Dive Brief:
- The consumer-oriented and operated health plan Tennessee's Community Health Alliance (CHA) has pulled its plans from the state's federally-run exchange, freezing enrollment on Jan. 15.
- CHA's enrollment grew "exponentially" from 2014 to 2015—although in 2014, the CO-OP enrolled fewer than 1,000 individuals in five of eight rating areas, against a goal of 25,000. It is unclear how many individuals the program enrolled prior to Jan. 15 of this year, but the organization insists that it is in no trouble and is on track to offer plans in 2016.
- In the second enrollment period, CHA sold in all eight rating areas, as well as offering substantially-lower premiums than most of its competitors. Four other issuers continue to offer plans on the exchange: BlueCross BlueShield of Tennessee, Assurant Health, Cigna and Humana.
Dive Insight:
"Freezing enrollment in CHA was a decision we made after lengthy discussions with CHA leadership, the Department of Health and Human Services and an analysis of CHA's financial conditions and projections," said Tennessee Department of Commerce and Insurance Commissioner Julie Mix McPeak. "This course of action is the best one for CHA and for Tennessee consumers."
Despite CHA's assertion that nothing is wrong, freezing enrollment is an unprecedented move in the CO-OP world, and sends a pretty strong message about the viability of the model—especially given that Iowa's CoOportunity Health just bit the dust, despite enrolling more than 35,000 members and earning $127 million in premium volume (its first-year target was 12,000 members.) There are 21 CO-OPs left and with risk-adjustment funds not looking terribly promising, it's hard to trust CHA's cheerful message.
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