Health Republic Insurance of New York
Liquidation Administration Website

Frequently Asked Questions – General

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1. What is a liquidation proceeding?

Liquidation is the process of bringing a business to an end, collecting any assets of the business, and distributing any assets to eligible claimants. Once the process is complete, the business is dissolved.

Article 74 of the New York Insurance Law governs the liquidation of New York insurance companies. The law authorizes the Superintendent of Financial Services of the State of New York to apply to the Supreme Court of the State of New York (the trial-level court in New York State) for authority to liquidate an insurer if, among other things, the insurer consents or is insolvent.

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2. What is the status of Health Republic’s liquidation?

At the direction of the Superintendent of Financial Services of the State of New York (Health Republic’s primary regulator), Health Republic terminated all of its insurance policies as of November 30, 2015. Since that time, Health Republic has been winding down its operations and preparing for an orderly liquidation.

On , the Superintendent commenced a liquidation proceeding for Health Republic by submitting an Order to Show Cause and Verified Petition in New York State Supreme Court. Health Republic consented to the liquidation. The Order to Show Cause was approved by the New York State Supreme Court on April 22, 2016.

On May 10, 2016, following a hearing, the Court approved a Liquidation Order that authorized the liquidation proceeding and appointed the Superintendent as the Liquidator. The Liquidation Order also directed the Liquidator to take possession and control of Health Republic’s property and assets and to liquidate Health Republic’s business and affairs in accordance with the New York Insurance Law.

The Liquidation Order and the Transcript of the May 10 hearing are currently available in the Key Documents section of this website. Spanish translations of both are available here.

On October 17, 2016, following a hearing, the Court entered an Order Approving the Procedure for the Liquidator’s Adjudication of Claims. The Claims Adjudication Procedures and the transcript of the October 11 hearing are available in the Key Documents section of this website.

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3. What is the purpose of the Order to Show Cause and the Liquidation Order?

The filing of the Order to Show Cause by the Superintendent of Financial Services of the State of New York was the first step in the liquidation proceeding.

On April 22, 2016, the Order to Show Cause was approved by a New York State Supreme Court judge. It ordered Health Republic to appear at a hearing set for May 10, 2016. At the conclusion of the hearing on May 10, the judge approved the Liquidation Order, which authorized the liquidation proceeding and appointed the Superintendent as the Liquidator.

The Liquidation Order also directed the Liquidator to take possession and control of Health Republic’s property and assets and to liquidate Health Republic’s business and affairs in accordance with the New York Insurance Law.

The Liquidation Order also provides for certain injunctive relief that the Liquidator believes is in the best interests of Health Republic’s former providers and members and other creditors.

The Liquidation Order and the Transcript of the May 10 hearing are currently available in the Key Legal Documents section of this website. Spanish translations of both are available here.

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4. Why did the Superintendent seek to place Health Republic into liquidation?

The Superintendent of Financial Services of the State of New York determined it was necessary to seek to place Health Republic into liquidation because of Health Republic’s financial condition. Specifically, during its first year of operations, Health Republic experienced losses significantly greater than projected.

On September 25, 2015, the New York State Department of Financial Services directed Health Republic to cease writing new health insurance policies and to commence an orderly wind-down process. For additional information regarding the decision to seek to place Health Republic into liquidation, please see the Verified Petition.

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5. What will the liquidation proceeding accomplish?

The liquidation proceeding will accomplish an orderly liquidation of Health Republic’s remaining assets in accordance with the requirements of the New York Insurance Law. The goal of the proceeding will be to maximize distributions to claimants while minimizing the duration and cost of the liquidation proceeding, to the extent possible. Payments from Health Republic’s estate will be made in a fair and equitable manner in accordance with statutory requirements, upon approval by the Court.

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6. How do I submit a claim against Health Republic?

PROVIDERS should have submitted policy claims by March 31, 2016 in accordance with the procedures and deadlines set forth in the contracts governing their provision of services to Health Republic’s Members. Policy claims submitted in accordance with the relevant contractual requirements do not need to be re-submitted.

Providers will receive Explanation of Benefits statements and information about the process for submitting any appeals as soon as available. Any additional information concerning the claims process for providers will also be posted on the website.

MEMBERS should have submitted policy claims for out-of-network services by March 31, 2016 in accordance with the procedures and deadlines set forth in their insurance policies. Policy claims submitted in accordance with the relevant contractual requirements do not need to be re-submitted.

