Consumer Operated and Oriented Plan (CO-OP) Program: Frequently Asked Questions

Summary

The Consumer Operated and Oriented Plan (CO-OP) program was included in the Patient Protection and Affordable Care Act (ACA; P.L. 111-148) in an effort to increase the competitiveness of state health insurance markets and improve choice. Under the program, the Centers for Medicare & Medicaid Services (CMS) uses appropriated funds to award low-interest loans to organizations applying to become CO-OPs—nonprofit, member-run health insurance issuers that sell health insurance in the state(s) in which they are licensed.

CMS awarded loans to 24 CO-OPs. One of the 24 was dropped from the program prior to offering health plans. Among the remaining 23 CO-OPs, 11 are offering health plans in 2016. The other 12 offered health plans at one time but are not currently offering health plans and are in various stages of shutting down. CMS awarded about $2.4 billion to the 23 CO-OPs that ever offered health plans.

The fact that about half of the CO-OPs have ceased operations has generated a lot of interest in the program. The purpose of this report is to address frequently asked questions about the CO-OP program. The report includes information about the structure of the CO-OP program, program requirements, the loan awards, and the current operating status of the CO-OPs.