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The Center for Consumer Information & Insurance Oversight

 

Loan Program Helps Support Customer-Driven Non-Profit Health Insurers

The Affordable Care Act creates a new type of private nonprofit health insurer, called a Consumer Operated and Oriented Plan, or "CO-OP." CO-OPs are directed by their customers and designed to offer individuals and small businesses additional affordable, consumer-friendly and high quality health insurance options.

The CO-OP program offers low-interest loans to eligible nonprofit groups to help set up and maintain these issuers. This page includes awards for initial funding which has resulted in a current CO-OP option for consumers in 23 states, as well as funding for four of the current CO-OPs planning to expand operations into a neighboring state to offer coverage in 2015.  

Beginning January 1, 2014, CO-OPs, are offering health plans through the new Health Insurance Marketplace, as well as outside the Marketplace.

CO-OP loans are only made to private, nonprofit entities that demonstrate a high probability of financial viability. All CO-OPs receiving loans were selected by CMS on a competitive basis based on external independent review by a multi-disciplinary team. As CO-OPs meet or exceed developmental milestones, funds are allowed to be incrementally drawn down.

CMS continues to monitor CO-OPs to ensure they are meeting program goals and will be able to repay loans. To ensure strong financial management, CO-OPs are required to submit quarterly financial statements, including cash flow and enrollment data, receive site visits, and undergo external audits. This monitoring is concurrent with the financial and operational oversight by state insurance regulators.

For more information on CO-OPs, including what federal loans were available, who could apply and licensing requirements, please visit: http://cciio.cms.gov/resources/factsheets/coop_final_rule.html

Detailed below is updated information about the awardees:

Compass Cooperative Mutual Health Network, Inc. d/b/a Meritus Health Partners
Service Area:
Arizona
Award Amount: $93,313,233
Award Date: June 7, 2012

Compass Cooperative Health Network (CCHN) is sponsored by prominent local experts in insurance, chronic disease coordination, use of health information technology to better coordinate care, and business startup. Compass Cooperative Health Network (CCHN) plans to offer health insurance coverage statewide over time in Arizona.

Colorado Health Insurance Cooperative, Inc. (CHI) d/b/a Colorado HealthOp
Service Area: Colorado
Award Amount: $72,335,129 (includes additional start-up funding of $2,939,129 awarded to Colorado Health Insurance Cooperative on October 18, 2013)
Award Date: July 23, 2012

The Colorado Health Insurance Cooperative, Inc. (CHI) is sponsored by the Rocky Mountain Farmers Union Educational and Charitable Foundation, Inc. (RMFU Foundation), which houses educational and outreach programs, and a regional cooperative development center. A significant component of CHI's plan is to create chapters in communities throughout the state in an effort to fully engage members in the business of the CO-OP. CHI intends to offer benefit plans designed for individuals and employers inside and outside the Colorado Health Benefit Exchange. The CO-OP is committed to offering a qualified health plan at the Silver and Gold benefit levels in both the individual and Small Business Health Options Program (SHOP) Exchange markets. CHI also plans to offer at least one Value Based Plan (VBP) in the small group market. CHI is planning on marketing its insurance plans on a state-wide basis.

HealthyCT, Inc. d/b/a HealthyCT
Service Area: Connecticut
Award Amount: $127,980,768   (includes additional start-up funding of $3,752,768 awarded to Healthy CT on November 5, 2013) and additional solvency funding of $48,427,000 awarded to Healthy CT on September 26, 2014)
Award Date: June 7, 2012

HealthyCT is sponsored by the Connecticut State Medical Society (CSMS) and the CSMS-IPA (a statewide Independent Practice Association), and plans to offer high-quality, coordinated medical care with strong physician-patient relationships at its foundation. HealthyCT will encourage the use of patient-centered medical homes in providing health insurance coverage statewide.

Land of Lincoln Health Mutual Health Insurance Company (formerly Metropolitan Chicago Healthcare Council CO-OP) d/b/a Land of Lincoln Health
Service Area: Illinois
Award Amount: $160,154,812
Award Date: December 21, 2012
Land of Lincoln Health intends to offer health plans throughout the State of Illinois that facilitate the delivery of efficient, evidence-based medical care through a consumer-focused and innovative health care delivery model. The CO-OP is sponsored by The Metropolitan Chicago Healthcare Council (MCHC). MCHC is a membership and service association comprising more than 150 hospitals and health care organizations working together, since 1935, to improve the delivery of health care services.

CoOportunity Health (formerly Midwest Members Health)
Service Area: Iowa and Nebraska
Award Amount: $145,312,100, (which includes an additional solvency funding of $32,700,000 awarded to CoOportunity Health on September 26, 2014)
Award Date: February 17, 2012

CoOportunity Health is sponsored by the Iowa Institute, a community organization. The CO-OP provides health insurance coverage throughout Iowa and Nebraska.

