The Nevada Co-op made its first impression in Northern Nevada last week with the announcement of its new rates. This is a dramatic change from last year. In 2015 CEO Tom Zumtobel stated, “I don’t know why anyone in Northern Nevada would buy (the co-op) plans”. The meeting held with Health Insurance brokers was very informative.
What is the health insurance co-op?
The Co-op is a non-profit health insurance entity formed through the Affordable Care Act. It works similar to an insurance company but it gets more favorable treatment due to its nonprofit status. The Co-op continues to be very popular in Las Vegas. There they sell individual health insurance plans and small business health insurance plans. There it competes with Health Plan of Nevada for the largest share of the market. Last year very little information was available about this company. As they mentioned last week “New” is not a word people like to associate with their health insurance. Their original introduction to the Northern Nevada market was in 2014. Due to its high price, low name recognition, and low consumer outreach and education, the plans didn’t gain traction.
What about Northern Nevada?
Last week CEO Tom Zumtobel and other sales representatives of the Nevada Co-op held a meeting to inform health insurance brokers about their products for 2015. According to Tom, they have made several changes to try and gain market share. This includes the expansion of their provider network, the reduction in their prices, and their plan structure. These are some of the largest changes you can make to a health plan.
- The network list: The Co-op works similar to a Point of Service plan. This means you’re not automatically assigned a primary care physician. Since no primary care physician exists, the specialist does not require a referral. In 2015 for Northern Nevada we are using the First Health Network of Providers, EXCLUDING RENOWN. Renown hospital and its affiliated doctors couldn’t strike a deal with the Nevada Co-op. Therefore they are specifically excluded from the plan. The Co-op DOES cover Carson Tahoe Regional Medical Center and they could be the least expensive insurance carrier for Saint Mary’s in Northern Nevada. They also cover Northern Nevada Medical Center.
- The Price: In the exchange, Anthem has been the cheapest insurance company. The Co-op will be the cheapest “Point of Service” plan design and it will have a significantly larger network than Anthem. If you’re looking for the cheapest of the cheap, it will still be Anthem, but the Co-op has the cheapest “Good” option this year.
- The Plan Design: Anthems plans focus on healthier people (which is a nice way of saying they don’t cover a lot.) The Co-op has about the same level of benefit as Anthem. This isn’t taking in to account buy-up options or Cost-Sharing Reductions available to many members.
For more information about the Co-op or any health insurance company in Nevada, feel free to contact us!