LEWISTON — The state’s only health insurance co-op has lost nearly half its membership in the past year — from 84,000 to 48,000 — partly because its rate increases prompted people to look elsewhere for insurance.
But the Maine Bureau of Insurance says having fewer members may actually help Community Health Options this coming year, and co-op leaders agree.
“We do see this as something we’d planned for,” Community Health Options spokesman Michael Gendreau said. “I really feel like we’re really entering into ’17 from a much stronger position, with solid capital and a solid, good membership.”
In its monthly statement on the co-op, the Maine Bureau of Insurance noted Monday that Community Health Options’ insurance claims and expenses were down — a good financial sign.
It also pointed out that membership had dropped to 48,000 between Feb. 1, 2016, and Feb. 1, 2017, with 76 percent of those members buying individual insurance, 23 percent buying small group insurance and 1 percent buying large group insurance.
The bureau said the co-op’s smaller capital can better financially support a smaller membership. Having 36,000 fewer members to pay for, along with better-priced insurance plans, will put the co-op in the best position for a successful 2017, the bureau said.
Gendreau said Community Health Options lost about 10,000 of those 36,000 members when it left New Hampshire this year. He believes others left for other insurance companies because the co-op upped its insurance rates for 2017.
Co-ops are health insurance companies run by members for members. They were created through the 2010 federal Affordable Care Act to increase competition among health insurers and to provide consumers with greater choice in the marketplace.
Community Health Options began selling plans in 2013 and quickly rocketed to the top of Maine’s individual health insurance market, attracting members with its low premiums, broad network of doctors and hospitals and unique program benefits. Before it opened, the co-op had expected to reach about 40,000 members within five years. Instead, it reached that level within its first year.
At one point, Community Health Options was the only profitable co-op in the country. That changed in 2015 when its insurance claims for all those members were higher than expected. It began losing money.
To try to regain its financial footing, the co-op cut administrative expenses, temporarily suspended sales of new individual insurance plans and pulled out of New Hampshire.
The Maine Bureau of Insurance has been closely monitoring the co-op since early 2016.
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