The fines were assessed after insurance regulators evaluated more than 10.8 million claims from 34 companies representing 80 percent of Ohio's health insurance market, according to department spokesperson Todd Boyer. Of the claims examined, 86 percent were paid or denied in compliance with the state's prompt-pay law that requires health insurance claims to be paid or denied within 24 days of the insurer's receipt of a completed claim. The state's 24-day deadline applies only to "clean" claims, or those submitted to the insurers with all of the information necessary to process them.

While it may be unrealistic to wish for 100 percent compliance, that's what the department would like to see," says Boyer. He adds that the department used guidelines established by the National Association of Insurance Commissioners (NAIC) to determine whether the claims data examined by regulators

showed a statistical "anomaly" or a more serious problem.

According to Boyer, the NAIC has ruled that anything less than 93 percent full compliance with prompt-pay laws is a red flag and may indicate "systemic" problems. "That's why we not only assessed the fines, but also had the insurers submit corrective plans," he says.