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Oregon health insurer to shutter, advises 15,000 customers to find other plans

If you are currently one of the 15,000 people affected by this news and need assistance finding replacement coverage, please contact our office. We have many plan options available and can help walk you through the complicated enrollment process.

 

Health Republic Insurance, one of two federally created Consumer Operated and Oriented Plans in Oregon, won’t offer plans in 2016 and is winding down operations, it announced today.

The decision comes after the federal government announced if would pay only 12.6 percent of what is owed to insurers under the “risk corridor” program. The decision has a negative financial impact of more than $20 million on Health Republic, CEO Dawn Bonder said, in a statement.

All current Health Republic individual and small group policies “remain in full effect through the end of 2015,” the company announced. The Lake Oswego-based health insurer has nearly 15,000 members, including employees from more than 800 small businesses.

“Since our inception in 2013, Health Republic designed and priced all our plans in reliance upon the risk sharing guarantees of the Affordable Care Act,” Bonder said, in a statement. “This has placed us in a difficult financial position that could jeopardize our members and partners. As a result, we believe the most ethical step is for Health Republic to refrain from entering the market in 2016 and begin an orderly wind down of business.”

Health Republic said it will work with the Oregon Insurance Division to “ensure a smooth transition” and will pay all claims through 2015.

The risk corridor program, which came up far short of the money insurers are owed, also hit Moda Health particularly hard.

One-third of the CO-OPs created under the ACA have failed, including those in Iowa, Nebraska, Kentucky, West Virginia, Louisiana, Nevada, Tennessee, Vermont, New York and Colorado.

There were 23 CO-OPs created in 2011 at a cost of $2.4 billion in order to ensure that consumers had plenty of choices and a direct voice in their insurance plans. Oregon was the only state with two CO-OPs, Health Republic and Oregon’s Health CO-OP.

Even with other CO-OPs around the U.S. starting to fail over the summer, Bonder wasn’t too worried.

“My pro formas had us always using money first two and a half years,” Bonder said in late August. “I scratch my head to figure out why it’s such a shock to folks that CO-OPs aren’t making money.”

And in late September, she said the company was “growing steadily and sustainably.”

http://www.bizjournals.com/portland/blog/health-care-inc/2015/10/oregon-health-insurer-to-shutter-advises-15-000.html?ana=e_ptl_bn_breakingnews&u=q82Wjl1mQIrEiCUMXgmyDw07b212ad&t=1445018101