Health Republic Insurance of New York (HRINY), a Consumer Operated and Oriented Plan (CO-OP), established under the Patient Protection and Affordable Care Act and governed by state law, is just one of nearly a dozen CO-OPs to discontinue ongoing business in advance of the November 1, 2015 open enrollment period for the January 1, 2016 plan year. On September 25, it was announced that HRINY would not offer coverage for the 2016 plan year.

The New York State Department of Financial Services (NYDFS), the New York State of Health Marketplace (the New York Exchange), and the Center for Medicare and Medicaid Services (CMS) on October 30 announced that it would take additional action regarding HRINY to assure orderly transition for its enrolled membership.

Subsequent review of HRINY’s finances by NYDFS and CMS revealed that the company’s financial condition is substantially worse than previously reported and, therefore, the regulators had determined that it is in the best interest of consumers to terminate all HRINY policies (both individual and small group) on November 30, 2015 to allow policyholders to transition to new coverage thereafter. A special enrollment period effective December 1, 2015 through year-end, December 31, 2015, has been established, and a special customer service help line at 1-855-329-8899 will provide assistance to guide members through the transition process. The DFS Consumer Hotline can be accessed for questions not related to enrollment through the New York Exchange by calling 1-800-342-3736. A link to DFS’ press release can be viewed here.

Also, on October 30, two Arizona domiciled CO-OPs were placed under an order of supervision, which prohibited issuance of new business or renewal of existing policies. The impact of the demise of these CO-OPs, initially envisioned as a consumer-friendly alternative to for-profit insurers and a way to provide more competition, enhanced consumer choice, and better coverage, will be experienced by the consumers and their health care providers as well as by the other health insurers participating on the Federally Facilitated Marketplace and state-hosted exchanges.

Questions should be referred to Cynthia Borrelli.


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