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The not-for-profit Health Plan offers a community-based approach to health insurance.


Written by Zack Harold

If your company needs a place to keep its money and you want to put it somewhere small and locally controlled, you might consider joining a credit union. If you have the same criteria for health insurance plans, you might consider The Health Plan. “We’re not owned by a hospital system or a group of investors, or anything like that. We’re owned by the community,” says Health Plan President and CEO Jim Pennington.

The insurance company is set up as a not-for-profit, 501(c)4 organization. That gives The Health Plan freedom most health insurance providers do not have. Instead of chasing profits, the company’s primary goal is to provide affordable, high-quality plans. “We’re not worried about beds being full at a hospital or a return on the dollar for a private equity firm,” Pennington says.

For every dollar The Health Plan collects in premiums, 90 cents goes to pay claims by members. The rest is used to cover administrative costs. The company is able to do this because it works with health care providers and consumers to keep costs low.

On the provider side, The Health Plan works with physicians and hospitals to make sure they are offering high-quality care at affordable rates. On the consumer side, the company holds flu shot and blood test clinics to head off costly medical conditions. It also works with new policyholders to make sure they have established medical homes and understand how benefits are structured, and it co-sponsors summer camps for children with asthma and diabetes to teach them how to manage their diseases.

Health care is constantly getting more expensive, but Pennington says The Health Plan’s goal is to keep costs down so its member companies do not have to pass costs on to their employees. “They’re able to provide an affordable health care product to the employees. That’s the objective,” he says.

 

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