The State of New Jersey
NJ Department of Banking and Insurance
search  


Home > Health Insurance Programs > FAQs - Health Republic Insurance of New Jersey - Consumers
FAQs for Individual Consumers Previously Covered by Freelancers Consumer Oriented and Operated Plan, d/b/a Health Republic Insurance of New Jersey (Health Republic)
What’s happening?  What does it mean for you?  What do you need to do?
1.  What happened to Health Republic?  
  Health Republic, like all insurance companies, must meet financial requirements to ensure that it has enough money to pay all of its financial obligations, most importantly its financial promises to policyholders and their medical providers.  When a company fails to meet these requirements and is found to be in a hazardous financial condition, the Department of Banking and Insurance (Department) takes action to protect consumers and providers.  Here, the Department asked the Court to issue an Order of Rehabilitation.  The Court granted this request and issued an Order of Rehabilitation on October 19, 2016.  That Order allowed the Department to take control of the company.  The Department carefully reviewed Health Republic’s financial condition after taking control and determined that it was not possible to restore the company to a solvent position.  The Department then sought an Order of Liquidation, which was entered on February 3, 2017.
 
2. What does this mean?
  The last date that any Health Republic coverage was in effect was December 31, 2016.  To have coverage effective January 1, 2017 members had to apply for a new plan from another carrier by December.  We have reason to believe that most Health Republic members have obtained 2017 coverage from other carriers.  If you have not yet obtained new coverage, you have until March 1 to purchase an individual plan but you will have a gap in coverage.
 
3. What will happen to claims that Health Republic did not pay?  Will I be responsible for them?
  The New Jersey Life and Health Guaranty Association (Association) will pay claims directly to providers for covered services subject to a 20% reduction.  You will not be responsible to pay providers for the 20% reduction or for any other amounts unpaid by Health Republic for covered services.  If you are due money from Health Republic because you directly paid a provider's bill (in excess of your co-insurance, co-pay and/or deductible) for a covered service that should have been covered by Health Republic the Association will process your claim and pay the appropriate reimbursement to you. Please contact QualCare at 800-992-6613 or via e-mail at info@qualcareinc.com for further information on how to seek reimbursement for these claims.
 
4. What should I do if I get a bill for services that Health Republic should have covered?
  Contact the Department at 800-446-7467.  We will ask you to provide information regarding the bill so we can advise you how to proceed. 
 
5.  What if I believe I have other claims for monies owed to me by Health Republic beyond any reimbursements of amounts for medical bills paid directly to a provider?
  All parties having an interest in the liquidation of HRINJ (previous members, subscribers, policyholders, providers that have previously submitted claims, vendors and others) will be mailed Proof of Loss forms directly from the insolvency office for Health Republic on or before March 1, 2017.  All Proofs of Loss must be filed in writing pursuant to the directions on the form and must be postmarked no later than August 2, 2017, to be considered.
 
OPRA
OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
line
Adobe Acrobat
You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.
state seal
Copyright © 2011, State of New Jersey
New Jersey Department of Banking and Insurance