Group Market Ė Connecticut
December 1, 2016
HealthyCT is Going Out-of-Business; Need to Enroll in Other Health Insurance Coverage
Please carefully read this information about the future of HealthyCT and your groupís health insurance coverage.
The Connecticut Insurance Commissioner as Rehabilitator of HealthyCT has determined that the rehabilitation efforts for HealthyCT have been unsuccessful and the company will be moving into liquidation at the end of the year. This means the company is going out-of-business, and your companyís HealthyCT group insurance coverage will end January 31, 2017.
It is very important that you enroll in other health insurance coverage immediately so that your employees continue to have health insurance coverage.
Changes When Liquidation Occurs on December 31
If your groupís coverage has not already been replaced as of January 1, 2017, the Connecticut Life and Health Insurance Guaranty Association will continue your group insurance coverage for the month of January 2017 under the terms of your HealthyCT policy subject to the limits discussed below. You must pay your groupís January premium in order for coverage to stay in force. Please immediately work with your broker or agent to find alternative coverage for your group and avoid any gap in coverage as no coverage will be available under your HealthyCT policy or Guaranty Association coverage after January 31, 2017.
Pharmacy and medical claims will continue to be processed and paid for covered services received through the end of coverage. All claims paid after January 1, 2017 will be funded by the Connecticut Guaranty Association in accordance with its governing statutes.
$500,000 Claims Limit
The Guaranty Association has a $500,000 per member limit on payment of medical and pharmacy claims; this $500,000 limit does not include member cost share and is based on the contracted rate HealthyCT reimburses providers Ė not what the provider charges. Any medical and pharmacy claims in excess of $500,000 will be a claim with HealthyCTís estate but a large portion of the overlimit amount could be the memberís responsibility if remaining HealthyCT assets are insufficient to pay all of the overlimit amount.
Coverage Termination Notice
An official notice will be mailed to you soon notifying you that your group health policy will be terminated January 31, 2017. In order to have coverage in January 2017, you must pay the premium due for January.
Deductible Credit Reports
HealthyCT can provide group medical loss experience and deductible reports for discussions with new carriers.
Websites for Up-to-Date Communications
For updates on HealthyCT, visit the HealthyCT or Connecticut Insurance Department websites.
For more information:
Contact the Insurance Departmentís Consumer Affairs Division:
Phone: 860-297-3900 or 800-203-3447