Community Health Alliance Not Offering Plans in 2016

Community Health Alliance Mutual Insurance Company (CHA), the nonprofit health insurance company serving more than 27,000 Tennesseans, will no longer offer health insurance plans. “Last week’s announcement of a risk corridor reimbursement of just 12.6% cast doubt on the collectability of over $17 million of CHA’s risk corridor receivable and led to an unavoidable outcome,” said Jerry Burgess, President and CEO. “CHA has been covering members since 2014 and built positive partnerships with its health care providers, vendors, agents and all other stakeholders to serve its members,” added Burgess. Current benefit plans will be honored until the end of their plan year and CHA is continuing to meet its financial obligations. In the coming days, weeks and months, CHA will continue to focus all of its efforts on taking care of its members and also working with the Tennessee Department of Commerce and Insurance as well as the Centers for Medicare & Medicaid Services to help ensure a smooth transition.

Frequently Asked Questions (FAQs):

If I bought individual insurance with CHA, what will happen to my coverage?
The coverage you bought will remain in effect through December 31, 2015.

Can I continue to buy insurance through CHA?
No. You need to find new coverage to begin January 1, 2016. Open enrollment begins November 1 and runs through January 31, 2016. You must purchase replacement coverage by December 15, 2015 to have insurance on January 1, 2016

What does the wind down of CHA mean to providers?
Providers will be paid for claims incurred through December 31, 2015.

Where else can I enroll for insurance in the Federally Facilitated Marketplace?
Visit www.healthcare.gov for access to insurers participating in the FFM or call 1-800-318-2596. There will be up to four carrier options on the FFM, depending on your geographic location.

Will this change my premium?
No. Premiums will not change through the 2015 plan year. Your premium may change when you purchase coverage from another company for 2016 coverage.

Should I keep paying my premium?
Yes. You must pay your premium through the end of 2015 to have coverage.

Can I still see my regular doctor and have prescriptions filled at the same pharmacy?
Yes. The provider network should remain in place through 2015. Once you shop for new coverage for 2016, check provider directories for the other companies to ensure your doctors and preferred facilities are members of those networks.

Can my doctor refuse to see me because of the situation?
No. Contracts between CHA and providers should remain in force during the runoff.