Members will receive Explanation of Benefits statements and information about the process for submitting any appeals as soon as available. Any additional information concerning the claims process for members will also be posted on the website.

BROKERS, VENDORS, AND OTHER CREDITORS should not file claims against Health Republic at this time. Based on the information available to date, it is highly unlikely that Health Republic will have sufficient funds to pay any claims against Health Republic other than (1) claims for administrative expenses (i.e., expenses incurred in administering the liquidation proceeding) and (2) a portion of the claims under Health Republic policies submitted by providers and members. Under the New York Insurance Law, administrative expenses and policy claims must be paid in full before any other claimants may receive distributions.

Please check the Health Republic website periodically for updated information on the claims process.

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7. I have a question regarding the 1095-A or 1095-B tax form I received. How do I submit an inquiry?

As a former Health Republic member, you were issued a 1095 form for 2015.

Individuals who obtained Health Republic coverage through the NY State of Health (the "Marketplace") should have received a 1095-A form on or before February 1, 2016. If you have any questions about your 1095-A form, you should contact the Marketplace help line at (855) 766-7860.

1095-B forms are issued by Health Republic to individuals who enrolled in Health Republic insurance directly (rather than through the Marketplace) and to employees of all businesses who were enrolled in Health Republic insurance. 1095-B forms for the 2015 plan year were released by Health Republic on March 31, 2016 in accordance with federal guidelines.

If you are a Member with questions about your 1095-B form, you may submit them directly using the "Submit an Inquiry or Complaint" link provided on the Members page.

For more information about the 1095 form, please visit the IRS website. Please note that nothing on this website should be construed as tax advice. Members should consult with a tax professional if they have questions about the 1095 form.

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8. I received a bill from my health care provider asking me to pay an amount in excess of my normal cost sharing (co-payments, coinsurance, or deductibles) because Health Republic has not paid its share of the cost to the provider. Do I need to pay the excess amount to my provider?

No. We have been advised by the New York State Department of Financial Services that New York law prohibits health care providers from billing Health Republic members for any amounts in excess of their normal cost sharing, a practice commonly referred to as “balance billing.” This applies equally to in-network and out-of-network providers.

If you believe you have been balanced billed, please contact the New York State Department of Financial Services at (800) 342-3736.

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9. What if I mistakenly paid a premium to Health Republic for a period for which I did not have insurance coverage? For example, what if I paid a premium for December 2015, at which point Health Republic was no longer providing insurance coverage?

If you believe you mistakenly paid a premium to Health Republic, you may be entitled to a refund of that premium. Please submit an inquiry directly on the link below.

Submit Inquiry

If you require assistance with submitting an inquiry regarding your premium refund, please call (866) 680-0893 (toll-free).

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10. What is the total amount of claims against Health Republic?

The total amount of claims against Health Republic will be determined during the liquidation proceeding. Prior to the filing of the liquidation proceeding, Health Republic began to review anticipated claims against it from health care providers and other claimants. The claims review process will continue during the liquidation proceeding and will be governed by the New York Insurance Law.

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11. Has Health Republic determined how much money is available to pay claims and when claims will be paid?

No. At this time, it is not possible to provide an accurate estimate of the amount of assets that may ultimately be available for distribution to Health Republic’s claimants. The amount of assets that may be available, and the timing of any distributions, will depend on the outcomes of several key events, the resolution of which are not expected for an extended period of time.

The amount of assets available to satisfy claims will depend in large part on any additional payments that may be made to Health Republic under three programs established by the federal Patient Protection and Affordable Care Act of 2010. These programs, commonly known as the “3Rs,” are the risk adjustment, reinsurance, and risk corridors programs. The 3R programs are intended to help protect health insurance companies, like Health Republic, from larger-than-expected losses during the first few years following passage of the Act. The amount and timing of any payments Health Republic may receive from the 3R programs remains unsettled, and will depend upon decisions to be made in the coming months by the federal government.

Based on the information available to date, however, it is highly unlikely that Health Republic will have sufficient funds to satisfy any claims against Health Republic other than (1) claims for administrative expenses (i.e., expenses incurred in administering the liquidation proceeding) and (2) a portion of the claims under Health Republic policies submitted by providers and members. Under the New York Insurance Law, administrative expenses and policy claims must be paid in full before any other claimants may receive distributions.

