New Hampshire, Maine Monitoring Struggling Health Insurance Co-Op

March 22, 2016

New Hampshire insurance regulators are working with their counterparts in Maine to monitor a financially struggling health insurance cooperative that serves both states.

Community Health Options, based in Lewiston, Maine, was the only cooperative in the country to make money on the Affordable Care Act’s public insurance exchanges in 2014, but it saw big losses last year and stopped taking new customers in December. Last week, the Maine Bureau of Insurance announced it will be monitoring and posting financial updates about the cooperative every month.

In New Hampshire, where the co-op is one of five companies offering individual ACA plans, Insurance Commissioner Roger Sevigny says his priority is making sure New Hampshire residents are treated fairly.

With 71,500 members, the co-op is the largest provider of individual health insurance in Maine. In New Hampshire, it has 12,700 customers.

After experience higher-than-expected enrollment and claims costs, Community Health Options posted a $31 million loss in 2015, and is now setting aside $43 million to cover possible big losses this year. Officials have said premiums are likely to go up, and the cooperative plans to submit its proposal to state insurance regulators in May.

If Maine regulators determine that the company would not be able to meets its obligations on an ongoing basis, consumers would be entitled to a special enrollment period during which they could select new coverage.


Topics Maine

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