Alaska, Oregon suspend Moda Health as finances worsen

Alaska insurance regulators on Jan. 28 suspended Moda Health Plan from accepting new or renewal policies in the state, citing concerns with the Oregon-based company’s financial situation.

The Alaska Division of Insurance acted after officials in Oregon placed the company under supervision because of its financial condition.

Moda is one of two companies offering individual insurance policies for Alaskans on the federally facilitated health insurance marketplace. The other is Premera Blue Cross Blue Shield. The division of insurance last year approved average rate increases of nearly 40 percent for both companies.

The Oregon Department of Consumer and Business Services said its supervision order calls for the company to obtain sufficient capital and to present a business plan that demonstrates Moda can operate in sound financial manner into the future.

The department said its actions were prompted by Moda’s “excessive operating losses and inadequate capital and surplus.”

Under the order, Moda cannot issue new policies or renew current policies in the individual market or add new groups in Oregon, the department said in a release. The department said it will begin working with Moda to transfer its individual market plans to another carrier.

“Our primary goal is to ensure consumers are protected,” Patrick Allen, the department’s director, said in a release. “We will continue to work closely with the company to find a sustainable path going forward while minimizing risk to consumers.”

Lisa Morawski, a spokeswoman for the department, said a lot of what happens next will depend on the plan that Moda presents and whether the department finds it acceptable.

About 10,000 Alaskans are enrolled by Moda on the individual market and about 7,500 on the small group market, Alaska Division of Insurance Director Lori Wing-Heier said in an email response to questions. There are other options in the group market, she said.

“The division will do everything within its authority to see that Moda’s policyholders will continue to access medical services until they can be transitioned to another insurer,” Wing-Heier said in a release.

About 244,000 Oregon residents were enrolled in Moda plans in the individual, small group and large group markets as of Sept. 30, according to the Oregon Department of Consumer and Business Services.

U.S. Rep. Don Young, R-Alaska, said Thursday’s announcement “is meant to protect Alaskans from the failings of an individual insurance provider, but it also begs the question of the overall instability of our current health care system.” The system went through a shake-up last year, with other companies announcing their departure from the individual market.

“The Alaska Division of Insurance has made assurances that Moda policy holders will continue to be able to access health care services, their claims will be paid and consumers will be protected,” Young said in a release. “Alaskans should know that the state and the congressional delegation will be working with them as this process moves forward.”

02/03/2016 - 2:56pm