Evergreen Still Awaits CMS Approval

Disappointing news for the ACA individual market in Maryland, and for Evergreen Health Cooperative. Evergreen is currently transitioning from a nonprofit cooperative to a for profit venture. But because Evergreen hasn't completed that transition, which requires final approval from the Centers for Medicare and Medicaid Services, the Maryland Insurance Administration had no choice but to suspend them from the 2017 individual market at the last minute. Meanwhile, Evergreen's CEO, Dr. Peter Bielenson said he hopes to finalize the conversion in April or May of 2017.

"Evergreen Health has been an exciting entrant into Maryland’s individual insurance market and an important alternative to the limited options for coverage that consumers have historically had. Therefore, Consumer Health First is disappointed that approval has not been forthcoming as yet on its request to move from a non-profit to a for-profit entity.  We hope to see that approval early in 2017.  This is critical if Maryland is to have a more competitive insurance market that works to the benefit of consumers.”  - Jeananne Sciabarra, Executive Director

United Healthcare withdrew from the MD individual market earlier this year, and now that Evergreen is suspended, that leaves only three insurers for consumers to choose from: CareFirst, Cigna and Kaiser. 

Approximately 6,000 Marylanders who currently have insurance through Evergreen Health are impacted by CMS’ delay to approve its proposed transfer to a for-profit corporation.

A few important things to know are:

  • December 15, 2016:  Consumers will be automatically transferred into either a CareFirst or Kaiser Permanente plan to ensure coverage on January 1, 2017.  
  • December 31, 2016: Those who want to pick their own plan must make their decision by the end of the year.  
  • Assistance is available at Maryland Health Connection.
  • Find a FAQ for consumers.    

For those with coverage through Evergreen:  please let us know about your experience.