JOINT RELEASE: Lawmakers Urge Insurance Carriers to Support Former Friday Health Consumers
DENVER, CO – State lawmakers, led by Representatives Andrew Boesenecker and Lindsey Daugherty, today sent a letter to Colorado’s health insurance carriers urging them to honor former Friday Health Plan enrollees’ payments toward their deductibles and out-of-pocket maximums.
The national bankruptcy of Friday Health Plans has meant Coloradans formerly enrolled in Friday plans are now in the position of needing to purchase new health insurance for the rest of this plan year. Kaiser Permanente and Denver Health have reached agreements with the Division of Insurance (DOI) to honor the payments Friday consumers have accumulated toward their deductibles and out-of-pocket maximums.
In the letter, state lawmakers wrote, “These types of nationwide financial failures are unfortunate and rare, but we do have mechanisms in place to protect Colorado consumers and providers. As we look closely at what transpired with Friday Health Plans, it’s clear that the health insurance industry has a role to play to secure the stability of the market, which is essential for carriers, providers, consumers, and businesses in our state.
“Our hope is to see additional carriers come to agreements with DOI in the wake of Friday’s failure and for DOI to use every tool at its disposal to encourage the industry to honor consumers’ payments toward cost sharing obligations. If additional tools or incentives are necessary, we stand ready to help encourage a more robust market response to future failures of insurance plans in Colorado.”
The full text of the letter is below:
To the Colorado Association of Health Plans, Rocky Mountain Health Plans and Kaiser Permanente Colorado:
We write to you regarding the national failure of Friday Health Plans and the steps Colorado is taking to protect consumers and ensure continued health insurance coverage for former Friday enrollees.
As you know, the national failure of Friday Health Plans has left many Coloradans in the position of needing to purchase new health insurance for the rest of this plan year. We commend the state for the actions taken to liquidate Friday in a careful and orderly way and continue coverage for impacted consumers.
These proactive steps have included direct intervention from the Division of Insurance (DOI) to ensure provider claims are paid and legislation we passed to include Friday Health Plans in the Colorado Guaranty Association– the state’s backstop for health plans facing insolvency. In addition, we are encouraged that DOI has reached partnerships with Kaiser Permanente and Denver Health for these carriers to honor the deductibles, copays, out of pocket maximums and other cost sharing obligations incurred or accumulated by Friday Health Plan consumers while receiving additional funding through the state’s reinsurance program in return.
The agreements with Kaiser and Denver Health will mean that Friday Health Plan consumers can obtain coverage from these carriers and these carriers will honor the payments consumers have made toward their deductibles and out-of-pocket maximums. In other words, their contributions toward copays, coinsurance and their deductible will be recognized by their new plans and be credited toward this plan year. This is meaningful, as 83-85 percent of Friday enrollees have access to Kaiser or Denver Health plans.
We appreciate the pro-consumer engagement from these carriers. Our expectation is that additional carriers rise to the occasion to support Colorado consumers.
Friday enrollees switching to plans with carriers other than Kaiser Permanente and Denver Health will not, as of now, see their deductible or out-of-pocket maximums honored by their new carrier, and we encourage consumers purchasing plans from these companies to file claims directly with Friday’s estate to recoup what they have paid toward their cost sharing obligations. A document with frequently asked questions and answers for former Friday enrollees can be found here: https://drive.google.com/file/d/1cb2cK0Lm4Fy-VU_4j2BxF0UY2LNTEhS5/view
These types of nationwide financial failures are unfortunate and rare, but we do have mechanisms in place to protect Colorado consumers and providers. As we look closely at what transpired with Friday Health Plans, it’s clear that the health insurance industry has a role to play to secure the stability of the market, which is essential for carriers, providers, consumers, and businesses in our state.
Our hope is to see additional carriers come to agreements with DOI in the wake of Friday’s failure and for DOI to use every tool at its disposal to encourage the industry to honor consumers’ payments toward cost sharing obligations. If additional tools or incentives are necessary, we stand ready to help encourage a more robust market response to future failures of insurance plans in Colorado.
Sincerely,
Speaker Julie McCluskie
Representative Andrew Boesenecker
Representative Lindsey Daugherty, Chair, Health and Insurance Committee
Representative Matthew Soper, Ranking Member, Health and Insurance Committee
Senate Majority Leader Dominick Moreno
Speaker Pro Tempore Chris deGruy Kennedy
Representative Judy Amabile
Senator Janet Buckner
Senator Lisa Cutter
Representative Elisabeth Epps
Senator Tony Exum, Sr.
Representative Lorena Garcia
Representative Cathy Kipp
Senator Chris Kolker
Representative Sheila Lieder
Representative Meghan Lukens
Representative Javier Mabrey
Representative Karen McCormick
Senator Kyle Mullica
Representative David Ortiz
Senator Dylan Roberts
Representative Emily Sirota
Representative Tammy Story
Senator Tom Sullivan
Representative Brianna Titone
Representative Stephanie Vigil
Representative Mike Weissman
Senator Faith Winter
Representative Steven Woodrow