The Louisiana Department of Insurance announced today that the Louisiana Health Cooperative, Inc. (CO-OP), a health insurer formed under the provisions of the Affordable Care Act (ACA) as a non-profit health insurance company, will be winding down its operations at the end of 2015. The CO-OP will not offer coverage in 2016 but will continue to honor all in-force policies for the approximately 17,000 individuals that currently receive health insurance coverage from the CO-OP. Most of the CO-OP members enrolled in coverage through the health insurance exchange operated by the federal government under the ACA.
“We are more than just actively monitoring this situation,” Insurance Commissioner Jim Donelon said. “The Department of Insurance is on-site at the CO-OP and we have been in constant communication with the company. We will continue to closely review the financial status of the company in order to work to ensure that the CO-OP has the financial ability to pay all claims. We do not want anyone, whether a policyholder or a doctor or hospital or pharmacist that has claims, to be left unpaid.”
The CO-OP has informed the Louisiana Department of Insurance (LDI) it plans to contact impacted customers via mail. The LDI’s Office of Financial Solvency is examining issues that led to the current situation but the primary concern is to ensure that policyholders are treated fairly and informed of their options for coverage in 2016.
“The Department of Insurance has a seasoned team of professional regulators that will monitor and regulate the orderly wind down of the company, and I’m confident that our health insurance market can absorb the CO-OP’s book of business,” Donelon added. “It is a difficult time for health insurers of every size. The onerous burdens of Obamacare have shocked health insurance markets and caused instability in pricing and predictability, and as a result, we’ve seen premiums spike upward. Start-ups in insurance, especially health insurance, are always a tough row to hoe. Obamacare has made that even more difficult.”
The Department of Insurance offers the following guidance for CO-OP policyholders:
If I have a policy with the Louisiana Health Cooperative, Inc. do I need to get a new policy right now?
All policies that are in force with the CO-OP will be honored. No one’s health insurance policy will be canceled by the CO-OP. All individual market (non-employer sponsored) insurance policies end on December 31, 2015. If you have a CO-OP policy, you will need to enroll in new coverage that will be effective on January 1, 2016. The Open Enrollment period for health insurance coverage for the 2016 calendar year runs November 1, 2015 through January 31, 2016.
If you want a new health insurance policy effective on January 1, 2016, you will need to pick a new health plan from a different insurance company by December 15, 2015.
Where can I get help finding a new health insurance policy?
“It is very important that people not have a lapse in coverage. Consumers should contact their health insurance agents to secure a new policy for 2016. If you don’t have an insurance agent, you can go to the website of the Department of Insurance, www.ldi.la.gov and find a list of agents that can sell a policy through the Exchange,” Donelon said. Consumers can also call the Health Insurance Marketplace at 1-800-318-2596 or go to www.healthcare.gov to view or purchase health coverage on their own.
Any policyholder that received a tax credit through the Exchange should be aware that tax credits can only be maintained if new coverage is received through the Exchange.
Is it possible that my current monthly premium with the CO-OP will now increase?
There will not be any surprise or previously unannounced rate increases because the CO-OP has decided to wind down its operations.
Can my doctor refuse to see me because I have a CO-OP health insurance policy?
Providers (your doctors, hospitals, pharmacies, etc.) are required by their contracts to continue treating you. If a doctor in your network refuses to honor their network agreements, please inform the CO-OP as soon as you can or call the Louisiana Department of Insurance Office of Consumer Services at 1-800-259-5300 or 225-342-5900.
Where can I contact the Louisiana Health Cooperative, Inc.?
Members can contact the CO-OP at 1-855-475-3702, Monday through Friday from 8 a.m. to 6 p.m. or via email at firstname.lastname@example.org. Policyholders with questions can also contact us at the numbers shown above.
About the Louisiana Department of Insurance: The Louisiana Department of Insurance works to improve competition in the state’s insurance market while assisting individuals and businesses with the information and resources they need to be informed consumers of insurance. As a regulator, the LDI enforces the laws that provide a fair and stable marketplace and makes certain that insurers comply with the laws in place to protect policyholders. You can contact the LDI by calling 1-800-259-5300 or visiting www.ldi.la.gov.