Kentucky Health Care Cooperative
Service Area: Kentucky and West Virginia
Award Amount: $81,494, 772 (includes additional start-up funding of $2,492,590 awarded to Kentucky Health Care Cooperative on December 11, 2013, and $20,170,682 in expansion funding awarded November 26, 2013)
Award Date: June 19, 2012

Kentucky Health Care Cooperative is sponsored by a coalition of business leaders, providers and community organizations who plan to improve health outcomes throughout the Commonwealth of Kentucky by providing better access to high quality care at an affordable cost.  The CO-OP has partnered with the Health CO-OP of West Virginia, a nonprofit organization that currently does not participate in the CO-OP Program and is sponsored by the West Virginia Primary Care Association.  It plans to expand its service area to offer statewide coverage in West Virginia starting in 2015.

Louisiana Health Cooperative, Inc.
Service Area: Louisiana
Award Amount: $65,790,660 (includes additional start- up funding of $750,000 awarded to Louisiana Health Cooperative, Inc. on December 17, 2013)
Award Date: September 27, 2012

Louisiana Health Cooperative, Inc. (LAHC) is sponsored by a coalition of providers and business leaders, including Ochsner Health System, who plan to improve health outcomes by providing better access to high quality care at an affordable cost. LAHC plans to provide statewide coverage in Louisiana with the mission of serving their members by promoting and supporting the delivery of integrated healthcare in each of their products and services. LAHC will participate in individual and small group markets in the health insurance Marketplace.

Maine Community Health Options (MCHO)
Service Area: Maine and New Hampshire
Award Amount: $132,316,124 (includes additional start-up funding of $2,586,124 awarded to Maine Community Health Options on July 19, 2013 and combined additional solvency funding and expansion funding of $67,630,000 awarded to Maine Community Health Options on September 26, 2014)
Award Date: March 23, 2012

Maine Community Health Options is sponsored by Maine Primary Care Association, which is a membership organization comprised of Maine's community, tribal, migrant, and homeless health centers.  The CO-OP currently provides statewide coverage in Maine.  Maine Community Health Options intends to provide health insurance coverage statewide in New Hampshire starting in 2015.

Evergreen Health Cooperative Inc.
Service Area: Maryland
Award Amount: $65,450,900
Award Date: September 27, 2012

Evergreen Health Cooperative, Inc. (Evergreen) plans to provide high quality, affordable care to Maryland residents while pioneering innovative forms of healthcare delivery. Evergreen intends to provide health insurance coverage statewide and in the Maryland Health Benefit Exchange.

Minuteman Health, Inc.
Service Area: Massachusetts and New Hampshire
Award Amount: $156,442,995 (includes additional start-up funding of $2,135,125 awarded to Minuteman Health, Inc on November 22, 2013, and $65,809,790 in expansion funding awarded on December 12, 2013)
Award Date: August 13, 2012

Minuteman Health, Inc. (MHI) is sponsored by Tufts Medical Center and Vanguard Health Systems, two hospital systems that intend to participate in the MHI network. MHI's mission is to deliver efficient, quality healthcare financing to their future membership. They propose to initially provide regional coverage in eastern and central Massachusetts and expand to offer statewide coverage by July 2014. The CO-OP plans to provide statewide coverage in New Hampshire starting in 2015.

Michigan Consumer's Healthcare CO-OP
Service Area: Michigan
Award Amount: $71,534,300
Award Date: May 17, 2012

Michigan Consumer's Healthcare CO-OP is sponsored by a coalition of 15 county health plans, which are private, non-profit corporations that provide a limited health coverage benefit to low-income individuals in Michigan. Michigan Consumer's Healthcare CO-OP plans to provide health insurance coverage statewide.

Montana Health Cooperative
Service Area: Montana and Idaho
Award Amount: $85,019,688 (includes $26,881,388 in expansion funding awarded on November 22, 2013)
Award Date
Award Date: February 17, 2012

Montana Health Cooperative is sponsored by a coalition of small businesses and community leaders and plans to add a strong primary care capacity to Montana's rural and medically underserved communities. Montana Health Cooperative will provide health insurance coverage statewide. The CO-OP plans to provide statewide insurance in Idaho starting 2015.

Nevada Health Cooperative (formerly Hospitality Health CO-OP)
Service Area: Nevada
Award Amount: $65,925,396
Award Date: May 17, 2012

Nevada Health Cooperative is sponsored by the Culinary Health Fund, its national parent Unite HERE Health, and the Health Services Coalition. Nevada Health Cooperative will operate for everyone in the Marketplace in the individual and small group markets. Nevada Health Cooperative plans to provide health insurance coverage statewide.

Freelancers CO-OP of New Jersey d/b/a Health Republic Insurance of New Jersey
Service Area: New Jersey
Award Amount: $109,074,550 (includes additional start-up funding of $1,861,250 awarded to Freelancers CO-OP of New Jersey on November 22, 2013)
Award Date: February 17, 2012

Freelancers CO-OP of New Jersey is sponsored by Freelancers Union, an association of independent workers that is partnering with providers with an innovative and effective Patient-Centered Medical Home model. Freelancers CO-OP of New Jersey will provide health insurance coverage statewide.

