New York speeds up PPACA CO-OP shutdown

State and federal regulators announced that they are teaming up to shut down Health Republic Insurance of New York on Nov. 30, rather than letting the company stay open until the end of the year.

Meanwhile, in Arizona, managers of Meritus Health Partners and Meritus Mutual Health Partners say they believe that their companies meet all state standards and are opposing an order for supervision requested by Arizona Director of Insurance Andy Tobin.

Health Republic of New York

The New York State Department of Financial Services, New York’s state-based health insurance exchange, and the Centers for Medicare & Medicaid Services (CMS) said they want to transition the company’s individual and group coverage enrollees to new coverage earlier than expected because a “review of Health Republic’s finances has found that the company’s financial condition is substantially worse than the company previously reported in its filings.”

About whether the company will have enough money to pay claims, officials said regulators “are working to protect those insured under Health Republic policies and to make sure claims are paid to the maximum extent possible.”

Health Republic of New York is one of the nonprofit, member-owned Consumer Operated and Oriented Plan (CO-OP) carriers started with loans from the Patient Protection and Affordable Care Act (CO-OP) program. Organizers received a total of $265 million in CO-OP program loans.

Health Republic of New York ended 2014 with 155,402 enrollees, or about one-fifth of New York state individual market enrollees, but it lost $35 million on $529 million in revenue, according to a report from the U.S. Department of Health and Human Services Office of Inspector General and the U.S. Government Accountability Office (GAO).

The New York financial services department, the New York State of Health exchange, and CMS announced Sept. 25 that Health Republic would stop writing new policies but that the company would continue to pay claims on in-force policies until the end of the year.

An unnamed Health Republic of New York broker relations manager said today in a broker conference call that group deductibles will re-set, but that insurance regulators are asking other insurers to give holders of individual Health Republic policies credit for the portions of their deductibles that they have already met. 

The manager said he knew the producers on the call would be in a mad scramble to re-write Health Republic business, and would have many questions.