Dental tools on a hundred dollar bill. The concept of health insurance, profitable business.
Colorado state lawmakers are calling on the state’s health insurance carriers to observe payments made to deductibles and out-of-pocket maximums from former enrollees of Friday Health Plans, which is shutting down this month.
As the 30,000 Coloradans affected by Friday Health Plans’ liquidation seek new insurance coverage following the company’s bankruptcy, they could potentially face brand new deductibles — the amount a consumer must spend before insurance benefits kick in — in the middle of the plan year.
If a former Friday Health Plans enrollee already paid their $5,000 deductible this year, for example, there is worry that a new insurer will not carry over that progress on the new plan and force them to start from scratch.
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Kaiser Permanente and Denver Health have already reached agreements with the state’s Department of Insurance to honor payments towards deductibles, copays, out-of-pocket maximums and other cost-sharing obligations incurred by Friday Health Plans consumers. Lawmakers want others to follow suit.
“We appreciate the pro-consumer engagement from these carriers. Our expectation is that additional carriers rise to the occasion to support Colorado consumers,” the lawmakers, led by Democratic Reps. Andrew Boesenecker and Lindsey Daugherty, wrote in a letter sent Thursday to the Colorado Association of Health Plans, Rocky Mountain Health Plans and Kaiser Permanente Colorado.
Rep. Matt Soper, the ranking member on the House Health and Insurance Committee, was the only Republican to sign on to the letter.
Lawmakers wrote that about 85% of Friday Health Plans enrollees have access to a Denver Health or Kaiser Permanente plan. That leaves nearly 5,000 people with the potential burden of meeting a brand new deductible.
“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,” they wrote.
The lawmakers urged people who are switching to plans other than Kaiser Permanente or Denver Health to file claims directly with Friday Health Plans’ estate to recoup lost costs.
The DOI filed with Denver District Court earlier this summer to liquidate the Alamosa-based Friday Health Plans on Aug. 31, following a rapid decline in the company’s finances. Several other states have taken similar actions. Consumers can access answers to frequently asked questions here.
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