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NY extends deadline for enrollees leaving failing insurer Health Republic

Health Republic, a federally backed health insurer, will

Health Republic, a federally backed health insurer, will shut down on Nov. 30, 2015, because of financial problems. Credit: iStock

New York State has extended the time Health Republic customers have to enroll in new plans for 2015 until the end of the month.

And the state Department of Financial Services said this week it is investigating "inaccurate representations Health Republic made to the state about its financial condition."

For the third time, the state Department of Financial Services and New York State of Health marketplace have changed the deadline for the more than 200,000 enrollees in Manhattan-based Health Republic to find other coverage for the rest of this year.

On Sept. 25 the state announced that the federally backed insurer was going out of business by the end of 2015 because of financial problems. But on Oct. 30 the state announced that Health Republic's finances were "substantially worse than the company previously reported" and would shut down Nov. 30. People had until Nov. 15 to find new coverage for the rest of the year, the state said.

Then on Sunday the state announced that individual and family Health Republic members have until Nov. 30 to select a new health insurance plan for the rest of this year. However, "due to information-technology constraints," after Nov. 15 they won't be able to enroll online and instead have to call the customer service center.

The state has set up a Health Republic hotline at 855-329- 8899.

The state also announced it will auto-enroll individual Health Republic consumers who didn't sign up for December coverage in new plans to ensure no one has "an unexpected gap in coverage." People can opt out of the auto-enrolled coverage, which would be effective Dec. 1.

The finance agency also said it had opened an investigation "specifically focused on Health Republic's inaccurate financial reporting. NYDFS investigators are collecting and reviewing evidence relating to Health Republic's substantial underreporting to NYDFS of its financial obligations."

The agency said the international restructuring firm Alvarez & Marsal is taking over management of Health Republic.

The state also said it is "taking actions" to apply an existing state law that prohibits providers from collecting from consumers money owed by insurers such as Health Republic. Also, under state law, Health Republic members who are in treatment for a life-threatening or disabling condition, or are in the second or third trimester of a pregnancy when their new coverage becomes effective, may be able to continue to receive care from their provider for up to 60 days or through pregnancy under their new policy, even if their provider does not participate in their new health insurer's network.The state is also in discussions with Memorial Sloan Kettering Cancer Center in Manhattan, which only took Health Republic on the exchange, "to ensure access to care for Health Republic consumers for up to a year.

But Wendy Darwell, Nassau-Suffolk Hospital Council's chief operating officer, said hospitals have heard little from the state. "What our members do know is that they already have millions of dollars in claims that are unpaid," she said.

Meanwhile, brokers were unhappy to learn Friday their commissions from Oscar Health Insurance -- to which many brokers had been switching their Health Republic clients because its network was the most similar -- were being cut by more than half to $6 per contract per month.

"What Oscar has done is unconscionable," said Jason Samel, president of JayMar Insurance Agency in Jericho. He said he had switched about 300 Health Republic clients to Oscar.

Oscar co-founder Mario Schlosser said the decision was made so the company grows "in a controlled manner."

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