Press Release: Meritus Health Placed Under Supervision

Fri, 10/30/2015 - 15:52

Media Contact:

Andy Tobin, Director of Insurance

(602) 364-3475

 

Meritus Health Placed Under Supervision

 
Two Arizona health insurance companies have been placed under supervision by the Arizona Director of Insurance, Andy Tobin.  Director Tobin filed an Order for Supervision on October 30, 2015, to place Meritus Health Partners and Meritus Mutual Health Partners into supervision.  Meritus declined to consent to the Order for Supervision.  The Meritus companies’ ability to write new policies or renew existing policies is suspended.  The Centers for Medicare and Medicaid Services has removed the Meritus plans from the Marketplace.  Director Tobin, appointed as Supervisor under Arizona law, will oversee the two companies.

Under Supervision, both Meritus companies will honor their individual and group health insurance plans through the end of 2015.  As part of the Order for Supervision, Meritus may not issue new policies or renew existing policies.  Current Meritus policyholders should seek new coverage for 2016 when Open Enrollment begins November 1, 2015.  An affected policyholder may contact the Marketplace to inquire about a Special Enrollment Period, if the policyholder needs more time to select a non-Meritus plan.  Currently, there are expected to be eight companies on the Exchange in Arizona representing roughly 120 individual plans, and three companies offering approximately 15 small group plans.  There are additional plans available off the Marketplace, as well.

“The Governor’s number one priority is protecting Arizona citizens and I intend to do just that,” said Director Tobin.  “We will work to make policyholders’ transition as seamless as possible.  Policyholders will be able to select a new plan from companies available on the Marketplace when Open Enrollment begins November 1, 2015.”  

The Meritus companies were incorporated on December 7, 2012, as nonprofit corporations for the purpose of becoming Consumer Operated and Oriented Health Plans (Co-Ops).  Meritus received start-up and solvency loans from the Centers for Medicare and Medicaid Services under the Affordable Care Act in the aggregate of approximately $93.3 million.  The Meritus companies were two of twenty-three healthcare Co-Ops that were formed around the country. The Meritus entities have yet to make a profit and have lost over $78 million since their inception. 

"It's disappointing that the Meritus CEO and Board of Directors declined to consent to this order," Tobin said. "However, with Open Enrollment beginning this weekend and many Meritus policyholders subject to automatic re-enrollment, it was vital that the Department step-in and protect Arizona citizens."

Meritus has both Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) products that provide coverage for approximately 59,000 Arizona residents, mostly in Maricopa, Pima and Pinal Counties. 

Affected consumers are urged to contact, the “Marketplace” at 1-800-318-2596, work with their agents/brokers, or request help from a local assister https://localhelp.healthcare.gov.  If you have questions about insurance claims, continuation of coverage, health care appeals, or other issues specific to your insurance coverage, contact the Arizona Department of Insurance Consumer Affairs Division at 602-364-2499 (metro Phoenix) or 800-325-2548 (outside Phoenix).

 
About the Arizona Department of Insurance

The Arizona Department of Insurance, an agency of the State of Arizona, is responsible for the education and protection of insurance consumers and for oversight of the insurance industry in the state.

PDF icon Press Release Meritus Health Plans Placed Under Supervision 10302015.pdf
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Until a final version is published in the Arizona Administrative Code, the Department is making a clean copy of the rule changes available on its website at: https://insurance.az.gov/insurers/licensingregistration/reinsurer.

Please contact Mary Kosinski at [email protected] or (602) 364-3471 if you have questions.
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Mr. Tobin was appointed in October as director of the Arizona Department of Insurance, a role he will continue to serve while filling his new post.

Previously, Mr. Tobin served for several years in the Arizona State House of Representatives, including as Speaker of the House. He also brings extensive private sector experience in the areas of banking, insurance and aerospace.

“I want to thank Superintendent Kingry for his service and dedication to the state,” said Governor Ducey. “Andy Tobin is a proven and effective leader who has helped make Arizona government more efficient and accountable to taxpayers. I know he’ll bring that same approach to the Department of Financial Institutions, and I thank him for his willingness to take on this new role in service to the state and citizens of Arizona.”

Mr. Tobin joined Governor Ducey’s administration in January, initially as director of the Arizona Department of Weights and Measures. In that role, he was instrumental in consolidating the agency into other areas of government, cutting down on bureaucracy and waste and increasing the efficiency and quality of service to Arizona taxpayers.