Contact: Liz Martins, Public Information Officer 
Phone: (775) 687-0772
E-mail: emartins@doi.nv.gov   

FOR IMMEDIATE RELEASE – Friday, June 2, 2023  

Nevada Division of Insurance provides guidance for Friday Health Plans of Nevada members

 

Summary of what has happened:

On June 1, 2023, Nevada Insurance Commissioner, Scott Kipper, filed legal action with the Nevada District Court to place Friday Health Plans of Nevada under regulatory supervision (referred to as a receivership) due to growing concerns about the reliability of Friday’s financial reporting to the Division.

This action will allow the Commissioner to assume oversight and management of the day-to-day operations of the company, while performing a thorough financial analysis.

Policyholders’ contracts will remain in effect and members will need to continue to pay their premiums in accordance with the terms of their policies to ensure there is no disruption to their coverage. 

Once the court approves the receivership, the Commissioner will appoint a Special Deputy Receiver (SDR) to communicate with policyholders during the receivership process.

Information may also be accessed through the Nevada Division of Insurance website at doi.nv.gov or by calling the Division of Insurance at (888) 872-3234.

The Division of Insurance offers the following guidance for FHP-N members:

Question #1: Is FHP-N still in business?

Yes. The company will be placed into a conservation receivership; however, it is not writing new or renewing policies at this time.

Question #2: What does receivership mean?

A receivership is a court proceeding similar to a bankruptcy proceeding.  A company can continue to operate in receivership.  A company can come out of receivership, or it can be shut down.  In a receivership, the Commissioner is appointed the Receiver of the insurance company. The Receiver takes over the troubled insurance company to conserve or rehabilitate it for the protection of its members, providers, and the public. Under the Receiver, a Special Deputy Receiver (“SDR”) is appointed to handle the day-to-day administration of the company. 

A conservation receivership allows the Receiver to analyze the company’s operations and financial situation in order to determine the best option for policyholders and creditors—either by rehabilitating the company, liquidating the company, or returning the company to private management. 

A rehabilitation receivership results in a plan to adjust company operations that led to the receivership.  

If it is determined that there is no way to correct the deficient operations, the court can order liquidation.  In liquidation, the company’s assets are sold, debts are paid, and the company is closed. 

The Commissioner is requesting that FHP-N be placed in a conservation receivership at this time.

Question #3: Why was it necessary to place FHP-N in receivership?

Friday Health grew very fast and needed additional capital in order to sustain the growth. It was unable to secure additional capital. A receivership allows the Receiver to protect the capital and assets to ensure funds are paid out by priority—in Nevada, policyholder claims are one of those priorities  

Question #4: Do I still have health insurance? 

Yes.  FHP-N’s health insurance is still in effect.  If anything changes, the SDR will notify all members. 

Question #5: Do I need to keep paying my premiums?

Yes. Members will need to continue to pay their premiums in accordance with the terms of their policies.

Question #6: Can my doctor or other provider refuse to see me because I have a 2023 FHP-N health insurance policy?

Members can continue to see plan providers (your doctors, hospitals, pharmacies, etc.) under the terms of their policies. If you believe that your provider is refusing to honor their network agreements, please inform FHP-N (see Question #14.)

Question #7: Who should I contact for problems with my EXISTING claim?

Contact FHP-N. Refer to Question #14 for contact information.

Question #8: What should I do if I currently have a claim check that was issued for a claim on an FHP-N policy?

You should cash the check or deposit it with your bank.

Question #9: I received a bill from the doctor, what should I do?

Claims should be submitted to FHP-N in the same manner via the website portal. Refer to Question #14 for contact information.

Question #10: I have moved since submitting my claim; how do I update my address?

Contact FHP-N. Refer to Question #14 for contact information.

Question #11: I have a surgery approved and scheduled in 2023, will it still happen?

At this time your coverage will continue under the terms of your policy.

Question #12: Can I renew, make changes, or add coverage to my FHP-N coverage?

No renewals or new policies will be issued.

Question #13: Can I change insurance companies right now?

Not at this time unless you have a qualifying event. The Patient Protection & Affordable Care Act allows individuals to get new insurance coverage because of a qualifying event or during open enrollment, which begins on November 1, 2023, and continues through January 15, 2024.  For more information, contact the Nevada Health Link. 

Question #14: How can I contact FHP-N?

Friday Health Plans of Nevada
Phone: 844-535-2000, Monday-Friday 8 a.m. – 5 p.m. PT
Email: questions@fridayhealthplans.com
Website: https://www.fridayhealthplans.com

Question #15: How do I keep up with what is going on in the receivership?

Once the court orders the receivership, a website will be set up with all of the information related to the receivership. 

Guidance For Producers:

Question #1: Can I switch my individual clients to a different carrier now?

On-exchange individuals are not able to switch at this time unless they have a qualifying event or there is a special enrollment. Generally, changes in insurance providers for on-exchange individuals must occur during open enrollment, which begins on November 1, 2023, and continues through January 15, 2024.  For more information, contact the Nevada Health Link. 

 
Question #2: Can I switch my group clients to a different carrier now?

Yes.  The small group market is not subject to the open enrollment requirements. 

Guidance For Providers:

Question #1: Do I have to continue to see patients with a FHP-N policy?

Yes. FHP-N is still operating in Nevada and the network contracts between FHP-N and providers are in effect. 

Question #2: Will I be paid for services rendered to patients with an FHP-N policy?

Yes. FHP-N is still operating in Nevada and the network contracts between FHP-N and providers are in effect. 

Question #3: Do the federal and state surprise billing laws apply?

Where applicable, these laws continue to apply until FHP-N coverage ends.

Question #4: How should I file claims?

You should continue to file claims in the same way as before.

These FAQs will be updated as information becomes available.

About the Nevada Division of Insurance

The State of Nevada Division of Insurance, a Division of the Nevada Department of Business and Industry, protects the rights of Nevada consumers and regulates Nevada’s $22 billion insurance industry. The Division of Insurance has offices in Carson City and Las Vegas. For Fiscal Years 2021 and 2022, the Division investigated 5,062 consumer complaints, answered approximately 25,000 inquiries, and recovered over $8 million on behalf of consumers. For more information about the Division of Insurance, visit DOI.NV.GOV and follow us on our social media channels: Twitter | Facebook | LinkedIn | Instagram.

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