OpportunityTitle: Consumer Operated and Oriented Plan [CO-OP] Program
CategoryExplanation: The Patient Protection and Affordable Care Act, Pub. L. No. 111-148, enacted on March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, enacted on March 30, 2010, are collectively referred to in this announcement as the &#147;Affordable Care Act.&#148; The Department of Defense and Full-Year Continuing Appropriations Act, 2011, Pub. L. No. 112-10, which amended the Affordable Care Act, was enacted on April 15, 2011. Section 1322 of the Affordable Care Act created the Consumer Operated and Oriented Plan program (CO-OP program) to foster the creation of new consumer-governed, private, nonprofit health insurance issuers, known as &#147;CO-OPs.&#148; In addition to improving consumer choice and plan accountability, the CO-OP program also seeks to promote integrated models of care and enhance competition in the Affordable Insurance Exchanges established under sections 1311 and 1321 of the Affordable Care Act.     The statute provides loans to capitalize eligible prospective CO-OPs with a goal of having at least one CO-OP in each State. The statute permits the funding of multiple CO-OPs in any State, provided that there is sufficient funding to capitalize at least one CO-OP in each State. The statute directs the Secretary to give priority to applicants that will offer CO-OP qualified health plans on a Statewide basis, will use integrated care models, and have significant private support.
AdditionalInformationOnEligibility: Please see page 21 of the full announcement for eligibility information.
Description: We estimate that 51 applicants will be awarded loans under the CO-OP program joint Start-up and Solvency Loans or only Solvency Loans because section 1322 of the Affordable Care Act envisions the creation of at least one viable CO-OP in every State and the District of Columbia. These numbers are estimates. The actual number of awards will vary according to the number of applications and the size of awards. The estimated number of awards reflects the statutory goal of the CO-OP program to establish a CO-OP in each State. It should be noted, however, that the statute allows CMS to fund more than one eligible prospective CO-OP qualified nonprofit health insurance issuer in any State if the funding is sufficient to do so. However, CMS is unlikely to fund CO-OPs that will directly compete with each other for the same target market if actuarial analysis indicates that these CO-OPs would be less likely to repay loans under those circumstances. If there is no applicant from a State, CMS may award loans to encourage the expansion of a eligible prospective CO-OP qualified nonprofit health insurance issuer from another State to that State or take other steps to encourage the development of a CO-OP in a State. Additionally, an applicant may apply for loans to establish a CO-OP in more than one State. For the purposes of this Funding Opportunity Announcement (FOA), a &#147;State&#148; means each of the 50 States and the District of Columbia. All awards (new and continuation) that are issued under this announcement are subject to the availability of funds as well as satisfactory progress. In the absence of funding, CMS is under no obligation to make awards under this announcement.
GrantorContactEmailDescription: CO-OPProgram@cms.hhs.gov
GrantorContactText: Korisha Ramdhanie, Project Officer &lt;br/&gt;korisha.ramdhanie@cms.hhs.gov &lt;br/&gt;Phone: 301.492.4435 &lt;br/&gt;or &lt;br/&gt;Johanna Fabian-Marks &lt;br/&gt;Phone: 301.492.4434
CloseDateExplanation: First-round loan applications will be due October 17, 2011 and subsequent applications will be accepted quarterly up to and including December 31, 2012 according to the following due dates: January 3, 2012, April 2, 2012, July 2, 2012, October 1, 2012 and December 31, 2012.