IMPORTANT ANNOUNCEMENT

Friday Health Plans is being liquidated because it was insolvent and as a result of the insolvency the Wake County Superior Court (“Court”) ordered that Friday Health Plans be liquidated after a temporary period of rehabilitation to allow for members to find new health plans.  You may review the Order at this LINK.

Friday Health Plan policies were terminated effective September 1, 2023, and coverage ended at the end of day, August 31, 2023.

We have created FAQs for policyholders (LINK), healthcare providers (LINK), and agents and brokers (LINK) to provide specific guidance.  All others should follow the general guidance set forth in the following FAQs.

For all such matters you should complete the Proof of Claim form you received via mail or you may download a copy of the form at this LINK. Once completed you may submit completed Proof of Claim forms and associated documents at the following email address: fhpnc@examresources.net by secure or encrypted email only.

or you may mail the Proof of Claim form to the following:

     Friday Health Plans of North Carolina, Inc. in Liquidation

     145 N. Main St.

     P.O. Box 519 

     Stuart, VA 24171

All Proofs of Claims must be received by July 1, 2024.

All proofs of claim are due by July 1, 2024, or they are forever barred. After all proofs of claims are received the proofs of claims will be adjudicated and then the Liquidator will file a plan of distribution with the Court and distributions will be made in accordance with the approval of the Court and subject to the availability of assets in the Friday Health Plans Estate.

Yes. Covered medical services under Friday Health Plans policies will be paid for all dates of service prior to September 1, 2023, subject to the limits of the North Carolina Life and Health Insurance Guaranty Association (“Guaranty Association”).

Yes. The terms of your Friday Health Plans policy still apply.

Yes. There is a special enrollment period for members of Friday Health Plans to obtain new coverage.  If you have not already obtained new coverage you must do so by October 30, 2023, which is the last day of the special enrollment period. Your coverage will begin on the first day of the following month. For example, if you enroll in a new plan on September 23, 2023, your plan will be effective on October 1, 2023.

No. 

Yes. You may obtain a new plan through the Exchange and if you are eligible, you will receive premium subsidies.

We have provided instructions from the Exchange at this LINK, and a copy of notice you may have received from the Exchange at this LINK.  For help choosing and enrolling into a new Exchange Health Plan, you can visit this link https://localhelp.healthcare.gov and find local people to assist you. 

A special enrollment period allows you to enroll in a health plan outside of the normal open enrollment period.  The special enrollment period runs from July 2, 2023 until October 30, 2023.

Yes. Claims will continue to be subject to the terms of your Friday Health Plans policy and you may file an appeal.

No. At this time, you should follow the normal process for appeals.

You do not need to file a proof of claim with the liquidator for claims associated with medical services that are covered by your Friday Health Plans policy. The process for acceptance or denial of claims is unchanged. You may file a proof of claim for all other circumstances.  You may download the proof of claim form at this LINK.

It is unlikely you will be balance billed by a provider because in most circumstances providers are prohibited from balance billing members.

In most instances a provider is not allowed to balance bill you. If a provider does seek to collect money from you in excess of the applicable co-payment, coinsurance or deductible amount associated with your Friday Health Plans coverage you should call 844-465-5500 for help resolving the issue.

You may submit a proof of claim form, which is available at this LINK.

Yes. On December 19, 2023, we will begin the processing of mailing refund checks to Friday Health Plans’ policyholders where our records show that you overpaid the premium and there was no premium due because the policy was cancelled or terminated because of the liquidation of Friday Health Plans. The Liquidator issued premium refund checks for premiums paid in error above a de minimis amount of $10.  

If you believe that you are due a premium refund, you should file a Proof of Claim (LINK) with the Liquidator.   

If you believe that you are due an additional premium refund, you should file a Proof of Claim (LINK) with the Liquidator.

Yes. Covered medical services under Friday Health Plans policies will be paid for all dates of service prior to September 1, 2023, subject to the limits of the Georgia Life and Health Insurance Guaranty Association (“Guaranty Association”).

You should continue to follow the previous process. For more detailed information please follow this LINK.

On September 1, 2023, the Guaranty Association coverage was triggered and it will pay all covered claims subject to an overall limitation of $500,000 per individual member.

In the event you have claim for a covered service that is not paid because the limitation was reached, then you may file a Proof of Claim (LINK) for amounts that exceed the limitation. 

We are finalizing a process. We will update this FAQ once the process is finalized.

Yes. We will immediately publish notice if we update the claims process on this website.

The FHP website has contact information at this LINK.

You only need to file proof of claim for claims that exceed the Guaranty Association limitation or for claims that are unrelated to covered serviced under the Friday Health Plans insurance policies.

Determination of what constitutes a covered service under Friday Health Plans policies is same claims and appeals processes as before.

Commissions will be paid in accordance with the North Carolina law governing the priority of distributions and the availability of assets in the Friday Health Plans liquidation estate.

Friday Health Plans was insolvent and as a result the Wake County Superior Court (“Court”) ordered Friday Health Plans into receivership and ultimately into liquidation. You may read the order at this LINK.

You should file a proof of claim as soon as you can. You may download a copy of the proof of claim at this LINK.

All proofs of claim are due by July 1, 2024, or they are forever barred. After all proofs of claim are received the proofs of claim will be adjudicated and then the Liquidator will file a plan of distribution with the Court and distributions will be made in accordance with the approval of the Court and subject to the availability of assets.