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Life Health > Health Insurance

Maine CO-OP to pull out of New Hampshire

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A struggling Lewiston, Maine-based Consumer Operated and Oriented Plan carrier may be able to write individual major medical coverage in Maine in 2017.

State insurance regulators in Maine and New Hampshire say the nonprofit, member-owned carrier, Community Health Options, will pull out of the New Hampshire market in 2017.

But Eric Cioppa, the Maine insurance superintendent, did not talk about any suspension of business in Maine in 2017 in his version of the New Hampshire market withdrawal announcement, which was released Thursday, and he appears to be open to the idea that the company offer 2017 coverage in Maine.

Drafters of the Affordable Care Act in an effort to increase the level of competition in the private health insurance market. Community Health Options reported a profit in 2014, but it later began reporting a high level claims in 2015. Regulators forced it to stop selling 2016 individual and family policies Dec. 26, 2015. But the company is still in business, and the 2016 coverage the company sold before that date took effect as scheduled.

This year, the company has been doing a good job of meeting the performance goals in its operational plan, Maine officials said in the New Hampshire withdrawal announcement.

“Withdrawal from New Hampshire will allow Health Options to focus on its primary market in Maine, and on rebuilding its reserves,” Cioppa said in a statement included in the announcement. “In the past year, the company has worked to reduce expenses, improve operations, and better align premium rates with claims experience. Consolidating their business is expected to further improve the company’s stability.”

If the CO-OP’s finances continue to improve, it could return to the New Hampshire individual health market in 2018, according to Roger Sevigny, New Hampshire’s insurance commissioner.

Related: N.H. PPACA panel members agree that they’re stuck

As of July 31, Community Health Options was covering 65,188 people in Maine, and about 72 percent of the people who have individual health coverage in that state.

The company is covering about 11,438 people in New Hampshire. New Hampshire uses the U.S. Department of Health and Human Services system for ACA exchange enrollment. enrolled about 55,000 people in exchange plan coverage for 2016 during the ordinary open enrollment period, which ended Jan. 31, according to HHS data.

In some other states, CO-OPs have shut down abruptly, in the middle of the year.

Community Health Options will keep its current New Hampshire coverage in force until Dec. 31.

Enrollees can apply for coverage from other issuers through the ordinary enrollment process, officials say.

Open enrollment for 2017 individual major medical coverage starts Nov. 1.

Election Day is Nov. 8.

A New Hampshire exchange plan review document shows that the state’s 2017 menu could include plans from Celtic Insurance, Anthem, Harvard Pilgrim Health Care, and Minuteman Health.


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