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You are here: Home / Anderson On Health Insurance / Friday having a mid-year Termination event in Georgia

Friday having a mid-year Termination event in Georgia

by | 19 Comments

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The Georgia Office of Commissioner of Insurance and Safety Fire, the state’s insurance regulators, just announced that the ACA insurer, Friday Health Plans, will be shutting down mid-year in Georgia because there are substantial doubts that Friday has the ability to pay all claims if they continue to operate.

Friday Health Plans was placed into administrative supervision on March 8, 2023, by consent order to try to cure its surplus deficiency reported to our office on March 3, 2023. During this period of enhanced supervision our office has closely monitored the Company and determined that continued operation of Friday Health Plans was not possible without putting policyholders at risk, so we are acting to protect them.

Friday Health Plans policyholders that have health insurance coverage through the federally facilitated exchange – Your health insurance coverage will end at the end of the day on July 31, 2023. To ensure Friday Health Plans policyholders have an opportunity to replace their current exchange coverage before it is terminated, effective August 1, 2023, our office coordinated with the federal office known as the Center for Consumer Information and Insurance Oversight to implement a special enrollment period for members to select another exchange health insurance plan.

The special enrollment period starts on June 1, 2023, and ends on September 29, 2023. If you purchased health insurance from Friday Health Plans through the federal exchange you must choose a new exchange health insurance plan by July 31, 2023

So what does this mean?

If you are not insured via the ACA, this means nothing.

If you are insured via the ACA in Georgia but with a different company [DISCLOSURE: I have consulted with Alliant Health Plans, another Georgia ACA company, on a few different topics in 2023], this means very little.  In some counties, the benchmark may be reset if Friday had the cheapest or 2nd cheapest silver plan, which may slightly increase affordability for plans in the 2nd half of the year.

If you are insured via Friday in Georgia, this means something:

  • If you continue to pay your premium to Friday, your coverage ends on July 31.
  • If you want to continue to be insured, you need to pick a new insurance company ASAP
  • There is no indication that deductibles and other cost-sharing will roll over
  • There is no indication of an automated crosswalking process.
  • Manual action will be needed to keep coverage 

Now the only surviving insura-tech from the 1st and 2nd wave of VC money bonfires is OSCAR as BRIGHT is effectively gone and FRIDAY is going… more thoughts on this later this week.

Reader Interactions

19Comments

  5. 5.

    Juju

    I live in NC and I have Fridays health insurance. Will this eventuality happen in NC as well?  I wish I could say asking for a friend, but I can’t.

  6. 6.

    David Anderson

    @VeniceRiley:  I don’t think it is a red state thing except that the VC funded insurers went aggressively after states that had not expanded Medicaid as that is where the market and growth #s were if they underpriced their claims experience.

    @Juju: I would be surprised if Friday is able to honor all contracts through the end of the year.

  7. 7.

    Miss Bianca

    This is too bad – I had Friday Health coverage for two years here in CO, and it was the best coverage I had ever had under the CO Connect For Health program. Then this year they ended the sweet premium deal I had had, which was a clue to me that they might be having trouble at least in the state of CO.

  9. 9.

    pluky

    Not just Georgia, Texas and New Mexico are shut down as well. The company continues to operate in its domicile of Colorado, and a few other states. Can’t find any reason for the insolvency other than a vague statement by the company management that “we grew too fast”?

  11. 11.

    Roger Moore

    @pluky:

    Well “grew to fast” in Texas seems to have been because the growth was bought by seriously underpricing the plans offered.

    It may have been a matter of deliberately underpricing in order to attract customers.  That seems to be a very popular approach with VC these days, so I wouldn’t be at all surprised if it happened with health plans, too.

  12. 12.

    Ken

    @Roger Moore: a very popular approach with VC these days

    Along with “We’re paradigm-breaking! We’re going to show the companies that have been doing this for decades, how they should be doing it!”

    In other words, this XKCD.

  14. 14.

    OverTwistWillie

    Homer: Well, I guess I learned my lesson. The thing is, I lost creative control of the project. And I forgot to ask for any money. Well, live and learn.

  15. 15.

    Burnspbesq

    Folks in a number of other industries have learned all the wrong lessons from Tesla.

  16. 16.

    Ang

    My question would be – is Oscar doing something different than their VC/tech-bro competitors or do they just have a bigger pile of money to burn?

  17. 17.

    Barbara

    @pluky: “We grew too fast” in insurance speak means that they priced aggressively and higher enrollment means the losses are much bigger than anticipated.  If you think you can afford to lose, say, $2 million on an enrolled population of 10,000 and you end up with enrollment of 50,000 and you don’t have an extra $8 million — big problem.

    They can’t just stop paying claims.  They have contracts to cover people for a certain period.  Those losses are locked in.

  18. 18.

    David Anderson

    @Ang: They have more cash — and they stopped trying to buy marketshare (or were forced to stop buying marketshare by state regulators) in the past few years with below claims level pricing but they still have substantial losses and above average admin costs.

Comments are closed.