Coverage based on your needs, not on financial limitations.

Kentucky Health Cooperative no longer sells or administers health coverage. The nonprofit CO-OP announced on Oct. 9, 2015 that it would not offer plans for 2016, and it was placed in liquidation on Jan. 15, 2016 at the request of the Kentucky Department of Insurance. This page is kept as it stood in the member area of the co-op’s site on Oct. 1, 2013: the lookup tools it pointed to are no longer maintained for KYHC members, and the links below are preserved only so the page reads as it did.

What this page was for

It was the entry point to three member services. The first was a provider directory search, hosted for the co-op on an external plan-lookup service, for checking whether a doctor or facility was in network. The second was a formulary search and a pharmacy locator, both run by ProCareRx — members were told to pick Kentucky Health Cooperative 2014 Formulary from the products list once the search page opened. The third was a PDF of the prescription drug list itself. Nothing else was on the page: no plan prices, no enrollment form, no coverage rules. Anyone who followed a link here expecting current network or drug-list information is looking at a 2013 snapshot.

If that is what you came for, the general explanations are now in our guides rather than on this page: how HMO, PPO and EPO networks differ, what prior authorization means and how to follow it, and the vocabulary of formularies, deductibles and out-of-pocket limits. They are written to hold for any plan, not for one that has closed.

What Kentucky Health Cooperative was

It was one of the consumer-operated and oriented plans — CO-OPs — created under the Affordable Care Act: private, non-profit, member-governed insurers meant to exist for their members rather than for shareholders. On June 22, 2012 the Centers for Medicare & Medicaid Services awarded a $58,831,500 loan to launch it. In September 2012 the board named Janie Miller of Shelbyville as chief executive of the Louisville-based member corporation, which by then had been awarded start-up and solvency loans of more than $58 million.

The co-op sold coverage across all 120 Kentucky counties. Its own enrollment projection was around 30,000 members; enrollment passed 57,000 in its second year, and about 51,000 people were covered when the wind-down was announced. For many rural counties it was the second health plan on the Marketplace, which is the reason its statewide footprint mattered as much as its price.

Why it wound down

On Oct. 9, 2015 the co-op said it would not offer plans on Kentucky’s Marketplace when open enrollment for 2016 began on Nov. 1. Interim chief executive Glenn Jennings tied the decision to federal risk corridor money the organization had counted on and did not receive: the reimbursement announced for the country’s CO-OPs came to 12.6 percent, which for Kentucky meant $9.7 million against a starting figure of $77 million.

The trend had been going the other way. Losses of roughly $50 million in 2014 had been slowed to $4 million by the end of the first half of 2015, and the co-op expected to operate in the black in 2016. “In plainest language, things have come up short of where they need to be,” Jennings said. Current memberships ended on Dec. 31, 2015, and no new memberships were added. The full announcement is kept here: Kentucky Health Cooperative not offering plans in 2016.

What happened to policies and claims

The Department of Insurance took over day-to-day operations on Oct. 29, 2015, when the company was placed in rehabilitation. On Jan. 15, 2016 Franklin Circuit Judge Phillip J. Shepherd signed the order placing it in liquidation, sought by the department to preserve the remaining assets. “Once we determined the degree of financial hazard, the decision to move to liquidation was an easy one,” said Insurance Commissioner Brian Maynard; continuing to attempt rehabilitation, he said, would have increased the risk of loss for creditors and policyholders.

All individual health insurance policies and most group plans terminated on Jan. 1, 2016, and any remaining policies no later than Jan. 31, 2016. Special deputy liquidators, supervised by the Franklin Circuit Court, wound up the remaining business and distributed assets in the order set by Kentucky statute; the deadline for providers, agents and others to file claims was Oct. 15, 2016 and has long since passed. The liquidation notice is kept here: Kentucky Health Cooperative placed in liquidation, and the rest of the organization’s releases are in the news archive.

The page as it was kept in the archive

Below is the 2013 page itself, unchanged. The three services it links to were operated by outside vendors for the co-op and are not available to KYHC members any more.