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State takes over local health plan, monitors claims before August closing

The state took over Friday Health Plans at the end of June and determined the company only had enough money to operate in Colorado through Aug. 31.

COLORADO, USA — Katie Nelson thought it was a fluke when her pharmacist told her a prescription for her son’s continuous glucose monitor transmitter had been denied back in June.

Her health insurance carrier, Friday Health Plans, had covered the prescription in full since her family’s coverage started in the beginning of January.

The strange decision by the healthcare provider comes after an announcement earlier this month that Friday Health Plans will cease coverage in Colorado on Aug. 31, forcing 30,000 Coloradans who are covered by Friday Health Plans to find a new health insurance provider for coverage from Sept. 1 through the end of the year.

“That left us to scramble and try and get new health insurance coverage,” Nelson said.

Vince Plymell, a spokesman for Colorado’s Division of Insurance said the state wants to know about coverage issues in this final month of Friday Health Plan’s coverage. Consumers can file a complaint here.

What happened to Friday Health Plans? 

Colorado’s Division of Insurance took over the struggling health insurance provider in late June under a rehabilitation agreement. At the time, Colorado’s insurance regulators were hoping to continue coverage for those insured by Friday Health Plans.

“What happened is, essentially, it turned out that they didn't have enough money to continue for the remainder of 2023,” Plymell said. “The financial projections were worse than they had anticipated. So they weren't going to be able to finish out the year.”

In mid-June, the division of insurance announced the health plan would stop coverage on Aug. 31 at 11:59 p.m., offerings an FAQ page that’s continually updated about the situation. The department has opened a special enrollment period for the 30,000 people impacted by the closure.

What should you do if you’re insured by Friday Health Plans?

The division of insurance encourages anyone impacted by the closure to log in to Connect for Health Colorado to pick a new provider to ensure they’re covered starting Sept. 1 through the end of the year.

Nelson has already selected a new plan through Rocky Mountain Health Plans, the only of the options that would allow her son to see his same doctors, which is important as he suffers from Type 1 diabetes.

But there’s one problem.

“We’ve lost everything we paid into our deductible and all of that for this year,” Nelson said.

According to the FAQ, the division of insurance requested that other companies honor the deductibles and out-of-pocket maximums that customers have paid so far this year. Only Kaiser has agreed to honor those deductibles. Denver Health is considering them. Anthem, Cigna and Rocky Mountain Health Plans don’t plan to honor the deductibles, according to the division of insurance.

The state is still trying to determine how to make up the difference for those providers.



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