Maine co-op cuts off in­di­vid­ual en­roll­ment

Modern Healthcare - - REGIONAL NEWS - —Bob Her­man

Com­mu­nity Health Op­tions, a not­for-profit co-op in­sur­ance com­pany based in Maine that also sells health plans in New Hamp­shire, will limit in­di­vid­ual en­roll­ments this month be­cause of “higher-than-ex­pected claims costs.”

It’s an in­aus­pi­cious sign for the com­pany, one of the few suc­cess­ful co-ops cre­ated by the Af­ford­able Care Act. Twelve of the ACA’s 23 co-ops have folded this year or will be clos­ing down by year end.

Com­mu­nity Health Op­tions is one of three in­sur­ers sell­ing in­di­vid­ual plans in Maine and one of five in­sur­ers in New Hamp­shire. Both states use the fed­eral Health­Care.gov web­site for en­roll­ment. The co-op will stop di­rectly en­rolling peo­ple in in­di­vid­ual cov­er­age on Dec. 15, and those sign­ing up for its plans through the ex­change will have only un­til Dec. 26 to en­roll, the co-op said on its web­site.

The de­ci­sion to halt en­roll­ment early will not af­fect cur­rent mem­bers, and Com­mu­nity Health Op­tions still plans on pur­su­ing small em­ploy­ers into next year. “We aim to re­sume in­di­vid­ual en­roll­ment as soon as pos­si­ble, but in the mean­time con­tinue to fo­cus on group busi­ness,” CEO Kevin Lewis said.

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