non-profit health insurance companies

I did a quick search and didn’t see anything related to this. Pardon me if it’s been done before and point me in the right direction.

Anyway, we have non-profit hospitals, non-profit colleges, non-profit this and that. Are there any non-profit heath insurance companies? If not, why not? If so, where can I join? Or if not, how can we start one?

How about HMO’s? Do those count too?

I know of one HMO that claims (probably legally technically correctly) to be non-profit, but I think it’s kind of a sham.

See, this HMO runs its own facilities, has its own hospitals, labs, equipment, doctors, and other staff…

Except, that isn’t quite true. This HMO actually contracts out to other private providers to provide all the facilities, equipments, services, doctors and other staff. The HMO itself just collects members’ money and deals with all the administrative stuff.

This HMO contracts out about 99.99% of its health care work to just ONE other big FOR-PROFIT company, which exists just for that purpose. The HMO contracts out some miniscule amount of its work to other private providers and pharmacies, typically in otherwise-underserved outlying areas.

The HMO is so big and well-known in the areas where it does business, and the other company that actually does the work likewise, that their respective names are generally thought of as synonymous by the general public, and one rarely encounters either name without the other.

So, some amount of the money (a very substantial amount, I would think) the members pay to the non-profit HMO actually goes to the for-profit provider company. Since the two companies are so strongly connected, it’s hard to imagine this is all honest. The non-profit HMO could have agreed to pay an artificially high amount to the for-profit company – I don’t know, but I’m dubious about how honest this all is.

This was a known problem in the days of building the trans-continental railroads, when the directors of the major railroad companies would create separate companies (with themselves or their cronies also as directors and major stockholders of those separate companies), and contract out much of the actual railroad building work to them at inflated prices – thus concentrating the profits in those auxiliary companies. See how that works?

So I really wonder if this modern HMO, with a name that must not be uttered, is pulling some similar sort of bullshit.

Many of the Blue Cross plans, for instance Blue Cross California, Massachusettts, and Minnesota to name three. In Minnesota Healthpartners is a nonprofit HMO but they do offer regular insurance. Medica is another one here.

The Blues began as non-profits, I believe, although some-most-all are not now.

I researched all 40 something Blue Plans in the US.
Blue Cross of Kansas City is for profit as a result of a lawsuit alleging they had overstepped what a nonprofit is allowed to do.

Health Care Service Corp (Blue Cross IL, NM, OK, TX) is for-profit.

Anthem (Blue Cross part CA, CO, CT, IN, KY, ME, MO, NV, NH, OH, part VA, WI), is for profit publically traded.

AL, AZ, AK, part CA, FL, HI, ID, KA, LA, MA, MI, MN, MS, MT, NE, NJ, Excellus (central NY), Northeast NY, NC, ND, Northeast PA, Southeast PA, Central PA, RI, SC, TN, VT, WY, Carefirst (DC, MA, part VA), Highmark (part PA, DE, WV), Premera (AK, WA), Regence (ID, OR, UT, WA), and Wellmark (IA, SD) are all nonprofit. Carefirst and Regence attempted to go to for-profit at one time but did not due so.

It should be noted that being nonprofit doesn’t necessarily mean the premiums will be less. Even companies with the maximum allowed overhead + profit of 20%, that means 80% still goes out the door as payments for medical care, so it’s more about the kinds of deals made with providers and the effectiveness of efforts to control the costs of medical care (those “eat your brocolli” ads are on TV for that reason). Nonprofits in Minnesota regularly lose bids to for-profits like Aetna and UHC.

Finding a “true” non-profit- and not just an entity designed to accrue tax benefits for a larger company- is hard in certain parts of the country. A lot of people who work on health policy think non-profit insurance companies are the future of healthcare, but they are relatively sparse right now.

