Evergreen won’t renew individual health benefit policies

Important Announcement about Evergreen Health Cooperative Inc.

​ Baltimore — Evergreen Health Cooperative Inc. (“Evergreen” or “company”) will not be issuing or renewing individual health benefit policies, both on and off Maryland Health Connection (“Exchange”).   “After many months of working closely with Evergreen management, leadership at the Centers for Medicare and Medicaid Services and outside investors to find a workable solution, we have run out of time to meet the deadline for a January 1 effective date. We remain committed to a viable, competitive insurance industry in Maryland,” said Commissioner Al Redmer, Jr.   Evergreen is a start-up health maintenance organization (HMO) organized as a not-for-profit Consumer Operated and Oriented Plan (“CO-OP”) under the Affordable Care Act and was licensed by the Maryland Insurance Administration on March 28, 2013. CO-OPs were sponsored by Centers for Medicare and Medicaid Services (“CMS”) to increase competition among insurance companies.   This means that Evergreen Health plans are not available on Maryland Health Connection for the 2017 plan year (for policies effective January 1, 2017).   What this means for Evergreen individual policyholders:   Evergreen will be unable to offer or bind any new individual policies during Open Enrollment for the 2017 plan year (for policies effective January 1, 2017). Likewise, Evergreen also will be unable to renew any individual policies during Open Enrollment for the 2017 plan year.  Current Evergreen enrollees for 2016 who purchased policies on Maryland Health Connection will be renewed into the most similar plan available in their area effective January 1, 2017, to avoid a gap in coverage. Consumers are encouraged to make a decision and choose an alternative plan by December 15, 2016, to ensure you have notification of coverage before the effective date, January 1, 2017. However, changes can be made through December 31, 2016, for January 1, 2017 coverage. If they wish to choose an alternative plan, they need to contact Maryland Health Connection. Individual policies currently in effect will remain in effect until December 31, 2016. Current Evergreen enrollees for 2016 who did NOT purchase their policy on Maryland Health Connection (for example through Evergreen’s website) will need to obtain insurance for 2017 from an alternative insurer. Consumers are encouraged to make a decision and choose an alternative plan by December 15, 2016, to ensure you have notification of coverage before the effective date, January 1, 2017. However, changes can be made through December 31, 2016, for January 1, 2017 coverage. All changes will need to be made no later than December 31, 2016. If you have recently submitted an application to Evergreen for the 2017 plan year and have already paid for January 2017 coverage, a refund will be issued in the manner the payment was received. Additionally, you will need to purchase coverage for 2017 from an alternative insurer. Consumers are encouraged to make a decision and choose an alternative plan by December 15, 2016 to ensure coverage effective January 1, 2017. All changes need to be made no later than December 31, 2016. What this means for group policyholders:   This does not impact group policies. Group policies currently in effect will remain in effect until the policy renewal date. Group policyholders should continue to pay the premiums on their in-force policies to ensure continued coverage.   Where Consumers Can Get Assistance:  Contact Information for Maryland Health Connection: Go to MarylandHealthConnection.gov/help for information on how to enroll online, search for free, in-person help from a local insurance broker or consumer assistance organization, or enroll by phone. The Maryland Health Connection can be reached at 1-855-642-8572 (TTY: 1-855-642-8573).You can also download a free mobile app (Enroll MHC) to browse available plans and find local enrollment help. Contact Information for Maryland Insurance Administration:   Mary Kwei Maryland Insurance Administration Chief Investigator - Life and Health Complaint Investigations 410-468-2224 Mary.kwei@maryland.gov Contact Information for Evergreen Health: Evergreen policyholders may also obtain information online at https://www.evergreenmd.org or Member Services at 855-978-3282. About the Maryland Insurance Administration The Maryland Insurance Administration is an independent State agency charged with regulating Maryland’s $28.5 billion insurance industry. For more information about the Insurance Administration, please visit www.insurance.maryland.gov or follow us on Facebook at www.facebook.com/MDInsuranceAdmin or Twitter at @MD_Insurance.