Health Republic Closing FAQs Archives – Health Republic Insurance of Oregon

No Health Republic Insurance Company health policies remain in effect. Health Republic will continue to pay claims for covered services that were provided while policies were valid.

We are grateful to all the members, partners, staff, board directors, vendors, and others who have been supportive and remain determined to pursue the mission of affordable access to high quality healthcare for all. It was an honor to work with you.


General Information

Not covered yet for 2016?

If you are an individual (not part of a company group) and have not yet purchased 2016 coverage you can enroll at during Open Enrollment through 1/31/16. is the only place to apply for subsidies that help you pay your insurance premiums. If you need help we strongly recommend using a health insurance broker in your area.

If you get your health insurance as a benefit of employment and aren’t sure about your 2016 coverage please ask your HR contact.


To avoid a penalty at tax time you will need a 1095 form showing you had at least 9 months of coverage in 2015. If you were enrolled with us during calendar year 2015 we will send you a 1095-B by January 31, 2016, which will include all months you were covered by Health Republic (both directly with us and through the exchange). If you enrolled through the federal exchange ( the exchange will send you a 1095-A with the months you were covered through the exchange. If you were enrolled directly for part of the year and through the exchange for part of the year you will receive two forms, one from us and one from the exchange.

The form you receive from us will have all months you had health insurance coverage with Health Republic Insurance.

When you receive your 1095-B please review it for accuracy. If you believe the information on your 1095-B is inaccurate or you did not receive one and think you should have, please give us a call at 888-990-6635 and select option 3. KEEP A COPY OF YOUR 1095 FORMS.

You can see what the form 1095-B looks like here: 365-560-4201 For more information, visit the IRS website here: / or talk to your tax professional.


Call 888-990-6635 during our business hours which are 8AM – 5PM. For general questions during business hours, press option 4, you may need to leave a message but we will get right back to you. If you would prefer to contact us via email, please use Please do not send us any personal identifiable information or medical information via email.


  1. 1) For questions related to claims, EOBs, or bills you received from a provider for services received in 2015, please call 888-990-6635 and press option 1 during business hours.
  2. 2) For questions related to your 1095 tax forms, please call 888-990-6635 and press option 3 during business hours.
  3. 3) For all other questions related to eligibility in 2015, payments you may still owe for premiums, or premium refund questions, press option 4.


  1. 1) If you are a provider and have a question regarding a date of service in 2015 or earlier for a Health Republic Insurance member, please call 888-990-6635 and press option 2 during business hours.


  1. 1) If you have questions related to commissions or any other questions for Health Republic, please call 888-990-6635 and press option 4 during business hours.

Closure Announcement FAQ

Why is Health Republic Insurance closing?

When we designed health plans our goal was to ensure that even Oregonians with medical issues could afford treatment without becoming medically bankrupt. We believed we could do this because the federal government guaranteed that if we attracted more than our fair share of medical expense we would recoup some funds through a program known as the “risk corridor.”

In 2014 and 2015 we had medical expenses that exceeded the amount of money we received in premiums and we have been waiting for the government to meet its obligations. In October 2015 the government announced it would only pay 12.6% of the money owed through the risk corridor program and failed to commit to a timely 2015 payment. As a new and small insurance carrier this placed us in an unstable position. As a result of the government not following through on its promise of payment, we realized the best course of action for Health Republic is to refrain from offering 2016 plans and avoid the significant threat of failing in the middle of 2016, causing vast disruption to members and providers.

What does this mean for my insurance coverage?

Individual and Small Group Insurance coverage for all Health Republic members will continue uninterrupted through the end of 2015. Health Republic will continue processing all claims for 2015 and members can continue to use their insurance coverage as they have all year. As always, you will need to pay premiums in accordance with plan rules for your coverage to remain in effect.

Individual members will be able to choose a new insurance provider for 2016 during the next open enrollment period, which begins on November 1, 2015. We will not continue servicing any individual plans in 2016.

Existing Health Republic small group plans also remain in effect through 12/31/2015. We will not issue any new small group plans nor can we renew policies that are up for renewal December. All small groups must move to new coverage as of 1/1/2016. Additional information is available on our website:

What do I need to do?

When Open Enrollment starts on November 1, 2015 individual members should choose a new health care policy with a different carrier to begin coverage on January 1, 2016. A broker can help you enroll with a new carrier for a 2016 plan. If you are eligible to receive subsidies and/or cost-sharing you must enroll through the exchange.

If you are insured through your employer we will be reaching out to your small group administrator with additional information soon.

I think it’s terrible that the government is penalizing health insurance plans that played by all the rules of the ACA and relied on the risk guarantees. Who should I complain to?

You can let Oregon’s congressional representatives know that you are disappointed in their failure to honor their obligations. Here is a sample message:

Congress passed the Affordable Care Act and called on new, smaller regional health plans like Health Republic Insurance to take on big risks by covering previously uninsured people. Congress knew there were risks. That’s why they set up a federal program to protect new health plans. They promised to pay these health plans for helping people get insurance. Now the Feds are backing out on their promise and owe billions to smaller competitive health plans across the country.

  • On Oct. 1, the Feds informed health insurance plans across the country they would not be receiving billions of dollars owed to them this year.
  • The Feds are jeopardizing the stability of local and regional health plans that did their part.
  • Health Republic Insurance is owed over $20 million in “risk corridor” payments for helping more people get health insurance coverage.
  • The payment of only 12.6% of the 2014 risk corridor and uncertainty about the 2015 risk corridor dealt a lethal blow to Health Republic Insurance leaving nearly
  • 15,000 Oregonians without their preferred insurance provider

Health Republic Insurance did their part. We are mad that congress reneged on their obligation and caused the failure of a public-minded regional carrier.


Lake Oswego, Ore. (Oct. 16, 2015) – Health Republic Insurance, a non-profit health insurance carrier, announced today that it will not offer small group or individual plans on or off exchange in 2016. All current Health Republic individual and small group policies remain in full effect through the end of 2015. Members can continue to see plan providers and claims will be paid under plan terms.

The federal government recently announced it would pay insurance companies only 12.6% of their risk corridor receivable for the 2014 plan year and has created industry-wide concern about when, or if the 2015 risk corridor would be paid.

“Since our inception in 2013, Health Republic designed and priced all our plans in reliance upon the risk sharing guarantees of the Affordable Care Act (ACA). The government’s refusal to honor its risk corridor obligations represents a negative financial impact of over $20 million,” said Health Republic president and CEO Dawn Bonder. “This has placed us in a difficult financial position that could jeopardize our members and partners. As a result, we believe the most ethical step is for Health Republic to refrain from entering the market in 2016 and begin an orderly wind down of business.”

Health Republic will work with the Oregon Insurance Division (OID) to ensure a smooth transition for members, employers, providers, partners and staff. The company will pay all claims through 2015 and plans to fulfill all financial obligations.

Health Republic has offered individual and small group insurance statewide, on and off exchange, for 2014 and 2015. Currently the plan serves nearly 15,000 members including employees from over 800 small businesses in Oregon.

Health Republic advises all individual policy holders to shop for new plans when Open Enrollment begins Nov. 1, 2015.

About Health Republic Insurance

Unlike traditional health insurance companies, Health Republic is a 501(c)(29) private non-profit governed by its members, and by law must reinvest all profits back to its programs, including providing better care and lower costs for members. Health Republic provides access to health care in all parts of Oregon through the statewide Providence Network. This partnership offers members an extensive group of providers, practitioners, and facilities, including 60 hospitals and thousands of providers, labs, imaging locations and physician clinics throughout Oregon and SW Washington.