I will continue to follow developments on the Affordable Care Act as they affect Utahns in as unbiased a way as I can, as some of the clients I serve are affected by these issues.
Arches Health Plan, the only health care exchange co-op in Utah organized under the Affordable Care Act, has failed.
A co-op is a new type of non-profit health insurer directed by its customers which uses profits for its customers’ benefit. Their stated purpose is to try and provide quality, affordable health insurance to individuals and small businesses. At least seven such co-ops, operating in 23 different states, have already failed or are on a trajectory to shut their doors.
According to ksl.com, the co-op did not receive the federal funding it was anticipating under the “risk corridor” program that was built into the Affordable Care Act for loss mitigation.
https://www.ksl.com/?sid=37126534&nid=148&title=arches-health-plan-to-stop-operations&s_cid=queue-1
(visited October 29, 2015).
The non-profit began offering health plans in fall of 2013, beginning covering in January, 2014. The failure will affect 45,000 Utahns, who will now need to seek new coverage.
Spokespersons for the co-op says that it will honor its financial commitments through the end of the year.
Open enrollment on healthcare.gov begins on November 1st.
Customers are advised to continuing paying their premiums through the end of the year in order to maintain coverage.
A person affiliated with the co-op said it came as a surprise this month that the federal funding did not come through as expected. It may simply have been a result of too much risk in the market.
Rural Utahns will be most affected by this turn of events, as in 20 of Utah’s 29 counties there is only one other healthcare provider available as an option through open enrollment on healthcare.gov.
Let us hope for a soft landing for the people affected by this unfortunate situation.
This material should not be construed as legal advice for any particular fact situation, but is intended for general informational purposes only. For advice specific to any individual situation, an experienced attorney should be contacted.