No assurance can be given as to when, or to what extent, any claims may be paid. Additional information regarding the plan of liquidation for Health Republic (including the payment of claims thereunder) will be posted on the website from time to time.

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12. I have a contract with Health Republic to provide goods or services. Do I still have to provide those goods or services during the liquidation proceeding?

Yes. Any provider of goods or services currently under contract with Health Republic is obligated to provide the agreed-upon goods or services under the terms of the contract. The filing of the liquidation proceeding does not negate those contractual obligations to Health Republic.

The Liquidation Order prohibits parties to contracts with Health Republic from taking certain actions under those contracts (such as termination) as a result of, among other things, the filing of the liquidation proceeding.

Amounts owed by Health Republic for goods and services provided to Health Republic and accepted by the Liquidator after approval of the Liquidation Order will be treated as administrative expenses. Under the New York Insurance Law, administrative expenses must be paid in full before any other claimants may receive distributions.

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13. How long will the liquidation proceeding last?

It is not yet known how long the liquidation proceeding will last due to, among other things, lack of certainty regarding the timing and amount of potential recoveries by Health Republic from programs established by the federal Patient Protection and Affordable Care Act of 2010.

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14. How can I get copies of the legal documents filed in the liquidation proceeding?

You can sign up for “eTrack” on the New York State Unified Court System’s website to receive email notifications when activity occurs in the liquidation proceeding. Copies of documents filed in the liquidation proceeding will also be posted on the Health Republic website under the Court Docket page.

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15. How can I be added to the case mailing list?

To be added to the mailing list so that you receive copies of future mailings in the liquidation proceeding, please submit your information directly on the link below.

Submit Inquiry

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16. Can you please change my address on your mailing list?

Please provide your request in writing on the link below. Note that you will be asked to provide both your current address and your previous address.

Submit Inquiry

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17. Who can I contact if I have additional questions regarding Health Republic’s liquidation proceeding or the claims process?

You can call the Health Republic hotline at (866) 680-0893 (toll-free). Please note, however, that the information provided on the Health Republic website and at this “Frequently Asked Questions” page is all of the information available at this time. Please check the website periodically for updated information.

Also note that Health Republic, the Superintendent, their respective advisors, and the claims and noticing agent are not permitted to provide legal or tax advice.

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18. Why did I receive a notice regarding the commencement of a liquidation proceeding for Health Republic and a Notice of Entry of Liquidation Order?

You received or soon will receive a Notice of Entry of Order to Show Cause and a Notice of Entry of Liquidation Order because Heath Republic’s records show you as a former Health Republic member, provider, broker, or vendor.

The Notice of Entry of Order to Show Cause was sent for informational purposes. It was sent to inform you that the Superintendent of Financial Services of the State of New York commenced a liquidation proceeding for Health Republic on April 22, 2016 by submitting an Order to Show Cause and Verified Petition in New York State Supreme Court. Health Republic consented to the liquidation. The Order to Show Cause was approved by a New York State Supreme Court judge on April 22, 2016.

The Notice of Entry of Liquidation Order is being sent to inform you that, on May 10, 2016, a New York State Supreme Court judge authorized the liquidation proceeding and appointed the Superintendent as the Liquidator.

The Liquidation Order directed the Liquidator to take possession and control of Health Republic’s property and assets and to liquidate Health Republic’s business and affairs in accordance with the New York Insurance Law.

The Liquidation Order also provides for certain injunctive relief that the Liquidator believes is in the best interests of Health Republic’s former providers and members and other creditors.

Additional information about the liquidation proceeding is available on this website.

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19. Has Health Republic received my healthcare provider policy claims?

Healthcare providers may check whether Health Republic has received claims by clicking HERE and entering the billing provider’s tax identification number (TIN) and the date of service. You will be provided with the status of all claims submitted for services provided on that date, grouped by claim number and Health Republic member ID number. If you are unable to locate your claim utilizing the above link, please click HERE to submit an inquiry with the billing provider’s tax identification number (TIN) and the date of service, as well as your contact information. A member of our team will research your inquiry and provide a response.

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20. I am a Health Republic member; has Health Republic received my claims?

Health Republic members may check whether Health Republic has received their claims submitted on or after November 9, 2015 by clicking HERE selecting the “Search by Member Id” box, and entering the member ID number. You will be provided with the status of all submitted claims. If you are unable to locate your claim utilizing the above link, please click HERE to submit an inquiry with your member ID number as well as your contact information. A member of our team will research your inquiry and provide a response.

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