Department of Insurance seeks staff and equipment as PBM oversight, high‑risk pool and wildfire pressures mount

The Idaho Department of Insurance outlined budget priorities and market concerns to the Joint Finance‑Appropriations Committee on Jan. 21, citing pharmacy benefit manager (PBM) oversight, its high‑risk reinsurance pool and wildfire‑related insurance market pressure as drivers.

Department requests for FY2026 include one staff actuary (requested at $201,900 ongoing plus $3,000 one‑time for office equipment), a regulatory compliance specialist (requested at $41.03/hour, 80% of policy for pay grade O) to serve as an internal legal and policy 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 for state fire marshal replacement items (including $10,000 for turnout gear, $16,200 for cameras and $136,000 for two medium‑duty pickup trucks with equipment).

Noah Peterson, budget analyst with the Legislative Services Office, told the committee the Department of Insurance has 75.5 approved full‑time positions (63.5 in Insurance Regulation, 12 in the State Fire Marshal) and that FY2024 reversions totaled roughly $2.2 million split between personnel and operating expenditures.

Dean Cameron, director of the Department of Insurance, described implementation of last session’s PBM reform (House Bill 596) and ongoing oversight activities. "Most [PBMs] have complied and have submitted their data," Cameron said, adding that the department has hired a staff member to handle PBM complaints and data collection but that the workload is substantial and “a lot more work than what one person can do.” Cameron said complaints range from alleged underpayment of dispensing fees to contractual disputes and nonresponsiveness by PBMs; he told the committee the department will provide more detailed reporting as data collection continues.

Cameron also described Idaho’s high‑risk pool as a form of reinsurance that helps insurers manage the costs of more expensive conditions by identifying covered risks by CPT codes and sharing claims costs. The program, Cameron said, contributed to lower individual market rates and helped attract more carriers to the state exchange since it began operation and subsequent modifications.

Several members asked about wildfire impacts on the property insurance market. Cameron said wildfire and other national catastrophic losses, together with inflation and reinsurance cost increases, have tightened the property insurance market. "We had 1 carrier tell us that reinsurance rates went up by a % for them," Cameron said, and the department has seen carriers nonrenew policies in parts of Idaho and a growth in surplus‑lines (nonadmitted) market usage. He described a proposed legislative pool to both help homeowners harden properties against wildfires and to provide mechanisms to help carriers remain in the state.

Why it matters: the Department of Insurance collects premium tax revenue that funds multiple statutory distributions (including the high‑risk pool and general fund), enforces market rules for insurers and PBMs, and provides fire‑safety and arson investigation through the State Fire Marshal. Committee members sought concrete PBM complaint counts and compliance status; Director Cameron said he expects a fuller report as the department compiles the mandated PBM data.

No votes were taken; the department’s requests and the director’s market observations will feed JFAC’s broader budget deliberations.