POMCO Group to administer benefits for health reform CO-OP

SYRACUSE  —  POMCO Group will be the benefit administrator for a new nonprofit health-insurance plan in New York that is being created under the 2010 federal health-care reform law.

POMCO, which is based in Syracuse, will administer the first Consumer Operated and Oriented Plan (CO-OP) in New York. CO-OPs, which the federal Patient Protection and Affordable Care Act of 2010 calls for in every state, will be directed by their customers and aim to offer affordable health plans to individuals and small businesses.

New York’s CO-OP is slated to begin providing coverage at the beginning of 2014. It will start accepting enrollment in the fall of 2013.

“The idea of empowerment is central to the CO-OPs,” POMCO Group President and CEO Robert Pomfrey said in a news release. “Introducing a new level of competition to the market levels the playing field so more people can reap the benefits.”

The New York CO-OP is being started with $174 million in no-interest and low-interest loans from the federal Centers for Medicare & Medicaid Services. It is being sponsored by Brooklyn–based Freelancers Union, a national nonprofit organization that serves independent workers.

As CO-OP sponsor, Freelancers Union was responsible for selecting POMCO Group as the New York plan’s benefit administrator. It is also responsible for helping to start the CO-OP.

The CO-OP will be a separate organization from Freelancers Union. It will have its own CEO and board of directors. And the federal startup loans are going directly to the CO-OP.

New York’s CO-OP is one of 10 that the federal government has approved to receive a total of $845 million. Freelancers Union is sponsoring three CO-OPs — in New York, New Jersey, and Oregon.

Freelancers Union’s New Jersey CO-OP is in line to receive $107 million in federal loans, and the one in Oregon is set to receive $59 million.

POMCO Group is an independent benefits administrator for self-funded health and risk-management plans. It specializes in managing medical benefits, dental benefits, vision benefits, workers’ compensation, disability, and prescription-drug benefits. It also offers consulting services, employee-benefits statements, and commercial services.

The U.S. Supreme Court heard arguments in March on whether the 2010 health-care law is constitutional. The justices are expected to rule later this year.

Contact Seltzer at rseltzer@cnybj.com