Consumer Operated and Oriented Plan [CO-OP] Program

The Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) funds the establishment and operation of Consumer Operated and Oriented (CO-OP) nonprofit health insurance issuers under Assistance Listing 93.545, with the most recent posted opportunity due December 31, 2012.

The program provides startup and solvency loans to nonprofit health insurance issuers seeking to enter the individual and small-group markets. The underlying statutory framework (Section 1322 of the Affordable Care Act) envisions at least one viable CO-OP in every state and the District of Columbia, though CMS may fund multiple qualified applicants in a single state if funding permits and actuarial analysis supports repayment capacity. Applicants may seek loans to establish CO-OPs in more than one state. CMS has stated it will not fund competing CO-OPs in the same target market when analysis indicates diminished loan repayment likelihood.

The most recent posted opportunity (OO-COO-11-001, posted January 5, 2012) estimated approximately 51 awards of joint Start-up and Solvency Loans or Solvency Loans only, though the actual number of awards varies with application volume and award size. The source does not provide recent grant award data, aggregate federal dollars obligated under the program, typical award magnitudes, or any grant opportunities posted after 2012. The source indicates that all awards are subject to availability of funds and satisfactory progress, and CMS states it is under no obligation to make awards if funding is insufficient. No information about assistance-type mix, funding concentration among multiple agencies, or representative recent awards is available in the source material.

The absence of opportunities posted after 2012 and lack of recent award data suggest this program may not be actively soliciting applications at present; confirmation of current funding status should be sought directly from CMS before pursuing.