Fraud Prevention Fund), and $162,200 in one-time capital outlay (including vehicles, cameras and firefighter turnout gear). The department reported it has 75.5 authorized full‑time positions, with 63.5 in the Insurance Regulation Division and 12 in the State Fire Marshal division. The department’s premium tax distributions support insurance funds, the fireman’s retirement system, the high‑risk reinsurance pool and the general fund.

Director Cameron reported that the department is implementing requirements from last year’s PBM (pharmacy benefit manager) reform, including a new position to handle PBM-related compliance and complaints. "Most have complied and have submitted their data," Cameron said of PBMs’ statutorily required data submissions. He said complaints have ranged from dispensing fees to contract issues and nonresponsiveness and that the agency is still aggregating data and complaint counts.

Cameron described the state’s longstanding high‑risk reinsurance program and the use of a Section 1332 waiver to obtain federal matching that helped lower individual exchange rates and attract carriers to Idaho’s market. "We instituted that 3 years ago... we have doubled the number of carriers participating on the health insurance exchange," he said, describing the program’s role in stabilizing individual market rates by reinsuring certain high-cost conditions.

On homeowner insurance, Cameron said wildfire losses and national reinsurance market tightening are affecting Idaho. "This last year we burned a million acres, just under a million acres," Cameron said. He said some carriers are reducing writing activity in higher-risk areas and that the department is proposing legislation to create a pool that would both help homeowners harden structures against wildfire and provide a mechanism to help carriers remain in the Idaho market.

Representative Furness and other legislators asked about the high‑risk pool and the department’s wildfire proposals; Cameron said the proposed pool would fund mitigation efforts such as clearing combustible vegetation and retrofitting eaves and that it could also serve to spread or reduce risk for carriers. Cameron said the department is monitoring nonrenewals and several carrier solvency issues and warned that statewide homeowners’ premiums and access to coverage are under pressure.

The presentation also noted recent reversions and expenditure patterns: the department reverted about $2.2 million in fiscal 2024 (split between personnel and operating reversions), and fiscal 2025 included ongoing enhancements and a trailer appropriation tied to House Bill 596, which amended Idaho Code concerning PBM reporting; that trailer appropriation provided one FTP and $132,400 for implementation.

No formal vote was taken on the enhancement requests during the session; the director offered additional detail and said the department would provide further breakdowns as data collection continues.