A joint fund created to stabilize health insurance costs for New York City employees and retirees is insolvent and has accrued $3.1 billion in unreported liabilities, according to a Dec. 30 audit from the NYC Comptroller. The audit found that…
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Clever Care Health Plan CEO Karen Walker Johnson, BSN, thinks her company’s edge is one that bigger insurers might have trouble replicating. That edge is Clever Care’s focus on offering “culturally sensitive Medicare options,” and it is baked into the…
New York Gov. Kathy Hochul blamed a 38% average spike in health insurance premiums for state residents on the Dec. 31 expiration of ACA enhanced premium tax credits. The average monthly increase for a New York couple is $228. Out…
CMS has lifted its enrollment freeze on Gold Kidney of Florida after state regulators restored the insurer’s ability to accept new members. The agency released its intermediate sanction on Gold Kidney’s Medicare prescription drug plan, effective Dec. 15, 2025. The…
Optum has begun reviewing Minnesota Medicaid claims as part of an enhanced prepayment audit, state officials said, as the state grapples with a widening fraud crisis in its public assistance programs. On Jan. 5, Minnesota Gov. Tim Walz said he…
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New Mexico’s health insurance marketplace has reached record enrollment, despite the expiration of enhanced federal subsidies at the end of 2025, the Albuquerque Journal reported. More than 80,400 people have enrolled for medical or dental coverage through BeWell, the state’s…
Health insurance marketplace Access Health CT is extending its enrollment window until Jan. 31 for coverage that starts in February, according to an update on its website. The open enrollment period for qualified health plans and stand-alone dental plans began…
Public safety retirees in Arizona can access broader cancer insurance benefits through a new state law clarifying eligibility. Eligible retirees include former firefighters, law enforcement officers and corrections officers. The legislation passed in the spring, but the changes were effective…
Medi-Cal no longer covers GLP-1s for weight loss as of Jan. 1. Wegovy, Zepbound and Saxenda have been removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for weight loss or weight-loss indications. The…
Enhanced ACA premium tax credits expired Dec. 31, with congressional efforts to extend them stalled and no resolution in sight. The enhanced subsidies, introduced under the 2021 American Rescue Plan Act, increased subsidy amounts and expanded marketplace eligibility to households…