Washington Insurance Commissioner Mike Kreidler has suspended Dental Health Services’ ability to sell new dental plans for a year, after the insurance company not only failed to address hundreds of customer grievances, but also ended up double-charging people for premiums and cancelling numerous policies.

The Insurance Commissioner’s Consumer Protection Division detected an increase in consumer complaints about Dental Health Services in December 2016, which peaked in March 2017, and were related to access to services and poor customer service.

An investigation found the company failed to have comprehensive documented appeals and grievance processes, wasn’t processing grievances in a timely manner or maintaining a complete and accurate grievance log, failed to maintain an accurate online provider directory and to deliver enrollment and membership materials to consumers in a timely fashion after enrollment.

Dental Health Services of Seattle, based at 100 W. Harrison St. in Lower Queen Anne, entered into a consent order with the Insurance Commissioner in September 2017, which required it to complete corrective actions by March 31.

The Insurance Commissioner fined Dental Health Services $300,000, but suspended $200,000 of that amount under the consent order, which the company could have avoided paying had it met its March 31 deadline.

A March 21 audit found Dental Health Services had still not taken proper corrective actions to create a process for documenting and keeping grievance logs, monitor vendor performance and enforce contract terms, train employees, adequately supply enrollment materials and monitor providers to determine when contract revisions are necessary, according to an Oct. 19 order by the Insurance Commissioner imposing the remaining $200,000 fine.

Dental Health Services was granted an extended deadline of Sept. 28 through a Supplemental Compliance Plan, but the company again did not meet a number of required corrective actions surrounding appeals, processing grievances, quality assurance and vendor performance monitoring, according to the order.

The latest consent order the Insurance Commissioner and Dental Health Services entered on Nov. 13 suspends $400,000 of a $500,000 fine for further issues detected while performing monthly audits between April and September.

That includes failing to identify and process 23 appeals and 342 grievances, ranging from dissatisfaction with medical care to wait times.

The Insurance Commissioner found that Dental Health Services overcharged customers more than $56,000 in premiums. When a member cancelled their policy or it lapsed in 2016 or 2017, the company’s accounting software continued to calculate premiums that were due, according to the November consent order. When a policy was reinstated in 2018, those incorrect premiums were applied to a customer’s balance for years when they did not have a policy; those policies were then terminated for nonpayment, affecting 76 consumers.

“As a result of the erroneous member cancellations, members were directed to pay additional premium for months where premium had already been paid, resulting in the member being assessed premium twice for the same payment period,” according to the consent order. “To date, the Company has identified 492 subscribers who were assessed premium in excess of that which was due, resulting in $56,351.45 in refunds being issued and $5,635.14 of interest being paid to members to date.”

Under the consent order, Dental Health Services will not pay the suspended $400,000 fine if it commits no other violations within a two-year period and completes its compliance plan in that same timeframe. Part of the company’s corrective action plan includes hiring external auditors.

As of Dec. 31, Dental Health Services was prohibited from selling any new dental plans in Washington until it fulfilled its requirements under the compliance plan. The company can petition the Insurance Commissioner to begin selling new plans again after 12 months. It can still renew existing plans and sell new plans in other states.