Connecticut Places ‘Unsteady’ Health Insurance Startup Under Supervision

Connecticut’s insurance commissioner announced Tuesday that nonprofit health insurer HealthyCT must be placed under state supervision to protect the company’s 40,000 policyholders.

Commissioner Katharine Wade said HealthyCT’s financial condition has become “unstable,” “seriously jeopardized” by a recent $13.4 million payment the company was required to make to the federal government under a program intended to spread risk for insurers participating in Affordable Care Act exchanges, such as Access Health CT.

“This is not an action that we take lightly but did so in order to immediately protect the company’s 40,000 policyholders in Connecticut and make certain that their claims will be paid under the terms of their policies and for the duration of their policies,” Wade said.

The Wallingford-based Consumer Oriented and Operated Plan, or CO-OP, was ordered to stop writing new policies. Access Health CT announced Tuesday it would no longer sell coverage offered by HealthyCT on the exchange. It currently has 11,299 customers with HealthyCT health plans.

HealthyCT CEO Ken Lalime said individuals with HealthyCT plans will be covered through Dec. 31. They will need to choose a new insurance carrier during open enrollment this fall, for coverage beginning Jan. 1, 2017. For businesses with a HealthyCT plan that has an effective date on or before July 1, they will be covered through their plan year. Lalime said they must choose a new carrier on renewal in 2017.

“HealthyCT is committed to its customers and partners; and we will continue to support them, pay claims and meet other financial obligations during the period of supervision,” he said.

HealthyCT, which has a patient-centric model of care, was formed in 2011 to participate in the Affordable Care Act. But it has struggled like some other CO-OPs and small nonprofit insurers to attract enrollees, languishing behind major insurers. It decided in 2014 to also sell insurance outside the state’s marketplace to larger employers to help expand its enrollment.

Related:

• Affordable Care Act Startups in Poor Financial Health
• Sudden Collapse of Health Co-Op in N.Y. Leaves Doctors Owed Millions
• Iowa Insurance Commissioner Sues Feds Over Failed Health Co-Op