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Life Health > Health Insurance

Surviving PPACA CO-OPs may have 475,000 enrollees

By Allison Bell

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A new group of nonprofit, member-owned health insurers may now be providing coverage for about half a million Americans.

See also: Feds: PPACA Multi-State Plans really do exist

The U.S. Department of Health and Human Services (HHS) has released little information about the insurers organized using the Consumer Operated and Oriented Plan Program (CO-OP), a component of the Patient Protection and Affordable Care Act of 2010 (PPACA).

The HHS Office of Inspector General (HHS OIG), an agency that keeps tabs on HHS, put CO-OP financial information in a CO-OP report posted Thursday.

See also: Watchdog: CMS is giving 4 CO-OPs’ finances extra attention

One of the 23 CO-OPs, CoOportunity Health, shut down in 2014. Another CO-OP, Louisiana Health Cooperative Inc., has said it has decided to close down in December.

The 22 CO-OPs that are still in business today ended 2014 with about 475,000 major medical enrollees, up from none a year earlier, according to an analysis based on the HHS OIG data, and on a collection of CO-OP financial information that analysts at Standard & Poor’s Ratings Services posted in February, 

HHS awarded the 22 surviving CO-OPs about $2.3 billion in PPACA startup loan funding, or about $4,800 per first-year enrollee.

Many new companies, including new health insurers, lose money during their first year of operation.

The 22 surviving CO-OPs lost a total of about $375 million in 2014 on $1.7 billion in 2014 premium revenue, according to HHS OIG. At the end of the third quarter, they had about $553 million in surplus, according to S&P. As a group, the plans lost an amount equal to about 68 percent of their combined third-quarter surplus.

The plans lost an average of about $800 per enrollee for all of 2014 on about $3,500 in 2014 premium per 2014 enrollee.

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