Oregon's Health Co-Op Individual Members Can Apply Their Out-Of-Pocket Costs To New Plans
Policyholders must choose new plan by July 31
(Salem) -- Starting today, Oregon's Health CO-OP members in the individual market can purchase a plan from a new carrier and get credit for any money they have paid toward their deductibles and out-of-pocket maximums.
The Oregon Department of Consumer and Business Services, Division of Financial Regulation placed the financially struggling CO-OP in receivership last week. All CO-OP plans will end Sunday, July 31, and the state will wind down CO-OP operations and liquidate the company. Oregon's Health CO-OP is a nonprofit consumer operated and oriented health insurer (CO-OP) formed under the Affordable Care Act.
"It is unusual for plans to be canceled in the middle of the year, so we have been working hard and thinking creatively about how to better this situation for consumers," said Patrick Allen, DCBS director. "Although CO-OP members will have to switch plans, they will not lose the money they already have paid into their plan for deductibles and other out-of-pocket expenses."
Individual members can go to HealthCare.gov, call the HealthCare.gov call center, or work with their insurance agent to enroll in a new plan that will be effective Aug. 1. DCBS strongly encourages all CO-OP individual members reach out to their local agent or health insurance marketplace call center. Oregon insurers offering plans in the individual market have agreed to honor money already spent toward deductibles and out-of-pocket maximums, so consumers do not have to start over on their new plans.
"We appreciate the willingness of Oregon's insurance companies to help us protect these policyholders, who have to switch plans through no fault of their own," Allen said.
Members can also buy plans directly from an insurer, but they will not be able to receive tax credits and other financial help unless they purchase a plan through HealthCare.gov. Consumers must pay the premium to their new insurer for the plans to take effect.
For employer groups, they should work with their agent to find a new plan. Group enrollees may have to start over on their deductibles and out-of-pocket costs, depending on the new carrier. New group plans will be effective through Aug. 1, 2017.
"We realize this is a tight timeline for CO-OP members to choose a new plan, so we are prepared to do everything we can to help and ensure there are no gaps in coverage," said Berri Leslie, administrator of the Oregon Health Insurance Marketplace.
The Oregon Health Insurance Marketplace will be calling, emailing, and mailing information to CO-OP members over the next two weeks. Marketplace staff can also connect consumers with insurance agents who can help them choose a new plan. The call center will be staffed from 7 a.m. to 7 p.m. weekdays and 8 a.m. to 5 p.m. on weekends until July 31. Customers can call the Marketplace at 1-855-268-3767 (toll-free) or email [email protected].
More information and questions and answers are available at http://dfr.oregon.gov/public-resources/Pages/co-op.aspx.
Oregon's Health CO-OP has about 22,000 health insurance policyholders in Oregon: 12,000 in the individual market and 10,000 in the small and large group markets.
The Division of Financial Regulation is part of the Department of Consumer and Business Services, Oregon's largest business regulatory and consumer protection agency. Visitwww.dcbs.oregon.gov and www.dfr.oregon.gov.