POMCO Group Prepares for Administrator Role in Health Insurance Exchange

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POMCO Group, one of the nation’s largest benefits administrators, is preparing for its role as benefits administrator for the New York Consumer Operated and Oriented Plan (CO-OP) by hiring new employees.

health insurance exchange, CO-OP, Obamacare,

Donald P. Napier, POMCO Group Senior Executive Vice President

We are honored to have been selected as the administrator for Health Republic Insurance of New York and we are excited for the positive impact the CO-OP will have on the state of New York.

POMCO Group, one of the nation’s largest benefits administrators for self-funded employer groups, is preparing for its role as benefits administrator for the New York Consumer Operated and Oriented Plan (CO-OP) by hiring new employees. The CO-OP, Health Republic Insurance of New York, which will be available on the New York health insurance exchange and will provide health insurance to individuals and small businesses, begins open enrollment on October 1, 2013. POMCO Group was selected as the administrator for Health Republic Insurance of New York and will provide customer service to and process claims for the CO-OPs’ members.

Attempting to gauge how many members the CO-OPs will serve has been difficult as there have been varying enrollment estimates, however, POMCO Group has begun the hiring process for the employees necessary to manage various aspects of the health insurance plans for its anticipated initial membership. “This is an unprecedented moment in our history, never before have individuals and small businesses been provided the opportunity to purchase affordable, high-quality health care in a manner such as what the health insurance exchange will offer them,” stated Senior Executive Vice President Donald P. Napier. “We are honored to have been selected as the administrator for Health Republic Insurance of New York and we are excited for the positive impact the CO-OP will have on the state of New York.”

POMCO Group is currently hiring approximately 40 employees to service members of the New York CO-OP. As part of its agreement, POMCO Group will handle all customer service, claims processing, and various other plan management aspects for CO-OP members. The level of service that is required for the CO-OP members will initially be slightly different than that for typical POMCO Group members. “These new representatives will have to not only have an intimate knowledge of the CO-OP plans, but various aspects of the exchange as well,” states Director of Claims and Customer Service Sherry Fraser, “While this has certainly been a learning process for us, the one thing that is not new to us is our ability to deliver excellent customer service to our members no matter what type of plan they have.”

The health insurance exchanges are one of many requirements of the Affordable Care Act which was signed into law by President Obama on March 23, 2010. The exchanges will give individuals and small business the ability to purchase health coverage in a virtual marketplace from a variety of carriers including a CO-OP, where applicable. “Due to the fact that the health insurance exchange and the CO-OP are completely new entities, with its own specific processes, it has required us to build something from nothing; a concept that we are quite familiar with,” stated Account Management Director Jennifer Zando. While the exchanges are unchartered territory, as one of the nation’s largest benefits administrators, POMCO Group has expertise in developing plan designs for self-funded organizations that are fully customizable and unique.

In addition to hiring and training new employees, POMCO Group recently expanded its corporate headquarters in Syracuse, NY to accommodate the workers. The addition has added 18,000 square feet to the building.

POMCO Group is one of the nation’s largest benefits administrators, integrating customized services to develop comprehensive, cost-effective solutions for self-funded organizations. Comprised of specialized divisions with a united focus on offering customized, flexible group health, risk management and outsourcing options, POMCO Group was established in 1978 and has offices throughout the United States. To learn more about POMCO Group, visit http://www.POMCOGroup.com.

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