The only Consumer Operated and Oriented Plan (CO-OP) that reported a profit for 2014 is reporting a big loss for 2015.
Officials at the Maine Bureau of Insurance talk about the performance of Maine Community Health Options in a statement released earlier this week.
Maine Community Health Options, which operates in New Hampshire as well as Maine, is reporting a $74 million net loss for 2015, compared with $7.3 million in net income for 2014.
Because the managers of Maine Community Health Options now believe that the CO-O’s rates for 2016 are too low, the 2015 net loss includes a $43 million premium deficiency reserve for 2016, bureau officials say.
“In retrospect, [Community Health Options'] 2015 individual insurance rates were also inadequate,” officials say.
Bureau officials say the CO-OP’s financial picture changed quickly. In August 2015, managers were predicting that the CO-OP would lose just $3 million. In October, the company said it had lost $17.2 million in the third quarter but expected to break even for the rest of the year.
One problem was that, even though Maine insurance regulators asked the CO-OP to stop selling new, underpriced policies in October, HealthCare.gov managers were not able to get the CO-OP’s plans out of its enrollment system until Dec. 27, 2015.
“Consequently, individual health insurance membership continued to increase beyond the levels expected in [the CO-OP's] 2016 plan,” officials say.
But the company’s operating results for January were better than expected.
Under the current circumstances, the bureau will continue to monitor the CO-OP closely, and it will post a monthly assessment of the CO-OP on its website.
Representatives from Community Health Options were not immediately available to comment.
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