ACA plan from a CO-OP?

[tennistime]

Our old BCBS plan in Illinois is being phased out, so we're looking to get a new ACA compliant plan for 2015. One of the companies offering policies in Illinois is called "Land of Lincoln", which is a start-up business formed in 2013 as a CO-OP (Consumer Operated and Oriented Plan), using Federal loans to get them started. Their policies are very attractive based on price, coverage and doctor networks. They look like a good deal. So, we're interested in switching to them.

My big concern is what happens if they aren't financially viable?

I've read that they signed up way less than planned for 2014 (overpriced their premiums), and have dropped their premiums for 2015, hoping to gain market share. But, they are still very small in the market. What happens if they can't stay viable? What if they have a few huge claims, and can't support the business model? Or can't pay back their federal loans? Will I be stuck without insurance? Will I be liable for unpaid bills? Can I switch to another company mid-year?

I've asked them these questions (via their phone hotline), and am getting the runaround. Anyone else buying insurance from one of these CO-OPs? The ACA wants these CO-OPS to be the new way to manage costs going forward. But do we have to assume the risks? Thanks for your thoughts.

 

[robertf57]

There are protections for insurers built into the ACA for medical losses greater than planned, so I think this is not a major concern for patients at this time. Whether they can pay back their loans is also not a problem currently as my understanding is those loans aren't due yet. I would choose the network and coverage that suited my needs right now. In yearsr to come, these issues may become more problematic.