Evergreen Health will be liquidated and its enrollees will have to find new insurance plans by the end of September, a Baltimore City judge ruled last week.
Judge Yolanda Tanner also ordered a 30-day special open enrollment period for the month of September. Aetna, CareFirst, Kaiser Permanente and UnitedHealthCare will all participate in this enrollment period.
Evergreen’s closure affects about 25,000 Marylanders who have plans through the small group and large group employer markets.
Evergreen was created as a consumer oriented and operated plan (co-op) under the Affordable Care Act. It originally participated in all markets, but was focused on the individual market.
However, in the individual market, its members were deemed too healthy and the insurer had to make large risk adjustment payments to help cover insurers with sicker members. Last year, Evergreen was ordered to pay $22 million in risk adjustment fees.
Founder and CEO Peter Beilenson sought to convert the insurer to a for-profit company to keep the company running. That plan also included more focus on small and large group plans. As part of the conversion, Evergreen was ordered by the Maryland Insurance Administration to not participate in the 2017 individual health market.
Evergreen was set to return to the individual market for 2018 after it found investors in its bid to become a for-profit insurer, but after Evergreen was assessed another large risk adjustment payment, those investors backed out.
With the collapse of the deal, Maryland Insurance Commissioner Al Redmer placed the company into receivership. He hoped that he would be able to find new investors to take over the company.
Despite discussions with several potential investors, Redmer could not find a new deal. Then the receiver, Risk & Regulatory Consulting, LLC, petitioned the court for liquidation of the company.
Claims members filed with Evergreen prior to Sept. 1 will still be processed through their Evergreen contracts. After Sept. 1, consumers will have their claims processed under the terms of their new insurer. But the insurance administration cautioned members that through Sept. 30 they should still use their Evergreen insurance card when they receive treatment.
The administration also said that credit for deductibles, out-of-pocket maximums and other accumulating benefits under the Evergreen policies would not be carried over or transferred to new plans.