Ohio's CO-OP goes under, while HealthyCT expects profit in 2017

By Annette Boyle

Coordinated Health Mutual Inc., Ohio's consumer operated and oriented plan (CO-OP), went into receivership to allow the failing company to wind down its operations over the next 60 days, the state's Department of Insurance announced.

At the same time, HealthyCT, Connecticut's CO-OP, expects to be profitable in the first quarter of 2017, bucking the dismal trend that has led to the collapse of at least a dozen CO-OPs, according to the New Haven Register.

Free Webinar

Take Control of Your Escalating Claim Costs through a Comprehensive Pre-payment Hospital Bill Review Solution

Today managing high dollar claim spend is more important than ever for Health Plans, TPAs, Employers, and Reinsurers, and can pose significant financial risks. How can these costs be managed without being a constant financial drain on your company resources? Our combination of the right people and the right technology provides an approach that ensures claims are paid right, the first time. Register Now!

Coordinated Health's InHealth Mutual brand covered 22,000 Ohioans. Under the receivership, policyholders must continue to pay their premiums, providers must honor their contracts for service, and vendors must work with the receiver, Ohio's Lt. Gov. Mary Taylor, who is also the director of insurance, said in the announcement.

But not all the CO-OPs face the same problems.

"We're very viable," HealthyCT CEO Ken Lalime tells the New Haven Register. He credits the CO-OP's success to strategically adapting to changes in the Affordable Care Act and diversification. HealthyCT's business is split almost equally between individual insurance, small-group policies and large-group insurance, according to the article.

HealthyCT reported a loss of $27 million in 2015, which Lalime tells the paper was an expected outcome while the organization was building scale. The CO-OP reported 39,375 members at the end of March, according to the Register. Its latest annual report showed $92.2 million in cash and invested assets, notes the article.

HealthyCT is not the only successful CO-OP. Maryland's Evergreen Health has also beaten the odds, and reported in March that it was 30 percent ahead of its goals for individual enrollment for the year.

To learn more
- here's the Ohio DOI announcement
- read the New Haven Register article

Suggested Articles

Learn how health plans can demonstrate agility with analytics to shape benefit plans in a time of healthcare transformation.

HHS Secretary Alex Azar announced the government will distribute 30,000 doses of a new COVID-19 antibody cocktail on Tuesday.

Employers are increasingly integrating their health benefits as a way to achieve cost savings, according to a new report from Anthem.