October 30, 2015
Contact: Matt Anderson, 212-709-1691
NYDFS, NYSOH, CMS ANNOUNCE ADDITIONAL ACTIONS REGARDING HEALTH REPUBLIC INSURANCE OF NEW YORK
The New York State Department of Financial Services (NYDFS), the New York State of Health Marketplace (NYSOH), and the Centers for Medicare and Medicaid Services (CMS) today announced additional actions regarding Health Republic Insurance of New York (“Health Republic”) and a transition plan for Health Republic customers.
On September 25, 2015, NYDFS directed Health Republic to cease writing new health insurance policies and announced that the co-op will commence an orderly wind down after the expiration of its existing policies. However, a subsequent NYDFS and CMS-led review of Health Republic’s finances has found that the company’s financial condition is substantially worse than the company previously reported in its filings to NYDFS. In light of these developments, NYDFS and the NYSOH Marketplace have determined that it is in the best interest of consumers to end all Health Republic policies – both individual and small group – on November 30, 2015 so that customers can transition to new coverage after that date.
Information Regarding Individual Plans
Individual policies run on a calendar-year basis. Individuals who purchased a Health Republic plan on the New York State of Health (NYSOH) Marketplace must take action to choose a new plan for the remainder of 2015 on or before November 15, 2015. For assistance with this process, NYSOH has established a special Customer Service helpline at 1-855-329-8899. Customer Service hours are from 8 am to 8 pm on Monday through Friday and 9 am to 1 pm on Saturday.
Coverage issued with a December 1, 2015 effective date will be effective through December 31, 2015. Consumers can also enroll for 2016 coverage on the NYSOH Marketplace during the Open Enrollment Period which starts on November 1, 2015. To be covered on January 1, 2016, consumers must select a plan by December 15, 2015. A total of 15 health insurers will offer individual coverage for 2016 on New York State of Health. An interactive county map that shows the health plans offered on the Marketplace by county can be found at http://info.nystateofhealth.ny.gov/PlansMap.
Starting in 2016, lower income New Yorkers will be able to enroll in the new Essential Plan at a cost of $20 per person per month or nothing depending on income. The Essential Plan has no annual deductible, preventive care is free and other services have only a small copayment. Individuals can enroll in the Essential Plan only through the NY State of Health Marketplace. For more information on the Essential Plan visit, link. Consumers may also choose to buy a new health insurance policy outside the Marketplace directly from another insurance company or with the help of an agent or broker. However, if a consumer qualifies for financial assistance, they can only obtain that coverage through the Marketplace.
Information Regarding Small Group Plans
Employers with small group plans through Health Republic should act as soon as possible to choose a new policy from another insurer for its employees to ensure continuity of coverage after November 30, 2015. Small group plans typically run on a one-year basis from their effective date rather than on a calendar-year basis. Employers can choose to buy a small group plan either through the NYSOH marketplace or with the help of an agent or broker. If the employer purchases coverage through the Marketplace, they may be eligible for a small business health care tax credit for qualified employers that can cover as much as 50 percent of their contribution toward employee premium costs.
DFS Consumer Hot Line
For questions not related to enrollment through the NYSOH Marketplace Customer Service helpline, consumers can contact the New York State Department of Financial Services Consumer Hot Line with questions regarding Health Republic by calling 1-800-342-3736. The Hot Line hours are weekdays (Monday through Friday) from 8:00 a.m. to 8:00 p.m., and Saturday from 9:00 a.m. to 1:00 p.m.