Park Ridge, Illinois-based Clear Spring Health will close its Medicare Advantage (MA) business on June 1, 2026. The insurer announced it will discontinue all remaining MA plans across Illinois, Georgia, and Colorado. Moreover, coverage for all enrolled members ends on May 31. This decision marks a significant moment in the ongoing consolidation of the Medicare Advantage market.
Clear Spring Health Shuts Down MA Plans
Clear Spring Health formally announced its full exit from the Medicare Advantage market after what it described as “careful consideration.” Founded in 2017, the insurer built its operations around serving Medicare-eligible seniors through managed care plans.
The Timeline of the Decision
The company released member-facing materials this week confirming the exit. Member outreach calls began on May 6, giving enrollees limited time to arrange alternative coverage. Furthermore, Clear Spring confirmed that all claims submitted through May 31 will be fully processed. The company also noted that its systems are now restored and operational.
Who Are the Affected Members?
As of April 2026, more than 12,000 members were enrolled in Clear Spring Health’s MA plans, according to data from the Centers for Medicare and Medicaid Services (CMS). These members reside across three states: Illinois, Georgia, and Colorado.
What Members Should Expect
All enrolled members will lose their coverage effective May 31, 2026. Therefore, they must act quickly to secure new Medicare Advantage or traditional Medicare coverage. CMS typically activates a Special Enrollment Period (SEP) for members when a plan exits the market. Consequently, affected members should contact Medicare directly or consult a licensed broker to explore their available options before coverage lapses.
A Pattern of Exits and Penalties
The June 1 shutdown is not an isolated event. Instead, it is the latest step in a long series of contractions for Clear Spring Health.
State-Level Exits Before 2026
Clear Spring exited South Carolina and Virginia at the start of 2025. Those withdrawals signaled growing financial and operational pressures at the company. In addition, the insurer had already struggled to maintain the quality benchmarks CMS requires from MA plan operators.
CMS Terminates Part D Contract in 2023
In 2023, CMS terminated Clear Spring’s standalone Part D prescription drug plan contract. The reason: the insurer received star ratings below three stars for three consecutive years. CMS also imposed intermediate sanctions at that time, which suspended the plan’s enrollment and marketing activities. These sanctions effectively curtailed the insurer’s ability to grow its member base during a critical period.
What Happens to Members After May 31?
Member transitions from shuttered MA plans require immediate attention. Clear Spring Health stated that it “remains dedicated to supporting members throughout this transition.” However, members cannot afford to wait.
Steps Members Should Take Now
- Contact Medicare at 1-800-MEDICARE to confirm a Special Enrollment Period eligibility.
- Compare available MA plans and traditional Medicare options in their area.
- Review prescription drug coverage to avoid any gap in access to medications.
- Reach out to a licensed Medicare counselor or SHIP (State Health Insurance Assistance Program) for free, unbiased guidance.
Acting early ensures members avoid a coverage gap when June 1 arrives. Additionally, members should gather all documentation of current care providers and ongoing treatments to share with their new insurer.
CMS Fines Parent Company Group 1001
Clear Spring Health’s parent company, Group 1001, also faces regulatory consequences. In May 2026, CMS fined Group 1001 a total of $84,190 for two distinct violations.
Details of the Compliance Failures
First, CMS cited Group 1001 for overcharging enrollees due to claims processing errors. These errors affected provider payment rates and plan enrollment data. Second, the company charged enrollees more than the annual maximum out-of-pocket limit. This occurred because system errors caused the plan to incorrectly track out-of-pocket spending accumulations. Both violations directly harmed enrollees financially and represent serious lapses in compliance with CMS standards.
What This Means for the MA Market
Clear Spring Health’s exit reflects broader stress across the Medicare Advantage landscape. Several regional and mid-size MA plans have struggled to remain viable amid rising medical costs, lower reimbursement rates, and stricter CMS quality requirements.
A Broader Industry Trend
Larger national insurers such as UnitedHealth and Humana have also reported significant losses in their MA businesses in recent quarters. As a result, smaller regional payers face even greater pressure to maintain thin margins without the scale advantages of national carriers. The Clear Spring closure, therefore, is not an outlier — it is part of a broader pattern of MA market consolidation.
Implications for Seniors and Policymakers
Every MA plan exit disrupts care continuity for vulnerable seniors who depend on coordinated coverage. Policymakers and CMS must balance plan accountability with market stability. Otherwise, repeated exits will erode trust in the MA program and push more beneficiaries back to traditional fee-for-service Medicare, often at higher out-of-pocket costs.
