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Frequently Asked Questions (FAQs) for Customers Who Lost Friday

Health Plans Coverage as of August 31, 2023

Updated 2/15/24

Below are Frequently Asked Questions with more information regarding premiums refunds

(questions 1-3), paying of claims (questions 4-5), and background details on this situation

(questions 6 - 8). Questions from August and September 2023 regarding enrollment in a new

plan for the remainder of 2023 have been moved to the bottom of this document for

reference purposes (questions 9 - 23).

Premium Refunds

1. (updated 9/11/23 and again 2/15/24) Will I be refunded the premium that I

inadvertently paid or paid in error for a policy that was no longer active or had already

been terminated?

Yes. In February 2024, Friday will begin processing and mailing refund checks to the

policyholder’s last known address based upon Friday Health Plans’ records. Where Friday’s

records show that you paid premiums in error for health coverage on a health insurance plan

that was canceled or terminated because of, or following, the liquidation of Friday Health

Plans of Colorado, or Friday’s records show you paid premium in advance for health insurance

policies that were later canceled or terminated premium refund checks will be issued for

refundable amounts above $10.

2. (updated 9/11/23 and again 2/15/24) What if I don’t receive a premium refund, but I

think I should have received one?

If you believe that you are due a premium refund, you should file a Proof of Claim with the

Liquidator.

3. What if I believe that I am owed an additional refund in excess of the refund

check I received?

If you believe that you are due an additional premium refund, you should file a Proof

of Claim with the Liquidator.

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Paying Claims

4. Will health claims for Friday through August 31, 2023, still be paid?

Yes. Doctors, hospitals and other health care providers will still be paid for claims submitted

for services to people with health insurance from Friday, pursuant to the contractual terms

with the company. This action triggers the Guaranty Association to pay claims, and the

Association will pay up to $500,000 (the statutory limit) for claims for each person covered by

Friday.

5. Can health care providers require Friday Health customers to pay cash up front

for any services through August 31, 2023?

No, Friday’s contracts are required by law to include a hold harmless provision specifying that

consumers cannot, in any circumstance, be liable to a provider participating in Friday’s

network for care provided to the consumer except for their cost shares. In addition, Friday’s

contracts with providers are required to prohibit providers from collecting, or attempting to

collect, payment from a consumer for amounts that are owed to the provider from Friday.

Providers can continue to collect copayments and other applicable cost shares from customers

directly.

If a doctor, hospital or other health care provider is asking you to pay more than your cost

share amounts, such as your usual co-payment, deductible or coinsurance that are part of

your plan, or refusing to bill your Friday health insurance plan, please contact the Colorado

Division of Insurance Consumer Services Team as soon as possible - 303-894-7490 /

DORA_Insurance@state.co.us.

General Questions

6. Why did this happen?

As the DOI reviewed the financial projections of Friday Health Plans of Colorado after placing

it into rehabilitation, there were significant concerns about the accuracy of those projections.

And those projections have deteriorated even further since putting the company into

rehabilitation. The decision of the parent company to shut down operations July 6, instead of

working through a measured winding down of its business, also increased costs for the

Colorado company, further undermining earlier financial projections.

Heightened concerns about the ability of the Colorado company to get through the remainder

of the year could potentially put the upcoming open enrollment for 2024 at risk. In order to

avoid putting enrollment for tens of thousands of Coloradans at risk, it became evident that

the DOI would have to end Friday Health plans as of Aug. 31.

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The DOI also had growing concerns about health care providers (doctors, hospitals, etc.)

refusing to treat Friday members. Taking this action now should help those people who are

experiencing difficulties in getting the care they need.

7. How many people in Colorado were enrolled in a Friday health plan?

There were about 30,000 people enrolled in plans from Friday Health Plans of Colorado.

8. What is the Colorado Guaranty Association?

The association, officially known as the Life and Health Insurance Protection Association, is a

non-profit organization made up of life and health insurance companies that sell insurance

products in Colorado. The Colorado legislature authorized the formation of the association in

1991 to assist Coloradans with insurance policies from companies that become insolvent.

To protect consumers, the DOI championed the passing of HB23-1303 - Protect Against

Insurers' Impairment And Insolvency this past legislative session as it monitored the situation

regarding Friday Health. This legislation made Friday Health Plans of Colorado a member of

the Guaranty Association, offering protections to both consumers and health care providers in

the event of the failure of a company like Friday health insurance company that is licensed as

an HMO (health maintenance organization).

Questions from August - September 2023 Regarding Enrolling Coverage for the

Remainder of 2023

How and When to Enroll in New Health Insurance

9. Will I be able to enroll in a new health insurance plan?

Yes. You will have a Special Enrollment Period (SEP) when you can enroll in new coverage for

September through December 2023. It’s important to act soon so that you (and any covered

family members) are not left uninsured come September 1.

If you are enrolled in a plan from Friday Health through Connect for Health Colorado or

through Colorado Connect, including the OmniSalud program, you can select new health

insurance through those enrollment platforms.

If you, your spouse, or a parent (for those under age 26) has access to health insurance from

an employer, you may also have the option to enroll in that health insurance plan. Contact

the employer’s human resources or employee benefits office for specific rules and enrollment

deadlines.

Employers who have a small group plan (for small employers with less than 100 employees)

from Friday Health should contact their broker for details. Employees enrolled in these plans

should contact their employer for more information.

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