Division of Insurance’s closure decision – What does it mean?
DENVER – Colorado HealthOP has entered state-approved runoff and will not offer insurance coverage in 2016.
The runoff decision came after careful analysis of the company’s future financial condition and lengthy discussions involving the Centers for Medicare & Medicaid Services, and the Colorado Division of Insurance (DOI). Created as a Consumer Operated and Oriented Plan (CO-OP) under the Affordable Care Act, Colorado HealthOP has approximately 80,000 members.
Runoff is when a business winds down its existing business and pays all related policy claims while ceasing to take on new customers.
Colorado HealthOP policyholders will keep their insurance coverage through Dec. 31, 2015 so long as they continue to pay premiums. To continue insurance coverage in 2016, consumers must re-enroll in a new healthcare plan during the next Open Enrollment period beginning Nov. 1. Consumers should enroll by Dec. 15, 2015 for coverage effective Jan. 1, 2016.
Recent guidance about a federal program designed to assist health insurance carriers raised concerns about its future.
Colorado still has several carriers on the Exchange offering insurance coverage for 2016 and allowing Coloradans consumers to select a range of insurance plans, depending on their location.
Frequently Asked Questions (FAQs):
Individual Member Questions
I have doctor appointments scheduled for next week, can I still go? Am I still covered? Yes, so long as you stay current with your premium payments, you will be covered by your health plan through December 31, 2015.
Can I continue to buy insurance through Colorado HealthOP? No. You need to find new coverage to begin January 1, 2016. Open enrollment begins November 1 and runs through January 31, 2016. You must purchase replacement coverage by December 15, 2015 to have insurance on January 1, 2016
Can I change my insurance now? No, members will be able to choose a new health insurer for 2016 during the next open enrollment period, which begins on November 1, 2015 and runs through January 31, 2016. We recommend selecting a new plan during open enrollment before the end of the year as your Colorado HealthOP policy will expire December 31, 2015.
Where else can I enroll for insurance in Colorado? Visit www.connectforhealthco.com for access to insurers participating in the Exchange or call 855-752-6749. There will be several carrier options on the Exchange, depending on your geographic location.
Can I still see my regular doctor and have prescriptions filled at the same pharmacy? Yes. The provider network should remain in place through 2015. Once you shop for new coverage for 2016, check provider directories for the other companies to ensure your doctors and preferred facilities are members of those networks.
Can my doctor refuse to see me because of the situation? No. Contracts between Colorado HealthOP and providers should remain in force during the runoff.
Who should I contact at Colorado’s DOI if I have questions? You can reach the Division of Insurance at 303-894-7499.
Small Group Member Questions
My business just enrolled our small group with Colorado HealthOP, what happens to our coverage? So long as you stay current with your premium payments, you will be covered by your health plan for the term of your plan. More information will come soon.
Will I still get paid for treating Colorado HealthOP patients? Yes, you will be paid for claims incurred through December 31, 2015.
What does the dissolution of Colorado HealthOP mean to providers? Providers will be paid for claims incurred through December 31, 2015.
Colorado HealthOP did their part. We are mad that congress reneged on their obligation and caused the failure of a public-minded regional carrier.