Community Health Options, a Lewiston-based nonprofit health insurance cooperative, trimmed its losses for its third quarter compared to last year.

The cooperative said it lost $3.3 million for the July-September period, compared to a loss of $17.3 million for the same period last year.

The cooperative lost $31 million last year stemming from an unexpected deluge of claims as clients sought care for long-delayed conditions. In its wake, CHO set aside $43 million in reserves to cover potential losses for this year. The Maine Bureau of Insurance considered legal steps to put the insurer into receivership as part of a plan to drop thousands of policyholders, but was thwarted by the federal government, which requires customers continue to be covered.

The next few months will be critical for CHO because the last half of 2015 was when its losses mounted after turning a small profit in 2014 – the only health insurance cooperative set up under the Affordable Care Act to make money that year.

Last year, thousands of CHO policyholders, many of whom had not been covered by insurance before the ACA, sought medical care and started to hit out-of-pocket limits in the last half of the year, shifting the cost of their medical care entirely to CHO.

In a statement issued by the bureau earlier this month, state insurance regulators said CHO’s financial performance for the first nine months of the year was generally consistent with a plan developed by the bureau and CHO. But the bureau said the cooperative’s fourth-quarter results will have a “significant impact” on its ability to meet the plan for the full year.

For instance, the bureau noted, CHO and state officials will need to see if claims jump in the final three months of the year, whether CHO can recover some of the claims it pays from its reinsurance coverage and if the cooperative’s expenses continue to be held in check.

The bureau did note paid claims jumped by 30.5 percent over expectations in September, but said this was due to “an increase (in) the velocity of claim payments” and that outstanding – meaning unpaid – claims dropped compared to August. The bureau said CHO also reported its claim count, submitted claims, estimated paid claims and average net submitted claims were all at the lowest monthly levels for the year in September.

CHO’s finances could be affected by a lawsuit it has filed against the federal government, seeking to recover nearly $23 million under a program designed to help offset losses suffered by insurers during the first few years of the ACA. CHO paid into the program in 2014, but says it should have received a payment under that plan because of its’ 2015 losses.

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