A Pennsylvania health insurer must pay nearly half a million dollars in penalties for violating an injunction that ordered the company not to send mailers that impose rate and benefit changes to hundreds of elderly Iowa policyholders, a Polk County District Court has ruled.

The Aug. 31 ruling is the latest in a long-running dispute between insurance commissioners in Iowa and Pennsylvania that began in 2022 when Iowa Insurance Commissioner Douglas Ommen sought an injunction against Senior Health Insurance Co. of Pennsylvania (SHIP PA) after it declared it would change rates and benefits for Iowa policyholders without going through the required approval process with the state's insurance division.

At the time, Ommen said SHIP, which had sold long-term care insurance policies to more than

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