Insurers still scrambling to process former CoOportunity members
JOE GARDYASZ Feb 10, 2015 | 9:25 pm
3 min read time
675 wordsAll Latest News, Business Record Insider, Health and WellnessSome group insurance plan members in Iowa that had to switch coverage from the failed CoOportunity Health to other carriers are still waiting to receive their insurance cards, nine days after their new policies became effective.
Wellmark Blue Cross and Blue Shield, the state’s largest insurer, says it’s “working diligently” to process a wave of new business groups and individuals it has gained in the wake of the recent CoOportunity Health failure.
Wellmark spokeswoman Traci McBee said Tuesday that nearly 80 percent of the new groups and individuals that it is processing from CoOportunity have received their member numbers and insurance cards for coverage that went into effect on Feb. 1. The remainder of members whose coverage became effective Feb. 1 should receive their cards by mid-February, she said.
The Des Moines-based insurer declined to specify how many groups and individuals it gained from CoOportunity, but one source has said that about 260 employer groups have been moved to Wellmark from the failed carrier.
Steve Flood, senior vice president for insurance brokerage Holmes Murphy & Associates Inc., said that both Wellmark and UnitedHealth Group Inc. in particular have been processing “a tremendous number of groups.”
Despite the initial processing delays that some groups have experienced, “I don’t have any concern that people won’t be ultimately covered,” Flood said. “But it definitely could create more issues in the interim. It could require some extra legwork on the part of employees. I think especially in the two- to 15-person small-group market is where there will be a lot of friction.”
CoOportunity had approximately 115,000 members, about two-thirds of whom were Nebraska residents and the remainder Iowa residents.
“Our priority during this time is to ensure our members experience minimal disruptions in their care or services,” Wellmark’s McBee said in an emailed statement to the Business Record. “We have increased the number of resources dedicated to transitioning these new members significantly,” she said.
“Specifically, we have opened our call center and staffing over the last few weekends to expedite the handling of processing new groups and individual applications to get ID cards to members as soon as possible,” McBee said. “We’ve also proactively reached out to providers, pharmacists and agents to ensure they have the information they need so that Wellmark members are able to receive the services and care they need during this time.”
Flood said that the major carriers in the market – Wellmark, UnitedHealthcare and Conventry Health Care of Iowa – “have really bent over backwards to help employers and employees out” in the transition.
CoOportunity, which would have been beginning its third plan year, was deemed insolvent in late December by Iowa Insurance Commissioner Nick Gerhart. A petition for the carrier to be dissolved was filed by Gerhart on Jan. 29, and he has requested a hearing prior to the end of February in Polk County District Court.
As of Feb. 6, CoOportunity had 8,788 members remaining who had not switched to another carrier, Gerhart said. Of that total, more than 5,500 were enrolled through group coverage. Those group and individual members will still have some limited coverage through Nebraska’s and Iowa’s insurance guaranty funds this year as the carrier undergoes liquidation.
Flood said his brokerage had strongly advised employer groups it works with to switch from CoOportunity prior to Feb. 1. However, any groups that worked with Holmes Murphy or any other broker would have been warned of the limitations in coverage they will face, he said.
“CoOportunity was probably 15 to 20 percent below the pricing of the rest of the marketplace,” he said. “So that’s one reason that some employers and individuals may have chosen to stay.”
Gerhart said Monday he was not aware of any delays by carriers in processing new members, and that his division has not received complaints regarding providers not scheduling procedures because people didn’t have member numbers or cards.
“Unfortunately, we have very little control over companies’ turnaround time,” he said.