New Mexico Health Connections
Service Area: New Mexico
Award Amount: $77,317,782 (includes additional start-up funding of $5,441,589 awarded to New Mexico Health Connections on June 28, 2013 and additional start-up funding of $1,511,693 awarded on December 18, 2013 )
Award Date: February 17, 2012 

New Mexico Health Connections is sponsored by a coalition of community groups, business leaders, and providers. The CO-OP plans to work with their provider community to improve health outcomes in all 33 counties of New Mexico.

Freelancers Health Service Corporation d/b/a Health Republic Insurance of New York
Service Area: New York
Award Amount: $265,133,000, (includes additional solvency funding of $90,688,000 awarded to Health Republic Insurance of New York on September 26, 2014)
Award Date: February 17, 2012

Freelancers Health Service Corporation is sponsored by Freelancers Union, an association of independent workers whose model is driven by a focus on providing high quality, consumer oriented coverage and financial sustainability that emphasizes the use of patient-centered medical homes. Freelancers Health Service Corporation will provide health insurance coverage throughout New York State.

Coordinated Health Mutual, Inc. (Formerly Coordinated Health Plans of Ohio, Inc.) d/b/a InHealth Mutual
Service Area: Ohio
Award Amount: $129,225,604
Award Date: October 12, 2012

Coordinated Health Mutual, Inc. (CHM-OH) plans to provide statewide coverage in Ohio with the mission of offering health insurance that delivers high quality, affordable health care to citizens throughout the state.

Freelancers CO-OP of Oregon d/b/a Health Republic Insurance of Oregon
Service Area: Oregon
Award Amount: $60,648,505 (includes additional start-up funding of $1,161,005 awarded to Freelancers CO-OP of Oregon on November 15, 2013)
Award Date: February 21, 2012

Freelancers CO-OP of Oregon, sponsored by Freelancers Union, is partnering with providers that have an extensive integrated primary care model that will be a strong asset to this CO-OP. Freelancers CO-OP of Oregon will provide health insurance coverage statewide.

Oregon's Health CO-OP (Formerly Community Care of Oregon)
Service Area: Oregon
Award Amount: $56,656,900
Award Date: March 23, 2012

Oregon's Health CO-OP is sponsored by CareOregon, a non-profit Medicaid Managed Care Organization. Oregon's Health CO-OP will apply its CO-OP loans to participate in the state's new Health Insurance Exchange marketplace. They plan to provide coverage statewide.

Consumers' Choice Health Insurance Company (CCHIC)
Service Area: South Carolina
Award Amount: $87,578,208
Award Date: March 27, 2012

Consumers' Choice Health Insurance Company is sponsored by a dedicated team of volunteers from not-for-profit organizations, member-driven employer groups and business advocates with expertise in the South Carolina health care and insurance markets.

Community Health Alliance Mutual Insurance Company
Service Area: Tennessee
Award Amount: $73,306,700
Award Date: August 29, 2012

Community Health Alliance Mutual Insurance Company (CHA) is sponsored by Healthcare 21 Business Coalition (HC21), a member of the National Business Coalition on Health, and LBMC Employment Partners (LBMS), a professional services organization providing financial, accounting services, and Professional Employer Organization (PEO) services to small employers in Tennessee. CHA's mission is to create new health insurance options expected to meet the medical, wellness, and financial needs of insurance consumers in Tennessee. CHA is planning on offering its insurance plans state-wide.

Arches Mutual Insurance Company (Formerly Arches Community Healthcare)
Service Area: Utah
Award Amount: $89,650,303 (includes additional start-up funding of $4,250,000 awarded to Arches on September 6, 2013)
Award Date: July 6, 2012

Arches Mutual Insurance Company is supported by the Association of Utah Community Health, the Salt Lake City Chamber, and the Utah Health Policy Project. This CO-OP will participate in the individual and small group market Exchanges with the mission of transforming the nature of insurance payments and benefits to promote high-quality, patient-centered, integrated, and value-based care in Utah.

Common Ground Healthcare Cooperative
Service Area: Wisconsin
Award Amount: $85,071,455 (includes additional start-up funding of $204,855 awarded to Common Ground Healthcare Cooperative on December 17, 2013 and additional solvency funding of $28,450,000 awarded to Common Ground Healthcare Cooperative on September 26, 2014)
Award Date: February 17, 2012

Common Ground Healthcare Cooperative is sponsored by Common Ground, a community organization in Wisconsin that represents almost 100 small businesses, churches, unions, colleges, and community groups. Beginning its operations in southeastern Wisconsin, Common Ground Healthcare Cooperative will provide health insurance coverage throughout Wisconsin within five years.

Updated on: September 26, 2014