- CMS, the New York Department of Financial Services, and the New York State of Health Marketplace announced last week it is in the best interest of consumers to end all policies from Health Republic, the New York health cooperative who was ordered to shut its doors, on Nov. 30 so customers can transition to new coverage.
- After the cooperative was directed to cease writing new health insurance policies, a subsequent CMS-led review of the co-op’s finances found the company’s fiscal situation is “substantially worse than the company previously reported in its filings.”
- The insurer had received $265 million in U.S. loans via the ACA. Bloomberg Business reported it is unlikely the co-op will have to repay the full amount.
The health cooperatives have been receiving their unfortunate lion’s share of attention as the third enrollment period for the ACA marketplaces roll out. Recently, the Arizona co-op was removed from its respective marketplace, which came as a surprise to the insurer itself.
Before Arizona, Utah held the latest health co-op to shut its doors. Maryland co-op Evergreen Health Cooperative CEO Peter Beilenson recently told Healthcare Dive the co-ops left standing by Nov. 1 should be in it for the long haul.
A total of 15 health insurers to offer individual coverage for 2016 on New York State of Health.
Individuals who purchased a Health Republic plan on the New York State of Health Marketplace must take action to choose a new plan for the remainder of 2015 on or before Nov. 15. Coverage issued with a December 1 effective date will be effective through December 31. Consumers can also enroll for 2016 coverage on the NYSOH Marketplace. To be covered on January 1, 2016, consumers must select a plan by December 15.
Employers with small group plans through Health Republic should act as soon as possible to choose a new policy from another insurer for its employees to ensure continuity of coverage after November 30, according to a prepared statement from the New York Department of Financial Services. “Small group plans typically run on a one-year basis from their effective date rather than on a calendar-year basis. If the employer purchases coverage through the Marketplace, they may be eligible for a small business health care tax credit for qualified employers that can cover as much as 50% of their contribution toward employee premium costs.”