Maine Insurance Superintendent Approves Maine Community Health Options' Withdrawal from New Hampshire Market in 2017--Company will focus on primary market in Maine, while rebuilding reserves

September 1, 2016

 

Contact: Doug Dunbar
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Augusta -

Maine Insurance Superintendent Eric Cioppa announced today that he has approved a plan by Maine Community Health Options (Health Options) to withdraw from the New Hampshire market in 2017. Health Options, which is domiciled in Maine, has been closely monitored by the Bureau since the final quarter of 2015 when it began to report significant losses. Year to date in 2016, Health Options has been operating very close to its projections and plan.

“Withdrawal from New Hampshire will allow Health Options to focus on its primary market in Maine, and on rebuilding its reserves,” stated Cioppa. “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.” Cioppa added that the Bureau will continue to monitor and guide the company, to ensure that Maine consumers and the company’s creditors are protected.

As of July 31st of this year, Health Options’ New Hampshire membership numbered 11,438 individuals (including group members), compared to Maine’s 65,188. The company is Maine’s only Consumer Operated and Oriented Plan (CO-OP), created under the federal Affordable Care Act (ACA), and it covers approximately 72% of the individual market in Maine.

The New Hampshire Insurance Department (NHID) and the Centers for Medicare & Medicaid Services (CMS), which oversees the ACA Marketplace, also support the withdrawal. NHID Commissioner Roger Sevigny said the state is open to the possibility of Health Options returning to the market in 2018.

New Hampshire residents who are Health Options members will need to select a new plan in the upcoming Open Enrollment, starting November 1st. Consumers should enroll in a new plan as soon as possible during Open Enrollment, to prevent a gap in coverage and facilitate a smooth transition. New Hampshire members will receive a letter from Health Options providing more details.

Both Cioppa and Sevigny urge consumers to actively consider their options during Open Enrollment by comparing cost-sharing (deductibles, co-insurance, and copays) and networks (doctors, hospitals, and other providers covered by a plan).

Those with Health Options group plans in New Hampshire will be covered until their next renewal date. No new group plans will be sold for 2017 and no renewals will take place after October of this year. Group administrators will also receive letters from Health Options, with more details.

The Bureau of Insurance has staff available weekdays from 8 a.m. to 5 p.m. to answer consumer questions about all lines of insurance regulated by the Bureau. Individuals may call 207-624-8475 or 800-300-5000 (toll free in Maine) or TDD Relay 711, or email insurance.pfr@maine.gov. The Bureau also has numerous consumer guides and brochures that are available for viewing online at www.maine.gov/insurance.

Last Updated: September 1, 2016 2:38 PM