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Carriers to auto-enroll former Health Republic members for December

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The New York State Department of Financial Services and New York’s state-based exchange have arranged for three carriers to provide emergency replacement coverage in December for consumers affected by the sudden failure of Health Republic Insurance of New York.

See also: N.Y. CO-OP exiles face confusion, dash for new coverage

The carriers Fidelis Care, Excellus BlueCross BlueShield and MVP Health Care (MVP) will auto-enroll former Health Republic of New York members who do not take active steps by Nov. 30 to say what they want to do about coverage for December.

Regulators announced earlier this month that Health Republic, a nonprofit, member-owned Consumer Operated and Oriented Plan (CO-OP), would be closing Nov. 30, rather than winding its operations Dec. 31, like troubled CO-OPs in other states, because the condition of the CO-OP is worse than they had expected.

See also: New York speeds up PPACA CO-OP shutdown

Officials had said that they were asking carriers to give former Health Republic enrollees credit for whatever portions of their deductibles and out-of-pocket maximums they had met.

In the new announcement, officials said the carriers participating in the Health Republic backup coverage arrangement have agreed to “credit any deductible and out-of-pocket amounts that consumers have already paid through their Health Republic coverage during 2015.”

Health Republic enrollees affected by the switch will get notices about auto-enrollment for December in the third week of November, officials said.

“Consumers will be auto-enrolled into the same metal tier or option that is most similar to the coverage the individual selected through Health Republic,” officials said.

The affected consumers will have until Nov. 30 to call the exchange and pick an alternative plan, and they can decline the December coverage by not paying the December premium, officials said.

Consumers who actively choose coverage for December can enroll through the Web, but, because of system limitations, they have to telephone the call center to actively sign up for the December coverage if they do so from Nov. 16 through Nov. 30, officials said.

As of Nov. 11, a special Health Republic enrollee exchange hotline at (855) 329-8899 had received 24,000 calls, officials said.

Earlier, the New York department required Health Republic’s board to let the department appoint Alvarez & Marsal to take over as the company’s chief restructuring officer.

New York department investigators “are collecting and reviewing evidence relating to Health Republic’s substantial underreporting to [the department] of its financial obligations,” officials said. “Among other issues, the investigation will examine the causes of the inaccurate representations to [the department] regarding the company’s financial condition.”

See also: Low-cost CO-OPs win share


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