ACA Government Co-Ops: Is This Experiment Working In Your State?

[AllenChicago]

Well one just bit the dust...

IOWA only has this Coop and another company on Exchange and the Coop folds? This is distressing news. I started steering people away from our Coop last week after seeing similar fractures occurring within Land of Lincoln Health.

 

[somarco]

Co-ops are inherently risky, even more so under the constraints of Obamacare.

The NY based Freelancers Union took $340 million in Obamabucks to expand their operation which was established in 2003. Makes you wonder why an almost 10 year old company needed taxpayer dollars.

It seems that Sarah Horowitz, founder of Freelancers, is not without her detractors.

 

[ctg]

IOWA only has this Coop and another company on Exchange and the Coop folds? This is distressing news. I started steering people away from our Coop last week after seeing similar fractures occurring within Land of Lincoln Health.

We only had Coventry and CoOp statewide. Avera and Gunderson are small regionals only available in a few counties.

 

[AllenChicago]

I had to send a list of the people I enrolled in our Land of Lincoln Coop this week because the system that ties agents to applicants was never built...after 2 years!

I wish Land of Lincoln would just fold up and go away like Nebraska and Iowa had the good common sense to do. Looks like nothing but troubled waters ahead for my Coop clients...and of course, their agent.

ac

 

[AllenChicago]

These Cooperatives are supposed to be owned by the premium paying members. One of them is going to see if they are granted access to the financials of our state's LOLH.

 

[somarco]

These Cooperatives are supposed to be owned by the premium paying members

I wondered how they were structured. If chartered as an insurance company policyholders would have access (indirectly) to state guaranty funds. But if they are a true co-op or something like a fraternal organization where members have certificates (not policies) then there really aren't any guarantees.

 

[VolAgent]

I wondered how they were structured. If chartered as an insurance company policyholders would have access (indirectly) to state guaranty funds. But if they are a true co-op or something like a fraternal organization where members have certificates (not policies) then there really aren't any guarantees.

Hopefully for their insureds they went with the mutual structure. While the company folding might cause a SEP, someone has to be able to pay the claims already incurred.

 

[RayNY]

I wondered how they were structured. If chartered as an insurance company policyholders would have access (indirectly) to state guaranty funds. But if they are a true co-op or something like a fraternal organization where members have certificates (not policies) then there really aren't any guarantees.

"Article 43, HMO, Commercial, Municipal Coop, or Fraternal Benefit Society: Commercial"

As per HRINY's official filings.

FYI, Freelancers took 340M in NY, 109M in NJ, and 60M in OR. They used this half a billion dollars to establish new companies in these 3 sates under the Health Republic name. Freelancers just used their political clout and experience to get the contracts. Funding was not used to expand their current offerings, they just didn't have a different name to file under at the time. Freelancers is still around, Health Republic is something separate and distinct.

Sara Horowitz is hands-off when it comes to HRINY. They got the funding, got the filings, established the company, and then brought in a team to man the ship.

 

[AllenChicago]

1-6-2015

Our Land of Lincoln (LOL) cooperative just changed their out-of-network Out of Pocket from $13,200 to UNLIMITED $$$!

The SOB showed $13,200 last week and now says "Unlimited". I know that as an arm of our lawless government, these Cooperatives can do whatever they want, but getting rid of the Max OOP limit? ACA sets the max OOP.

Gosh I wish they weren't the lowest price Illinois carrier this year.

 

[Yagents]

ACA sets the IN-network OOP.

HMO's have no out of network coverage.......so what's the difference?