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New Choice for Uninsured: Co-Ops

Low-cost health plans run by cooperatives are among new options for the uninsured, say insurance executives and health care experts.

“It’s cost-effective coverage that people never had before,” said Eboni Britt, the marketing manager of the benefits administrator POMCO Group, which coordinates the sale of Syracuse’s new co-op insurance.

The Affordable Care Act’s health coverage mandate created opportunities for more insurance providers in the market.  Under the law, co-ops, or “Consumer Oriented and Operated Plans,” are meant to fuel competition through bargain prices. Consumers can buy the co-op or other insurance through the online exchanges created by the law.

For Syracuse, the exchange offers one co-op: The Health Republic Insurance of New York. It has the lowest health insurance rates in Syracuse — $291.14 a month compared to an average of $420.56, for a similar plan, according to the exchange. Other co-op plans are available through the exchange, but this specific option is available to only New Yorkers.

The Health Republic Insurance option was created by the Freelancers Union, an association of freelance workers that offers insurance to its 200,000 members. The union received $174.4 million from the government to set up the co-op in New York. It is run separately from the union and anyone is eligible to buy its insurance.

People have been eager to enroll because of its low prices, said Eboni Britt, POMCO’s marketing manager. “Anytime you can offer new options that are inexpensive, people are going to be interested,” she said.

But some experts have expressed concern about the new co-ops. The Syracuse insurance market is dominated by three providers: Excellus BlueCross BlueShield, American Progressive and New York Fidelis. All are long-established.

But newcomers like the co-ops don’t yet have a track-record, said James Coulthart, executive vice president of the Onondaga County Medical Society, the professional organization for doctors. He encourages potential buyers to be thorough in research before buying.

“It’s a very credibility-based service that they’re providing,” he said.

A small network could also hurt the co-op’s chances in the market, Coulthart said. Both Crouse Hospital and Upstate University Hospital accept Health Republic Insurance. But not all of their doctors do.

But new insurers with good business plans can still find room in the market, said Steve Wood, community health coordinator at ACR Health, a local nonprofit health group. “There’s always room for new insurers if their prices are competitive,” he said. That should lead to more enrollees, he said, and eventually a larger network of doctors who accept the insurance provider’s payments.
(Joe Infantino is a senior majoring in newspaper and online journalism with a minor in anthropology.)

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Posted in Spring 2014 | Comments Off