Important Notice: Small Group Plans Will Terminate Effective December 31, 2015
- Small Group Members: we will not renew Small Group plans for 2016
- We are providing information on how this affects you and what actions employers need to take.
- EMPLOYERS: if you are a small group employer (not an employee) and have questions, please call Member Services at 866-915-6619. To shop for a new small group plan, please contact your broker or visit Connect for Health Colorado.
NOTICE FROM THE Colorado Division of Insurance
On November 10, 2015, Marguerite Salazar Commissioner of Insurance for the Colorado Division of Insurance was appointed by the Denver County District Court as the Rehabilitator of Colorado HealthOP pursuant to § 10-3-512(1), of the Colorado Revised Statutes.
What does this mean?
This gives her the responsibility to take appropriate action to deal with the property and business of an insurer whenever a company is deemed to be statutorily impaired. For Colorado HealthOP (CO-OP), this meant that the CO-OP’s reserves did not meet the minimum requirements of Colorado law. We understand this will have an immediate impact on you and that you will have questions, many of which we hope to answer below.
Why is this happening?
There are other important considerations, besides concerns with Colorado HealthOP’s financial condition. Other reasons for this action follow.
- As your small group plan’s benefits are based on a calendar year, it makes sense to start your 2016 deductible and out-of-pocket accumulators as of January 1, 2016, rather than have to restart or attempt to manage the transfer of any credit you have accumulated at some point into 2016.
- Colorado HealthOP’s provider contracts (contracts with physicians, hospitals and other healthcare providers) may begin terminating after December 31st, which means you may experience difficulties in finding a provider that will accept your Colorado HealthOP insurance.
- And, once the Colorado Life & Health Protection Association assumes the liability for claim payments, the maximum amount available for an individual’s claims is limited to $500,000.
Is your Small Group coverage still in effect for 2015?
- Your coverage will not stop before December 31, 2015, as long as your employer continues to make the premium payments through December.
- However, your plan will stop before that date if your health coverage plan expires or is terminated by your employer prior to December 31st.
Will my claims still be paid?
- Please be assured that your claims for healthcare services received through December 31, 2015 will be paid by either the Colorado HealthOP or the Colorado Life & Health Protection Association up to its available limits.
- Whether you need to see your doctor, get medications refilled, schedule a medical procedure, or have lab work/medical imaging done, please rest assured that your coverage with the Colorado HealthOP will remain in effect through December 31st.
Will your employer need to shop for a new health insurance plan for 2016?
- Yes, your employer will need to begin shopping immediately for a new small group plan to ensure that the new plan will be effective on January 1, 2016, for employees.
- Employers (not employees) can get help finding a new plan can by contacting Connect for Health Colorado, or the insurance broker you use.
Thank you for believing in the CO-OP model and for taking part in our mission to make healthcare more accessible, affordable, and equitable for all Coloradans. It has truly been a pleasure to serve you.