My co-op insurer’s being shut down. What should I do?

Worried from Flickr via Wylio
© 2007 Pierre Tourigny, Flickr | CC-BY | via Wylio

Summary: So my insurance co-op is closing, leaving me suddenly uninsured or nearly so. What should I do? I get my health insurance through Health Republic Insurance of New York.  I am not a licensed insurance broker, and I do not want to give anybody any advice about what they should do, but I’ll talk a bit here about what I am doing.

 

 


First, I learned along with everybody else that Health Republic was closing down in New York. I figured — according to the announcement — that I had until Dec. 15 to start shopping, so I put that on the back burner.

Friends asked me to help them choose and I said I could not do that: not only do I not have the expertise to choose for you and your loved ones, I don’t have any formal training. Also, I don’t have the time.

Then, suddenly over the weekend, I learned that Health Republic is closing as of Nov. 30, and that it’s even in doubt whether we will be covered through the end of November. We must all choose new insurance plans as of Nov. 15 to insure coverage through December.

That coverage, it seems, we can choose for just a month — and then decide to continue through 2016 by signing up formally by Dec. 15 for calendar 2016. Or we can choose another plan Dec. 15 for 2016.

Confusingly, the New York State of Health says on its front page that we need not worry until Nov. 16 — It wasn’t until I signed in to my account that I found the emergency messages saying “Nov. 15 is the deadline.”

Here’s what I did, in case it’s of help

What I did:

First, to inform myself, I read these stories: The recent big problems; last month’s New York State news; the larger context, from The New York Times, about co-ops’ troubles. Other co-ops have been shut down since this story. There are hundreds of thousands of people who are in our situation.

health plan ending letter screenshot

1. Went to New York State of Health, and, following the instructions here, got a look at what’s available.

2. Became alarmed at the last paragraph of these instructions, about whether we are indeed covered in November. Please, New York State!

3. Did consumer research on the various plans offered in the tier that I am looking for: Oscar can be found here; Emblem is here; Fidelis is here.

Of course these are only Yelp ratings, and therefore anything but scientific. Still, as we know, opinions are valuable.

I also did a Google search for each provider with the “news” filter and “in the last year” filter.

Also of note: the insurance ratings agencies have a hard time rating insurance plans because they change a lot; you will notice on the NYSOH page that some plans are “too new to rate” so … we do what we can with what we have.

4. Checked to see what doctors and other providers we know and use are on the various provider lists for each plan. Some of the plans are shockingly small; some are only moderately small. We had recently done a tour of orthopedic providers in lower Westchester, so I was able to spot where those recommended providers were — and where they weren’t. Same with our existing primary care and gynecological providers.

5. Looked at the hospitals and other facilities (ambulatory surgical, walk-in care) that are in network. Are our providers there?

6. Checked the deductible. Judging from the state’s communications, it’s not clear right now that the December stopgap will honor our deductible, which we have met. But it does seem clear that if we have satisfied a $2,000 deductible, signing up for a $4,000 deductible plan for December might not be wise. Although, I am guessing, state and local and industry authorities will tell you that we are in uncharted territory for such topics.

7. Big networks are good, but is that big network going to be worth it for a month? I am working on a deadline, so I have to stop and think about this for a bit. New York’s Oscar says it has a big network, but people on Yelp complain that the Oscar provider directory — with “Magnacare” as the marquee name — does not actually extend to the full Magnacare directory.

Now, let us know what you know, and what you’ve learned

So, that’s my quick hit. When I last shopped for insurance, I blogged about it and collected resources here. It’s a bit stale, but insurance is not our primary focus. Sorry! But I am also glad to help others in this pickle.

If you’re interested in continuing the conversation, I’ll answer here on our blog, but will be unable to answer consistently on Facebook or Twitter. Here we can share information that will live beyond the Facebook and Twitter streams.

Again: This is a quick take: I know people are looking for information, and I am happy to share what I have — so long as you don’t count me as an expert.

You almost certainly have ways to improve this — insurance companies’ solvency ratings? your personal experiences with the current New York State offerings or others? — so let us know what you know.

Comments are open!