State Exchanges to Offer ‘CO-OPs’


Small businesses and individuals may soon be able to approach their state’s insurance exchanges, created through the ACA, and contract with private, not-for-profit organizations that sell health insurance products like HMOs or PPOs. Called CO-OPs (Consumer Oriented and Operated Plans), these organizations are made up of a board of members and are designed to offer quality, affordable, and consumer-friendly health plans in every state.

These CO-OPs will be subject to the same rules as other insurers, with a few exceptions. CO-OPs will:

  • Give enrollees a say in the health plan. Members elect the board of directors, a majority of whom must be enrolled in the CO-OP.
  • Use profits to benefit enrollees by offering lower premiums, robust benefits, high quality health care, and expanded coverage.
  • Educate enrollees about the plan and give enrollees a choice in how the health plan is administered.

The Centers for Medicare and Medicaid Services proposed standards for CO-OPs in July. Eligible organizations interested in establishing a CO-OP will be able to apply for a portion of the $3.8 billion in repayable loans made available under the ACA to fund start-up and capitalization costs. The proposed rules can be found at www.ofr.gov/inspection.aspx.

Career Opportunities

HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

Apply via email to jfedder1@hfhs.org or online at http://p.rfer.us/HENRYFORDlXqAJA

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