Moda Health can breathe a sigh of relief after the Oregon Insurance Division lifted the Feb. 6 consent order, which required the company to sell a variety of assets and take steps to improve its financial position so it could continue serving its members.
“Leading implementation of the ACA in Oregon and Alaska certainly challenged our financial resources in unanticipated ways,” Jonathan Nicholas, spokesman for Moda, told The Lund Report. “Last year we paid the medical bills of so many really sick people that our financial reserves took a huge hit. But we’ve now put all that behind us and are back to doing what we do best . . . taking care of those who count on us for access to the quality healthcare they need and deserve.”
Evidence of the high medical bills paid by Moda is readily apparent by looking at its health services ratio – the percentage of premium dollars that went toward healthcare services. In 2015, that ratio was 151.18 percent, however it went down significantly at the end of March to 101.52 percent, based on first quarter filings by the Insurance Division.
Moda has completed several transactions to generate the capital needed to meet regulatory standards and to meet its obligations to policyholders now and into the future. In addition to raising capital, the company has reduced its risk by withdrawing from the Alaska market and several Oregon counties, Lisa Morlawski, public information and communications director for the Department of Consumer and Business Services, told The Lund Report.
Although the order is lifted, she said, the company remains under increased financial solvency monitoring, and Oregon maintains the ability to take further action if needed.
In 2017, Moda will continue to offer individual and small group plans across the state, with the exception of 10 counties: Benton, Lane, Linn, Deschutes, Klamath, Lincoln, Tillamook, Crook, Jefferson, and Douglas.
Diane can be reached at [email protected].
