CO-OP stands for Consumer Oriented and Operated Plan. It’s a nonprofit insurance company operated by the people it serves. CO-OP members must be a majority of the board of directors, ensuring that it will always meet the needs of the members at large.
The Affordable Care Act established CO-OPs to foster competition among health plans by providing a nonprofit alternative to current health insurance companies. Ultimately, the goal of a CO-OP is to help lower health insurance costs for individuals and families, create more competition in each state-based health insurance exchange, and expand insurance choices in markets dominated by a few insurance companies.
Montana Health CO-OP is one of the initial seven co-ops funded on February 21, 2012, as a result of the Affordable Care Act. Through a loan from the Department of Health and Human Services, we established a consumer-oriented and -operated (CO-OP) health insurance company in Montana. Today, we are focused on providing affordable health insurance plans for individuals and families throughout the state. As a local CO-OP, we are a member-controlled and -operated organization. Enrollment for our 2016 plans begins November 1, 2015 and coverage starts on January 1, 2016.
CO-OPs will help manage increasing healthcare costs in three main ways:
- Cost savings through prevention, disease management, screening, appropriate pharmacy benefits and use of high-value providers
- Enhance competition in the state health insurance exchange, which is especially important in areas currently dominated by a few insurance companies
- Greater primary care access and care coordination for members
About 20 percent of Montana’s population does not have insurance. As the Health Insurance Marketplace (the online tool to help individuals choose a health insurance plan) becomes more widely used, we will be there as a viable, affordable option for this group.
At the same time, we will not focus solely on the state’s uninsured population. We are also a competitive option for small businesses and others who currently have insurance.