Park Ridge, Ill.-based Clear Spring Health will exit the Medicare Advantage market entirely on June 1, discontinuing its remaining business across Illinois, Georgia, and Colorado.
The insurer, founded in 2017, had more than 12,000 members enrolled in its MA plans as of April, according to CMS. Coverage for those members will end May 31.
The exit marks the latest in a series of contractions for Clear Spring Health. The company exited South Carolina and Virginia at the start of 2025. In 2023, CMS terminated the company’s standalone Part D contract following three consecutive years of star ratings below three stars. CMS also imposed intermediate sanctions at that time, suspending enrollment and marketing for the plan.
In member-facing materials released this week, the company said it had “decided to exit the Medicare Advantage business” following “careful consideration.” The company noted that “systems have been restored” and that all claims through May 31 will be processed. The company said member outreach calls began May 6.
Clear Spring’s parent company, Group 1001, was fined $84,190 by CMS in May for overcharging enrollees due to claims processing errors affecting provider payment rates and plan enrollment, and for charging enrollees more than the annual maximum out-of-pocket limit due to system errors that mistracked out-of-pocket accumulations.
“The company is deeply grateful for the trust that members have placed in it over the past nine years and remains dedicated to supporting them throughout this transition,” Clear Spring said.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
