LEWISTON — Maine Community Health Options is the only profitable health insurance co-op in the country, according to rating agency A.M. Best.
In a briefing released last month, Best said only one of the country’s 23 co-ops — MCHO — had both favorable underwriting and income as of last fall. While MCHO reported $10.9 million in net income, other co-ops had between $2.6 million and $39.8 million in losses.
CEO Kevin Lewis said he did not know the other co-ops’ financial details, but he confirmed MCHO is making money.
“We continue to operate in the black,” he said. “It’s a testament to our strong growth as well as our accurate and reasonable pricing.”
Co-ops are health insurance companies run by members for members. They were created through the 2010 Affordable Care Act in an effort to increase competition among health insurers and to provide consumers with greater choice in the marketplace.
The federal government gave nearly $2 billion in loans to the co-ops. A few quickly faltered. Others did well until they had to start attracting members, then they found their prices were set too high to compete.
Co-ops generally performed well enough to stay afloat, but as of the first quarter of 2014, only two had positive earnings, according to Best. By the third quarter, only MCHO was making money.
Since it began selling insurance in fall 2013, Lewiston-based MCHO maintained rates lower than its main competitor, Anthem Blue Cross and Blue Shield. It also offered unique program benefits and touted a broad network of doctors.
MCHO’s leaders expected to have 15,500 members by 2014. They got 40,000. The co-op also ruled the ACA marketplace, with 83 percent of people signing up for an MCHO plan. Fifty-seven percent of all individual health plans — sold on or off the marketplace — went to MCHO.
On Tuesday, independent U.S. Sen. Angus King commended MCHO’s growth on the Senate floor, calling the co-op “a good news story.”
With open enrollment ending Feb. 15, it’s too early to tell whether MCHO will get as great a share of Maine’s health insurance market this year, or whether it will continue to be profitable.
But two months into the year, MCHO has surpassed its 2015 goal with more than 65,000 members. Some of those members are in New Hampshire, where MCHO recently started offering plans.
Although his is so far the only profitable co-op, Lewis said MCHO often works with others, both giving and getting advice.
“We are really a culture of learning and constant improvement,” he said. “We don’t rest for a second.”
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