I can’t think of any sole insurance companies that are non-profit, but there are a number of organizations that insurance companies that also run clinics and even hospitals, organized as non-profits. Look for health cooperatives- almost all of those are non-profits. A few well-known non-profits:

Group Health Cooperative of South Central Wisconsin
ThedaCare (Wisconsin)
Group Health Cooperative of Puget Sound
Inova Health System (NoVa)

Also, check out this link for another long list.

There is no non-profit Blue Cross in California. You seem to be conflating it with Blue Shield, which incidentally is non-profit. Blue Cross is owned by Anthem, as noted previously, and is a publicly traded company answering to its shareholders above all else.

Also, there are co-operatives, which are member owned and will return some of their “profits” back to their members by way of dividends or rebates off prior-year premiums.

To be fair, Blue Cross and Blue Shield are the same organization (Blue Cross Blue Shield Association) on the national level, and Anthem is called Anthem Blue Cross Blue Shield in every state they operate in except California. In fact, in the 41 states where the BC/BS names are used, they are combined in all but three – California, Washington, and Idaho – although there are separate BC or BS organizations operating in parts of New York and Pennsylvania.

I thought that it was Premera Blue Cross in WA that attempted to go for-profit? IIRC, they abandoned that and went on to create LifeWise as a for-profit subsidiary.

Regence Blue Shield has contined to be non-profit.

  • jasg (former Premera, current Regence customer)

You’re right, I meant to say Carefirst and Premera. Carefirst tried going to for-profit but it didn’t work out and they returned to non-profit status.

And I did miss that Blue Cross and Blue Shield are different entities in CA. I was using Blue Cross as a generic term for the Blue Plans. It’s confusing even to someone that works in the insurance industry because some plans cover several states, some states have one plan, and some states have several, and not all of them have Blue Cross or the state name in their title. Most of these are “taxable nonprofits” meaning they pay taxes, so I’m not sure what the legal advantage is unless the tax rate is still less than for-profits. I have documents on insurance industry structures in Minnesota, and the nonprofits are usually a maze of different legal entities, some nonprofit and some for-profit, but ultimately the master holding company is nonprofit for Blue Cross and Healthpartners, for-profit for Medica. It has simplified a little bit since Blue Cross of Minnesota sold it’s life insurance business (MII life) and got out of the Workers Comp business (CMC workers comp) both of which were legally seperate companies (but housed in the same buildings as the main business and such). Healthpartners has never been in those lines, but they own hospitals and clinics under different legal entities while Blue Cross and Medica do not.

In Minnesota HMOs are required to be nonprofit, so UHC bought Medica to get around that law.

I’m not sure how this is being fair. Blue Cross in California is a subsidiary of Anthem, and was a subsidiary of WellPoint before that. Blue Shield in California is non-profit and has no association with the Blue Cross company, as I stated in my post. The post I replied to specifically referred to “Blue Cross part CA.” In fact, your post seems to reinforce the need to be clear that they are two separate companies, organized under two completely independent operating structures within California.

This being GQ and all that. :wink:

Isn’t the Cooperators Group, (of insurance companies), what once was a non profit insurance company? Started by farmers maybe? Long since gone capitalist, of course!

There are non-profit medical cost sharing programs (which also qualify under the new IRS standards for what is medical insurance coverage), but they are not insurance, and any I have found are christian based. Perhaps if you are serious about starting one you might consider this route over conventional insurance and maybe drop the christian requirement of membership.

It seems Kaiser Permanente is non-profit, or at least some parts of their operation are.

Yes, there are dozens, hundreds. They are all in countries like Canada, Sweden, Belgium, Italy, Malaysia, Mexico, Uruguay, Chad, Kiribati, North Korea . . . . . Sorry, none in the USA, the world leader in health care. Unless you quality for Medicare.

Did you even read the thread?

It isn’t the same thing exactly but some large companies run their own health insurance plan and it isn’t supposed to be a profit center. It is to save the company money by cutting out for profit insurance companies and providing the cheapest rates to the employees. Bose had its own health plan when I worked there.

I read the OP. Does that count?

From the introductory paragraphs of said wiki:

See post #2 above.