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Regulators: Maine CO-OP lost $74 million in 2015

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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.

See also: CMS hopes for cash from failed CO-OPs’ vendors

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. 

See also: Maine CO-OP to stop selling individual policies for 2016

One problem was that, even though Maine insurance regulators asked the CO-OP to stop selling new, underpriced policies in October, 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.

See also:

Watchdog: CMS is giving 4 CO-OPs’ finances extra attention

Low-cost CO-OPs win share


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