Press Release: Meritus Health Placed Under Supervision

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.

Notification of Close of Record

Notification of Close of Record on Holding Company rulemaking

Bureau of Justice Assistance Offers Resource on Damaged Vehicles

Washington - The Office of Justice Programs' (OJP) Bureau of Justice Assitsance (BJA) recommended today that in light of the anticipated high volume of flood-damaged automobiles in the aftermath of hurricanes Harvey and Irma, consumers educate themselves about a vhicle's history before making any purchase decisions.  Overseen by BJA, the National Motor Vehicle Title Information System (NMVTIS) is designed to prevent concealment of flood damage and other vehicle histories. After past hurricane events, authorities reported truckloads of flooded vehicles being taken out of the impact zone where they were dried out, cleaned and readied for sale to unsuspecting consumers in states that do not brand flood vehicles. It is currently estimated that due to Hurricane Harvey and Hurricane Irma, as many as 1 million flood-damaged automobiles could potentially be passed on to unsuspecting buyers in the coming weeks and months.

The floods caused by or associated with these hurricanes have resulted in severe water damage to thousands of vehicles that can make electrical systems and airbag sensors prone to failure. Prior to purchasing a vehicle, NMVTIS allows consumers to find information on the vehicle's title, most  recent odometer reading and brand history. A “brand” is a descriptive label that states assign to a vehicle to identify the vehicle's current or prior condition, such as “junk,” “salvage” or “flood” designation. By capturing into one system specific information from multiple entities such as state motor vehicle departments, insurance carriers, salvage auto auctions, automobile recyclers, and junk and salvage yards, NMVTIS offers states and consumers protection from title fraud and potentially unsafe vehicles.

“BJA remains committed to ensuring the consumer protection benefits provided by NMVTIS,” said Acting BJA Director Tracey Trautman. “We encourage prospective purchasers to consider obtaining a NMVTIS vehicle history report and have the vehicle checked by a trusted mechanic as part of making an informed used car-buying decision.” The list of approved NMVTIS vehicle history report providers can be found on the official NMVTIS website at: https://www.vehiclehistory.gov/nmvtis_vehiclehistory.html

The Office of Justice Programs, headed by Acting Assistant Attorney General Alan R. Hanson, provides federal leadership in developing the nation’s capacity to prevent and control  crime, administer justice and assist victims. OJP has six bureaus and offices: the Bureau of  Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office  of Juvenile Justice and Delinquency Prevention; the Office for Victims of Crime; and the Office of  Sex Offender Sentencing, Monitoring, Apprehending, Registering and Tracking. More information about  OJP and its components can be found at:  www.ojp.gov.

 

 

Director's Message Regarding Health Insurance Premiums for 2018

Open enrollment will be available from November 1, 2017 through December 15, 2017 for health insurance coverage commencing January 1, 2018.  Here are a few things you can expect when purchasing or renewing health insurance this year.

In Arizona, the overall average Marketplace (“on-exchange”) Plan Year 2018 rates have stabilized with only slight changes from last year’s premium rates.  This is significant for our market after sustaining large premium increases in 2017.  This premium rate stabilization gives us hope that more insurers may consider entering our market for Plan Year 2019. Unfortunately, like last year, Arizonan’s health insurance plan choices are limited.  Only two insurance carriers will be issuing tax subsidized major medical policies on the exchange in 2018.  One insurer will be offering health plans in Maricopa and Pima counties, and the other insurer will be offering plans in the other 13 counties.  Additionally, we are down to a total of 4 health insurers offering individual plans off-exchange for 2018. Visit our Health insurance rate page to see a list of plans and premium averages by county. 

Additionally, you can view detailed information, compare plans, and complete the enrollment process at the federal Marketplace website at https://www.healthcare.gov.

As you may have read, the federal government announced that it will stop reimbursing insurers for Cost Share Reductions (CSR) associated with major medical policies issued to Marketplace customers that meet the federal poverty level criteria.  This announcement did not result in any changes to the 2018 Arizona Marketplace plan rates for Open Enrollment.

Families with children should be aware that the federal government made some changes to the “child” premium rate calculations which will result in higher premiums for children.  This will have the greatest impact on families that do not qualify for the premium tax credit.  For an explanation of how rates for children will be changing, please read our Frequently Asked Questions document.

Under Arizona state law, the Department of Insurance is not given the legal authority to approve or disapprove the major medical health insurance rates filed with us.  Instead, the Department’s role is to review the rate filings and confirm that valid, detailed financial and actuarial justification (as required by federal and state law) is provided and any change in the rate is found reasonable by these standards.  In order to perform that review, the Department engages independent actuaries to scrutinize the rate filings in depth to confirm compliance with the laws and regulations.  You can read the insurers’ justification of their rate increases and a narrative describing the data and assumptions that the insurer used to develop its rate (a consumer justification) by visiting www.RateReview.Healthcare.gov.   Visitors can also see a list of all rate change filings (On and Off Marketplace, Individual and Small Group) on the Department’s Health Insurance Rate Information webpage.

Extension of Major Medical Transitional Policies through Calendar Year 2018

Phoenix - The Arizona Department of Insurance (ADOI) announced today that insurers in the individual and small group[1] major medical health insurance markets can choose to renew transitional policies for a policy year beginning on or before October 1, 2018, provided all transitional coverage ends by December 31, 2018.    Transitional policies are non-Affordable-Care-Act-compliant policies that have been continuously in effect since by or before December 31, 2013.  At least 6 health insurers have individual or small group transitional policies still in effect in Arizona.

This extension is the maximum extension permitted under the Insurance Standards Bulletin issued on February 23, 2017 by the Center for Consumer Information and Insurance Oversight (CCIIO), and gives insurers the option to continue the pre-2014 individual and small group policies covering approximately 70,000 Arizonans through the end of 2018.  Insurers that offer this extension of transitional coverage are required to send each policyholder a renewal notice that explains the offer to continue the transitional policy through the end of 2018 and includes information regarding any related price increase.  Insurers must also send a 90-day notice for the final discontinuation of the transitional plans.

The extension does not affect grandfathered policies issued prior to March 23, 2010.  These policies can remain in effect as long as they maintain grandfathered status.

For additional information on the Affordable Care Act, please visit the Arizona Department of Insurance website or call Consumer Assistance at (602) 364-2499. 

 

[1] Small Group refers to a policy issued to an employer who employs at least two but not more than fifty eligible employees

(ARS § 20-2301(A)(21)).

 

Insurance Professional License Number Crosswalk (MS EXCEL)

With the Department of Insurance move off of its old regulatory system to State Based Systems ("SBS"), the license number for each Arizona-licensed insurance professional (insurance producer/agent, surplus lines broker, insurance adjuster, etc.) changed. Attached is a MICROSOFT EXCEL file that contains the name, old (legacy) license number, new license number and National Producer Number for each insurance professional licensed whose license expired/expires on or after 4/30/2016. Use the LICENSE SEARCH menu option at the top of this page to view the license record for a particular licensee or company.

2017-2018 Insurer Annual Assessments

This document contains all 2017-2018 assessments effective July 1, 2017, that will be mailed to insurers on Monday, July 3, 2017.  Please either use the insurer's page from this document or the notice we mail, and EITHER: Remit payment using the NAIC OPTins system (OPTins.org); or, if you are unable to use the OPTins system, send payment with a copy of the insurer's assessment notice.

Assessments are due July 31, 2017.