Members Health Plan will be winding down operations

Members Health Plan of New Jersey is ceasing to write business and is beginning an orderly wind down of the Plan.

See below from Members Health Plan regarding winding down. 

MHPNJ IMPORTANT PLAN INFORMATION PLAN STATUS AS OF 7.12.21

Dear Broker:

We want to take the time to let you know that we value the support that you have provided to Affiliated Physicians and Employers Master Trust (“APEMT”) and Members Health Plan New Jersey (“MHPNJ”) over the years. This letter is to advise you that the APEMT/MHPNJ (the “Plan”) is ceasing to write business and is beginning an orderly wind down of the Plan. The financial deficiency the Plan has been facing for the past several months has not been sufficiently cured in the time period prescribed by New Jersey law. Therefore, the Board of Trustees on behalf of the Plan is implementing an orderly wind down of the plan. Please be advised that your client(s) must terminate their coverage with the Plan and seek new healthcare coverage for their employees and dependents as soon as possible.

Please note, All active employers enrolled in the Plan will be receiving a similar letter later today informing them of the wind-down plan. Click Here for a copy of the Employer Letter.

Effective immediately, the Plan is providing notice that it is discontinuing its Broker Commission Program per Section II (a) and (g) of our Broker Agreement.  All commissions will be subject to the priority scheme detailed in the Bankruptcy Code (11 U.S.C. § 101 et seq).

Click Here for Additional Broker Update provided by the Plans Bankruptcy Attorneys. If you are a General Agent, please forward this communication as well as the information related to proof of claim to your contracted sub-producers.

What is the impact of the wind down to you and your client(s) who may be currently enrolled in the Plan’s benefit programs?

• Your client(s) should seek alternative coverage as soon as possible. Eligible small employers may seek alternative coverage through the New Jersey Small Employer Health Program carriers and may submit an application for small employer coverage at any time. Eligible individuals may seek alternative coverage through Get Covered New Jersey, the state’s official health insurance marketplace, which has a special open enrollment period through the end of 2021.
• This communication is providing you with the required 180 days’ notice that your client(s) must seek new healthcare coverage for their employees and dependents immediately but no later than December 31, 2021. While 180 days’ notice is required by regulation, please do not delay in finding other coverage.
• Once your client(s) notify us of their intent to terminate, there is no waiting period for your client(s) coverage to terminate. Please contact us as soon as possible to terminate coverage. Be aware of the effective date of new coverage so that you can ensure no gap in coverage. Small group and individual policies will provide credit for charges incurred under current plans towards the Deductible under the new plan if there is no gap in coverage. However, note that credit is not provided for coinsurance paid under current plans to the maximum out-of-pocket under the new plan.
• Effective August 1, 2021, any groups remaining on the Plan will receive a rate increase of 26% and groups will not be provided with renewal quotes or increases at the time of their renewal. For example, if your client(s) renewal is currently scheduled for October or January, they will be receiving their rate increase on August 1st and at renewal the group will be continued at the rate provided in August until their termination date with the Trust or December 31, 2021, whichever is earliest.
• If your client(s) are currently due to renew their Association membership, they will not be required to renew unless they are using that membership for its other benefits.
• The Plan’s enrollment system will allow you to update adds/changes/deletes while your client(s) remain enrolled in the Plan’s medical and prescription benefit programs. Our service team is also available to assist you with day-to-day changes. 
• In accordance with the Plan’s Master Trust Agreement and your client(s) Health Plan Participation Request/Contract, any Employer enrolled in the Plan on or after January 1, 2020 is responsible for the Plan’s ultimate financial deficiency to meet the remaining obligations to claimants and/or medical service providers.
• During the next few weeks, the Plan will work with its Actuary to determine the assessment necessary for each Employer to pay who was enrolled in the Plan at any time since January 1, 2020.
• On or about August 15, 2021 your client(s) will receive a detailed statement regarding the assessment dollars they will need to pay to the Plan. The assessment will be collected via ACH if the group is still enrolled with the Plan. If the group is no longer enrolled with the Plan, your payment will be due by September 15, 2021. The Plan will work with Employers to provide payment plan options, including our credit card payment option and written extensions for payment.

It is important to note that until your client(s) termination date with the Plan (no later than December 31, 2021) the Trust cannot guarantee that claims for their employees and dependents will continue to be paid until we have collected the full assessment necessary to run out the program.  Therefore, we would encourage you to have your client(s) find other coverage as soon as possible and are relaxing our 60 day termination notice requirements to allow for notice of termination at any time prior to the termination date. We will not accept retroactive terminations, so ensure paperwork is provided to the Trust prior to the termination date.

While APEMT will be in a position to continue to administer the Plan, assist members and employees, and attempt to minimize damage and inconvenience , it is prudent to seek alternate coverage as soon as possible. As we are receiving a large volume of calls related to this issue, we would direct you to the plan’s website for additional information. Should you need to speak with a plan representative, please feel free to contact the Plan by calling 1-833-MEWANOW (1-833-639-2669) Option 8 or mail us at MHPNJinfo@concordmgt.com.    

For regulatory questions or should you need any support in finding other coverage, please contact the New Jersey Department of Banking and Insurance at 1-800-446-7467 or 609-292-7272. For more information on alternative coverage options for small employers visit www.state.nj.us/dobi/seh/. For information on individual coverage, individuals can visit: GetCoveredNJ

We thank you for your loyalty and trust in our Plan over the years.

Very truly yours,
The Board of Trustees
Affiliated Physicians and Employers Health Plan
Members Health Plan NJ