OIC issues “cease and desist” to Coordinated Care

The Office of the Insurance Commissioner has issued a cease and desist letter to Coordinated Care/Centene to stop issuing plans on the individual exchange market.

The following email was provided to me by two sources, both of whom received it directly from the OIC.

As you may be aware, Insurance Commissioner Mike Kreidler issued a cease and desist order to Coordinated Care Corp. to stop all sales of individual health plans in Washington state, effective Dec. 12.

He took this extraordinary step in response to the more than 140 enrollees who’ve complained to his office regarding the company’s lack of an adequate provider network, the surprise bills many have received because of these issues, and the company’s failure to correct its serious deficiencies.

The company must honor all coverage sold during 2017 and any 2018 policies sold before the order took effect.

As we learn more, we’ll keep you updated.

Yesterday, I asked the OIC for comment.  I asked Coordinated Care for comment on this this morning.  I will post any updates as I receive them.

Coordinated Care had the lowest priced plan on the individual market during the open enrollment period.  In Washington State, a market with a state-based exchange, open enrollment will continue to January 15th.

Cease and desist letters like this are uncommon.  The OIC often gives plans extensive opportunity to rectify or “correct” deficiencies.  Those can still be addressed, and it’s possible that Centene will be able to continue selling into the exchange market during this open enrollment period.

However, because this is related to network adequacy, the plan may only be able to correct these issues by getting a provider partner to agree to a contract. That may take time, depending on the status of the negotiations.