Overview: CoOportunity Health

Overview

CoOportunity Health is a member-governed, nonprofit health insurance company — one of 23 Consumer Operated and Oriented Plans (CO-OPs) — created by the Patient Protection and Affordable Care Act, also known as the Affordable Care Act or ACA. CO-OPs were included in the law to provide expanded marketplace competition and consumer choice.

CoOportunity Health is licensed as a health insurance company in Iowa and Nebraska and offers Qualified Health Plans (QHPs) certified by both states and the federal Centers for Medicare and Medicaid Services (CMS). All CO-OPs are recognized as tax-exempt under section (501(c)(29)) of the Internal Revenue Code We offer plans on the Health Insurance Marketplace (HealthCare.gov) for individuals, families and small businesses (1-50) qualifying for tax credits and other cost-sharing reduction. In addition, CoOportunity Health plans are available off-Marketplace for individual purchasers and employer groups of all sizes.

History

The ACA was signed into law on March 23, 2010. Section 1322 of the Act outlined the structure and governance of, as well as provided seed money for, nonprofit health insurance CO-OPs — controlled by and operated for the mutual benefit of their members. CO-OPs can operate locally, statewide, or in multiple states like CoOportunity Health, but every CO-OP board of directors must include a majority of members no later than two years after it becomes operational, ensuring the CO-OP always will meet the needs of the people it serves.

The “idea” of CoOportunity Health was pioneered in mid-2009, when our three founders, all experts in the health insurance and finance industries, began talking with one another and others about the possibility of building a different type of health insurance company. Founders Cliff Gold, Stephen Ringlee and David Lyons envisioned a health insurance cooperative that could provide low-cost coverage, additional options and be a solution to the current broken, fragmented healthcare system.

After the passage of the ACA in March 2010, the founders met again with more focus. Early in the process, they realized the CO-OP business model would require strategic business alliances to be market-ready in a relatively short period of time. Conversations with Midlands Choice and HealthPartners began. As time progressed, CoOportunity Health also established collaborations with both the Iowa and Nebraska Credit Union Leagues and the University of Iowa Health Alliance, all with one goal in mind: to provide CO-OP members with the best and broadest health plan choices available.

CoOportunity Health was officially “born” in February 2012, when approval and funding were received from the Centers for Medicare & Medicaid Services (CMS). The federal government has provided CoOportunity Health a solid financial foundation with $145.3 million in very low-interest loans: $14.7 million in start-up dollars to assist with activities associated with developing the CO-OP and $130.6 million to ensure the company’s solvency. The start-up loan must be repaid in five years and the solvency loan must be repaid, with interest, 15 years from the date of disbursement.After expenses are paid and reserves are set aside, surplus earnings are to be returned to members in the form of lower rates or better benefits.