Health Insurance CO-OPs
What is a Health Insurance CO-OP?
CO-OPS are new nonprofit health insurance plans created by the Affordable Care Act. CO-OP stands for Consumer Operated and Oriented Plans. These plans are now being formed, and they currently anticipate issuing health insurance policies to their customers starting January 2014.
How Will Health Insurance CO-OPs Be Structured?
CO-OPs are being set up as nonprofit organizations with a governing board representing the membership of the health plans. The goal of the program is to have at least one such CO-OP in each state. Congress set aside $3.4 billion for the government to award start-up loans to plans. Any profits generated by the plan will go to paying back the loans and to providing health benefits to the members of the plan.
Why Were CO-OPs Created?
Congress created funding for CO-OPs to foster creative health care options for health insurance shoppers and small businesses. Commercial plans are consolidating by buying other plans, which is leading to fewer choices for consumers. CO-OP supporters believe these plans can provide a valuable choice for consumers and one that can focus on new ways of providing healthcare in their communities and reach hard to serve rural populations.
Are CO-OPs Brand New?
No. Health insurance CO-OPs already exist in a few places. For example in Minnesota and Washington CO-OPs have significant membership.
How Should Consumers Evaluate CO-OPs?
CO-OPs are still being formed, but early indications are that they are focused on new and creative ways of delivering health care. If you are in a region of the country in which a CO-OP is available, it is a form of coverage you might want to consider. Be certain to review how the care is provided through the CO-OP to see if it’s right for you. If you travel frequently, also make sure you understand how care will be provided if you need it when you are outside of the CO-OP’s region of operation. Most importantly, review the physicians and facilities providing care within the CO-OP’s network as well as the premiums, cost for care and maximum out-of-pocket protections within the plan.
How HealthPocket Can Help
HealthPocket is focused on all forms of health insurance coverage, and we are especially interested in evaluating the effectiveness of new and creative entrants into the market. We can provide you:
- Fair analysis of how CO-OPs compare with other health plan choices in your area
- Quality scores for CO-OP plans
- Plan benefits that show how CO-OP plans might differ from other choices