Receivership Order Issued Against Meritus Health Insurers

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Phoenix – The Maricopa County Superior Court today issued an Order for Appointment of Receiver and Injunction against two Arizona health insurance companies, Compass Cooperative Health Plan, Inc., a health care services organization doing business as Meritus Health Partners, and Compass Cooperative Mutual Health Network, Inc., a disability insurer doing business as Meritus Mutual Health Partners.  Arizona Department of Insurance (ADOI), Interim Director, Leslie Hess, filed suit against the health insurers on August 1, 2016, requesting that the Court find both companies insolvent and issue an order appointing the Director of ADOI as the receiver for both companies. 

Both companies were placed under supervision by the Director of ADOI on October 30, 2015.  As a result, the companies were ordered to stop writing new and renewal business as of December 31, 2015.  With the issuance of the Director’s supervision order, Meritus enrollees were eligible to participate in open enrollment to obtain other health insurance for plan year 2016.

Under the Department’s Supervision, both companies have been winding down their operations and paying provider claims (hospitals, doctors, etc.).  However, the companies ran out of money and were unable to continue to pay provider claims without liquidating assets.  The Director sought an Order of Receivership to be able to liquidate the companies’ assets in order to pay provider and creditor claims in accordance with Arizona law. 

“Requesting the Court issue an order placing any company into receivership is not an easy step for me to take,” said Interim Director Leslie Hess.  Our agency’s number one priority is to protect the citizens of Arizona and I believe this order is necessary to do just that.” 

Meritus was incorporated December 7, 2012, as a nonprofit corporation and was one of the original 23 consumer operated and oriented plans (CO-OPs) that were formed around the country to offer health insurance.  The two Meritus companies provided health insurance coverage for approximately 59,000 Arizona residents in Maricopa, Pima and Pinal counties.

Copies of the Complaint and the Receivership Order are available on the Department’s website under the Meritus link.

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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 this state.

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)).

 

CV2016-011872: Meritus Insurers; COMPLAINT

Verified Complaint for Appointment of Receiver and Injunction

CV2016-011872: Meritus Insurers; RECEIVERSHIP ORDER

Order for Appointment of Receiver and Injunction

Meritus Health Insurers in Receivership, Common Questions and Answers

Answers to frequently asked questions concerning Meritus Health Partners, In Receivership, and Meritus Mutual Health Partners, In Receivership.

GO-PRO Video Leads to Conviction of Insurance Fraud Suspect

Phoenix, AZ – Robert Atlas falsely reported to GEICO that he had crashed his 2012 Corvette Stingray while exiting the I-10 freeway, on the exit ramp at Wild horse pass in Chandler Arizona. Robert was paid $61,465.11 by GEICO for the loss of his Corvette. It was later discovered that on 10/10/2015, Robert Atlas had actually raced his Corvette Stingray in a drag race at a drag racing event at Wild Horse Pass Motorsports Park. He subsequently lost control of his corvette during the race and crashed into the concrete barrier totaling his Corvette Stingray. This crash was captured on a Go-Pro video and published on YouTube. The policy does not cover damage caused to the vehicle if it was involved in drag racing. Robert was later shown the video footage and he admitted to making the false claim to GEICO Insurance.


On 1-25-17, Robert Atlas pled guilty to Insurance Fraud as a Class 6 Undesignated offense and as required by the Plea Agreement he paid the entire amount of restitution back to GEICO Insurance prior to sentencing. He was sentenced to two years supervised probation and was assessed $1,560.00 in court costs.


The case was investigated by the Arizona Department of Insurance Fraud Unit and prosecuted by the Arizona Attorney General’s Office.


YouTube video below.


https://www.youtube.com/watch?v=j-xdgp3x4g0