Baltimore Sun

Evergreen Health plans listed but not for sale

Insurer awaits approval for conversion to for-profit

- By Sarah Gantz sarah.gantz@baltsun.com twitter.com/sarahgantz

Marylander­s hoping to buy health insurance from Evergreen Health through the state’s online insurance exchange, which opened Tuesday, will have to wait.

In a bid to stay in business, Evergreen announced plans in October to be acquired by a group of investors and convert from a nonprofit to a for-profit insurer. It won’t be allowed to sell health plans through the exchange unless and until the Centers for Medicare and Medicaid Services approves the proposal, Matt Jablow, an Evergreen spokesman, confirmed Tuesday.

Evergreen plans and pricing continue to be listed on the Maryland Health Connec- tion in hopes the review will be concluded soon, said Andrew Ratner, an exchange spokesman.

But users who try to enroll in an Evergreen plan will be blocked and receive a pop-up message that reads:

“Evergreen plans are not available at this time. Maryland Health Connection expects to know soon if Evergreen plans will become available before open enrollment for 2017 ends. It is important to choose a plan by Dec. 15 to ensure Jan. 1 coverage. If you choose a plan now with a different carrier, you may still switch to Evergreen if those plans become available prior to the end of open enrollment on Jan. 31.”

People can buy individual health plans directly from Evergreen, but only plans purchased through the exchange are eligible for income-based subsidies.

Evergreen is one of 23 consumer- oriented-and- operated health plans founded under the federal Affordable Care Act. Led by former Baltimore City Health Commission­er Peter Beilenson, the Baltimore-based insurer is one of a handful of the co-ops still in business, and its bid to convert to a for-profit insurer is an attempt to stay afloat.

Other co-ops closed or are in the process of winding down, unable to attract enough members, draw enough premium revenue and withstand the weight of new and costly regulatory hurdles created under the health reform law.

Evergreen sought a buyer after being crippled by new insurance rules that required it to make a “risk-adjustment payment” that amounted to $24 million in 2015 — more than a quarter of its $85 million revenue that year.

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