Friday Health Plan was an ACA insurer. It was funded by venture capital money. It went Boom! Friday’s reserve position placed substantial doubt about its ability to pay claims. That is BAD! It freaks state regulators out. Stressed out state regulators aren’t good for insurers who want to remain going concerns.
State regulators have been winding down operations. Most states where Friday had a presence had a mid-year wind-down. Friday enrollees would lose coverage at the end of a month. They would have an opportunity to enroll in a new plan from a different insurer. This enrollment would restart cost-sharing accumulation. So someone who had maxed out their deductibles would soon be facing new deductibles. This invites massive selection.
A few states thought they could get Friday to limp through to December 31st. The plan would be for Friday enrollees to have full year coverage and then switch on January 1 to a new insurer with new cost-sharing that would have happened anyways. Colorado was one of these states.
The Colorado Division of Insurance (DOI) has filed with the Denver District Court to Liquidate Friday Health Plans of Colorado. This means that Coloradans who currently have health insurance from Friday Health Plans will have that coverage end on August 31, 2023. If you’re a Friday Health Plans customer, you will need to take action to enroll in new
health insurance for the remainder of 2023 and to avoid becoming uninsured….
8. Will my deductible and out-of-pocket maximum amounts carry over to a new
plan for the remainder of 2023?
The Division of Insurance (DOI) has requested that other insurance companies in Colorado honor the deductibles and out-of-pocket maximums that Friday Health customers have already accumulated for 2023.
● Kaiser has agreed to honor people’s deductible and out-of-pocket maximum
accumulations. Of current Friday enrollees, 85% have access to a Kaiser plan.
● Denver Health is still working through a decision about this. Once we know their
decision, the DOI will update this FAQ.
● Anthem, Cigna and Rocky Mountain Health Plans WILL NOT honor Friday customers’
deductibles and out-of-pocket maximums so far for 2023. People enrolling in these
plans will have to start over with these cost accumulators as of September 1.
I’m not involved in any of these discussions so I’m speculating right now.
I think Colorado is trying to do a smooth winddown that minimizes harm to enrollees. Kaiser is willing to take on cost-sharing and hold enrollees harmless. This likely means that they are going to get a lot of fairly sick people enrolling with them. The other insurers are likely worried about selection and are running away from the risk.