Nevada Health CO-OP in Receivership

On October 14, 2015, the Eighth Judicial District Court of Clark County, Nevada (the “Receivership Court”), in case number A-15-725244-C, and pursuant to Nevada Revised Statutes chapter 696B, entered its Permanent Injunction and Order Appointing Commissioner as Permanent Receiver of Nevada Health CO-OP (the “Permanent Receivership Order”). A copy of that order is available on the CO-OP’s website, www.nevadahealthcoop.org. Nevada Insurance Commissioner Amy L. Parks, as Permanent Receiver (“Receiver”), appointed Cantilo & Bennett, L.L.P. Special Deputy Receiver (“SDR”) of NHC. This action followed a temporary receivership order (“Temporary Order”) entered by the Receivership Court on October 1, 2015, following a determination that the CO-OP was in hazardous financial condition.

Under the terms of the Temporary Order and the Permanent Receivership Order (the “Receivership Orders”) and applicable Nevada law, the Commissioner as Receiver and the SDR are empowered by operation of law to immediately seize control of and oversee the operation and conservation of NHC as of the date of entry of the Receivership Orders. Preliminary review indicates that NHC is in hazardous financial condition. NHC staff and the SDR are focusing their efforts on the protection of NHC’s members and their health care coverage and protecting the interests of its Providers and other creditors.

The Permanent Receivership Order provides that:

All persons, corporations, partnerships, associations and all other entities wherever located, are hereby enjoined and restrained from interfering in any manner with the Receiver’s possession of the Property or her title to or right therein and from interfering in any manner with the conduct of the receivership of CO-OP. Said persons, corporations, partnerships, associations and all other entities are hereby enjoined and restrained from wasting, transferring, selling, disbursing, disposing of, or assigning the Property and from attempting to do so except as provided herein.

INFORMATION FOR MEMBERS OR ENROLLEES:

AS ANNOUNCED ON AUGUST 25, 2015, THE CO-OP WILL NOT PROVIDE HEALTH COVERAGE AFTER DECEMBER 31, 2015. IT IS IMPORTANT THAT YOU MAKE ARRANGEMENTS FOR NEW COVERAGE EFFECTIVE JANUARY 1, 2016. YOU MAY DO SO DURING THE OPEN ENROLLMENT PERIOD THAT BEGINS NOVEMBER 1, 2015, AND ENDS JANUARY 31, 2016, ON THE NEVADA HEALTHLINK EXCHANGE ESTABLISHED UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (“ACA”). INFORMATION ABOUT AVAILABLE HEALTH PLANS CAN BE FOUND AT WWW.HEALTHCARE.GOV. YOU MAY CONTACT YOUR BROKER, AGENT OR NAVIGATOR OR THE MARKETPLACE AT 1-800-318-2596 (TTY: 1-855-889-4325) FOR ASSISTANCE. YOU MAY ALSO:

    • Visit Nevada Health Link (www.nevadahealthlink.com), or call 1-855-768-5465 to learn more about the Marketplace and to see if you qualify for lower costs.
    • Email Nevada Health Link at: Contact@exchange.nv.gov
    • Visit LocalHelp.HealthCare.gov to find personal help in your area

Click here for additional resources and information about Open Enrollment.

Special Notice Regarding Telehealth (MDLive) Services: Nevada Health CO-OP will no longer be offering telehealth services effective October 1, 2015. This change comes as a result of the SDR’s efforts to conserve the CO-OP through the end of the year for the benefit of its members. CO-OP members are still entitled to receive health care services in person from participating providers under the terms of their policies through the end of 2015. Please contact your primary care doctor or other health care provider if you need medical assistance.

INFORMATION FOR PROVIDERS:

All physicians, hospitals, health facilities and other providers of health care services (“Providers”) to the members, enrollees, and policyholders (“Members”) of Nevada Health CO-OP.

The SDR will focus initial efforts on two parallel goals: (1) avoiding disruption in the delivery of health care to the Enrollees for the period that they are entitled to receive such care from NHC (ending no later than December 31, 2015), and (2) maximizing payment to Providers and creditors for services rendered initially during the receivership period (which commenced on October 1, 2015) and thereafter for amounts owed for services rendered before that date.

