The Colorado Division of Insurance announced Monday that health insurance coverage from Friday Health Plans of Colorado will terminate Aug. 31. The division requested the Denver District Court to transition the insurance company into liquidation.
The action affects more than 30,000 Coloradans and according to Vincent Plymell, communications director for the Colorado Division of Insurance, nearly 100 Montezuma County residents.
A special enrollment period exists for customers to obtain coverage for the remainder of the year.
Customers who obtained Friday Health Plans through the Affordable Care Act’s Health Insurance Marketplace’s open enrollment at the end of every year, meaning they paid for it out of pocket and not through a job or Medicaid.
Plymell said it’s imperative to register through the SEP by Aug. 31 to prevent an insurance coverage gap, even though the deadline is Oct. 31. For those who apply after Aug. 31, their insurance coverage will start at the beginning of the following month.
A gap in insurance coverage can be detrimental to a person’s health, whether it’s a lapse of chronic care or an accident.
Friday members can enroll in a plan through Connect for Health Colorado or through Colorado Connect, including OmniSalud – a plan that insures undocumented Coloradans. If members enrolled directly through Friday Health Plans, a broker or enrollment center can help pick a new plan for the customer.
“I am confident that Connect for Health Colorado has the enrollment support network and resources in place to help Friday Health Plan customers find a new plan and enroll for the remainder of the year,” Kevin Patterson, CEO of Connect for Health Colorado said July 17t.
Because of financial concerns during summer 2022, the DOI ordered Friday Health Plans to be under supervision, meaning that the insurance company had to provide more financial information more often.
In 2023, Friday Health Plans Inc. replaced its CFO and CEO.
“From our perspective, they were trying to right the ship based on some bad decisions,” Plymell said.
Although it seemed to DOI that Friday Health Plans’ premiums were sufficient and the financial projections looked satisfactory for the remainder of the year, other states – Georgia, Texas, North Carolina and Oklahoma – began having issues with the company.
In May, more concerns occurred, and the DOI told the insurance company to stop new enrollment and continue only with the people who already were enrolled.
Problems continued with the other states, and on June 21, Colorado's DOI put the company into rehabilitation, essentially taking over the company’s decision-making, finances and assets.
As soon as they took over they found that things were worse than they thought. They found they had unpaid federal taxes and owed close to $2 million to Connect for Health Colorado, the health insurance marketplace. Because of this, the federal government decided to hold back any tax credit payments they normally would issue to the company.
The DOI also began hearing complaints from Friday Health Plans members, and was informed that some medical centers and doctors refused to see patients who were the insurance company’s customers, even though contracts were still enforced. Ultimately impacting people’s care and their ability to get care.
To add to the table, during the most recent legislative session, Gov. Jared Polis and the DOI worked to add Friday Health Plans to the Colorado Life and Health Guarantee Association. This allows for health care providers to still get paid if something were to happen with the insurance company.
Last, Colorado Insurance Commissioner Michael Conway decided the division had to immediately act on this is to prevent any disruption during the Marketplace’s open-enrollment period later this year for 2024’s insurance coverage.
“Diving deeper into Friday’s finances after putting the company into rehabilitation, the Division became concerned about its ability to make it through the rest of the year,” Commissioner Conway said in a news release. “As a result, I am taking this step to protect Coloradans and the people enrolled in Friday, and to protect the open enrollment process for 2024.”
Plymell said it’s the best decision for a bad situation, even if extra work has to be done for all parties involved.
Not all insurance companies will take on Friday Health Plans’ customers deductibles, meaning some people will have to start over again and pay for health care appointments until the deductible is reached. As of now, Kaiser agreed to honor people’s deductibles and out-of-pocket maximum accumulations.
Denver Health is working on a decision about this matter.
The insurance companies that refuse to honor Friday members’ deductibles include Anthem, Cigna and Rocky Mountain Health Plans.
Again, in order to avoid any health insurance gaps, Friday Health Plans’ members need to enroll in another health insurance plan by Aug 31.
