Company Information

Company

Financial Strength

• $145.3 million in federal low-interest loans
• Gross revenues of $440 million
• Targeted margins of 1.7 percent; any surplus to be used to repay federal loans or return to members in reduced premiums or enhanced benefits
• Maintain risk-based-capital statutory requirements of federal and state regulators

Employees & Strategic Business Alliances

• Leadership team averages 25 years of experience in the health insurance industry
• Total of 40 full-time employees
• HealthPartners Administrators, Inc., provides claims processing, medical management and other administrative services
• Midlands Choice, Omaha, Neb., provides network contracting and credentialing services
• Collaboration with University of Iowa Health Alliance member organizations: Genesis Health System; Mercy-Cedar Rapids; Mercy Health Network; University of Iowa Health Care; Wheaton Franciscan Healthcare

Accreditations & Recognitions

• CoOportunity Health participates on the Iowa and Nebraska Health Insurance Marketplaces (HealthCare.gov) for individual purchasers and small businesses
• All health plan offerings are Qualified Health Plans (QHPs) certified by the Centers for Medicare & Medicaid (CMS) and meet all requirements of the Patient Protection and Affordable Care Act (PPACA)
• CoOportunity Health has received the Interim Health Plan Evaluation rating from the National Committee for Quality Assurance (NCQA)

Market Segment Focus

• On the Iowa and Nebraska Health Insurance Marketplaces for individuals and small businesses
• Off-Marketplace plans for individual purchasers under age 65
• Off-Marketplace plans for fully-insured employer groups of all sizes

Health Plan Offerings & Networks

• CoOportunity Premier and Premier HSA: PPO and high-deductible health plans (HDHP) offered statewide in all counties in Iowa and Nebraska. Uses the Midlands Choice Premier network that includes more than 23,000 physicians and other healthcare professionals, 339 hospitals, and 1,500 healthcare facilities in Iowa, Nebraska and bordering states.
• CoOportunity CorePlus UI Health Alliance and CorePlus UI Health Alliance HSA: Select-network PPO and high-deductible health plans (HDHPs) offered in select Iowa counties. Select network providers include the member organizations of the University of Iowa Health Alliance (UIHA): Genesis Health System, Mercy-Cedar Rapids, Mercy Health Network, University of Iowa Health Care, and Wheaton Franciscan Healthcare. The CorePlus network includes 60 hospitals and more than 10,000 primary care clinicians, specialists and other practitioners.
• CoOportunity Preferred UI Health Alliance and Preferred UI Health Alliance HSA: An exclusive provider organization (EPO) plan design offered in select Iowa counties. The Preferred network is identical to the CorePlus network, featuring UIHA member organizations.

Membership at a Glance

• Total enrollment more than 96,350
• More than 47,000 individual members
• More than 49,275 group members
• More than 2,800 employer groups
• As of Nov. 25, 2014