IT IS IMPERATIVE THAT YOU CONTINUE PROVIDING HEALTH CARE SERVICES TO ENROLLEES ON THE SAME BASIS AS BEFORE, WITHOUT CHARGING ADDITIONAL AMOUNTS OR REJECTING REQUESTS FOR APPOINTMENTS OR HEALTH CARE SERVICES.

Specifically, the Permanent Receivership Order provides at pages 4 and 5:

All providers of health care services, including but not limited to physicians hospitals, other licensed medical practitioners, patient care facilities, diagnostic and therapeutic facilities, pharmaceutical companies or managers, and any other entity which has provided or agreed to provide health care services to members or enrollees of CO-OP, directly or indirectly, pursuant to any contract, agreement or arrangement to do so directly with CO-OP or with any other organization that had entered into a contract, agreement, or arrangement for that purpose with CO-OP are hereby permanently enjoined and restrained from:

      • Seeking payment from any such member or enrollee for amount owed by CO-OP;
      • Interrupting or discontinuing the delivery of health care services to such members or enrollees during the period for which they have paid (or because of a grace period have the right to pay) the required premium to CO-OP except as authorized by the Receiver or as expressly provided in any such contract or agreement with CO-OP that does not violate applicable law;
      • Seeking additional or unauthorized payment from such CO-OP members or enrollees for health care services required to be provided by such agreements, arrangements, or contracts beyond the payments authorized by the agreements, arrangements, or contracts to be collected from such members or enrollees; and
      • Interfering in any manner with the efforts of the Receiver to assure that CO-OP’s members and enrollees in good standing receive the health care services to which they are contractually entitled.

The Commissioner as Receiver, and the SDR, thank you sincerely for your assistance in assuring uninterrupted access to care for the Enrollees. In turn the SDR will make every effort, subject to the availability of funds, to pay providers promptly for services rendered on and after October 1, 2015, and to retire earlier Provider debt in full as soon as the availability of assets permits such payment.

Failure to abide by the terms of the Permanent Receivership Order and existing agreements or arrangements with NHC may result in waiver of the right to collect payments and may also result in enforcement action by the SDR.

INFORMATION FOR BROKERS

IF YOU HOLD ANY UNEARNED PREMIUMS OR OTHER FUNDS OR ASSETS BELONGING TO NHC, PLEASE SEND IT TO THE ADDRESS BELOW WITHOUT DELAY.

After a careful review of NHC’s operations and financial condition, and effective at 12:01 A.M. on October 2, 2015, the Receivership has suspended the payment of broker commissions. However brokers may file claims for unpaid commissions as and when described below.

INFORMATION FOR CLAIMANTS:

In the near future, the SDR will put into place a process whereby members, enrollees, providers, and other parties interested in the affairs of NHC can file claims, with adequate supporting documentation, against the estate of NHC for amounts they believe NHC owes them. At that time a deadline will be set for the filing of claims. NO SUCH DEADLINE HAS YET BEEN SET. In due course the Receiver will evaluate claims in accordance with Nevada law and, depending upon the sufficiency of receivership assets, determine and report as to the amounts allowed to be paid on each. Although it is not yet necessary to do so, any party that wishes to and believes it has a claim against the estate of NHC may submit the claim, with adequate supporting documentation, to the address below:

Nevada Health CO-OP, in Receivership
ATTN: Special Deputy Receiver                                     (702) 823-2667 Telephone
840 S. Rancho Drive #4-321                                           (855) 606-2667 Toll Free
Las Vegas, Nevada 89106                                                info@nevadahealthcoop.org

We are unable to advise you at this time how soon such claims will be evaluated and paid. Any questions regarding this receivership or the affairs of NHC may be directed to the same address, telephone, or e-mail address. For copies of the document referenced in this notice, or additional information regarding the receivership of NHC, please visit our website, www.nevadahealthcoop.org or contact us at the above addresses and phone number.