martin and send cynthia or cindy jay and they're very unique and before i tell you why they're unique i want to introduce them and ask them that tell me a little bit about yourself  health insurance executive to have come up through the ranks of health insurance and i think the uniqueness you might be referring to is that i didn't come through the ranks of insurance i've been involved in health care  starting as a psychiatric technician and community hospital growing through a behavioral health services actually moving to administer psychiatric and substance abuse hospital several other hospitals after that actually worked for all delivery systems in the industry have worked in managed care i've worked in pharmaceutical i've worked for major lab and i've actually also worked in nonprofit a nonprofit health promotion institute i have a kind of a unique mix of corporate and nonprofit experience i was many and managing director of one of the largest social service agencies in manhattan  have my functional areas of expertise are communication marketing business development public affairs and i have headed up global global departments to that effect my master's degree is in health management and i have a profound interest in health and and wellness disease prevention so i was attracted to this particular position i was working as executive director of the new jersey health literacy coalition doing business development meeting key influencers in the state make a making a movement happen if you will and when i saw this was part of health reform i was intrigued and thinking this is really where i should be oh i was very intrigued when i spoke to you so health republican surance so just a little background for those that may not know that new jersey decided did not decide to develop their own marketplace that a state run marketplace and the marketplace is where those of you who do not have health insurance go to get health insurance under the affordable health care act and in new jersey as i understand there are three health insurance companies and you were one of the three who chose to be on the federally facilitated marketplace right there were more insurance companies of the jerseyites re who said will participate in the marketplace experience old well our first actual employee celebrated her first anniversary yesterday ok our chief operating officer prior to that there were consultants involved in putting together their response to the request for proposal from the centers for medicare and medicaid to develop a cooperative in the state so various people were called from different expertise u how a health insurance co op is different and unique to what most of us experience when they look for health insurance well i think that you know going back a bit so when the health care law was being discussed in the legislature and the law was coming to be one of the senators in the finance committee decided they were going to start really a more open market for people so they can have access affordable costs and access to care and it was mentioned why don't we start our bring back the co op idea which is the idea really states that an organization is consumer operated and oriented so it's for the consumer so let's bring back co ops we've had co ops in the united states for years they could be farm co ops credit unions and health co ops one of the  group health cooperative out of washington state so let's have an alternative to traditional carriers let's have something that's consumer oriented nonprofit and really huge that uses surplus revenues when they come back into the company to increase benefits in prove quality care and reduce costs and also decrease benefits if that's possible each year so really have the monies that really funnel through as far as surplus revenues being used to improve that the services to the people that are members so that's how we got started and that's what our purpose is so really also we are mandated to have fifty one percent of our board members be members of the co op when our board is fully developed so that means if i buy insurance through your co op right i could potentially be a board potentially  they were worthy of the loan that they have a plan that would work that could succeed that would sustain itself and then having been approved they were awarded two separate two components of one loan startup dollars about twelve and a half million dollars to really get the program off the ground and about ninety seven million dollars worth of solvent see funds essentially speaking to once you start issuing your insurance and people start using it in the members you know how to how to buy it for you to be able to cover particularly as a start up you know it's intended that in time obviously the proceeds will pay for cover itself but that's why you don't see many new start up insurance companies for the return on that investment that you pay it back but that's not the priority the priority is to build a sustainable insurance cooperative alternative to expand the marketplace and offer consumers something different and some of these sumption is really behind this to our to make sure that we focus on individual coverage and small business coverage and that's really part of the mandate if you will of them on where also tasks to be innovative and what we do going forward as far as our plan designs what we offer to the individual that may help them manage their health keep them well you know it's with the countries moving are hopefully moving from secure to well care that would be nice management and actually offer them ways to become engaged in it ok so before we get there let me ask this question your brand your start up where you're getting your providers where the doctor is coming from where the hospital is coming from where the biggest prescription drug companies coming from it's a good question because it's it's hard for people to imagine that you could have a company up and running in the year that we've just talked about and have all those things in place so one of our strategic partnerships early on after some determining what was the best way to to be able to provide services across the state of new jersey was to partner with a company called qual care that's been in existence for these ten to fifteen years if not  more a third party administrator that provides administration services for health care that has just about every hospital in the state of new jersey in their network i believe the number is approximately thirty thousand physicians and or providers other than physicians and they provide by nature of having the broader scope in their network we can offer the insurance to people from cape may to to the northern point so high point new jersey all the way east and west but having a third party in a straight or does that increase your cost decrease your costs keep in the same  other two carriers there are golf in the marketplace i think it is probably decreasing their cost is the same question that anybody might have when starting up any kind of company does it behoove us to hire a lot of staff or for now can we moral that can we rented can't we get something from someone else that we can utilize for a fee but that keeps our overhead costs lower and it also helped us when we were  establishing the co op reduce the cost to start up because we already had an established network ok and our partnership was quite mutually beneficial for each party to serve the members that we want to serve and state how does your plan have the the metal tears as the other plans are you are you essentially you're structured the same as the other two and that's what is at  we offer bronze silver gold and platinum and within that some other subsets i say essentially because i'm not sure that all the other two offer at each level but one of our experiences and certainly one of mine was that in the state of new jersey insurance is pretty highly regulated and that's not necessarily the case in every state that i want to thank are you finding it a good thing or i have jury's still out i have found of the department of banking in that surance to be very helpful to us i was not sure frankly in the beginning whether they would be and they were they have a lot of depth of experience and part of their job as regulators it's really to protect the citizens of the state and you know in the industry so they would want to make sure that somebody wasn't coming on and being issued a license and a certificate of authority which we got in there in june it was mentioned in june to us that couldn't sustain the business that would go out of business quickly that people would be left in a lurch if you will so to that extent the requirements ok so but if you're not in the marketplace then you don't have to offer that there have been insurance companies i'm not sure about in new jersey who do offer lesser as you know we were a start up so we started with nothing so one of the things that we had to do and are still having to do is educate the public about who we are why we're unique and what we are as far as an insurance company that may be an option for them to consider and if they're signing up for insurance what we found when we're doing this we also have questions about the a ca what's going on what is it that is and so we really serve that how is this going to impact me how much am i going to have to pay how do i get covered what do i get covered with are there are these is through an insurance company so i have to answer those types of questions and i would you  in the state and one of the things that we pride ourselves on our will pride ourselves on and we're preparing for and we have staff to do and also our staff it that we work with that qual care and also our outside vendor who does a lot of the enrollment for us and then in the claims work we talk we we connect with people we return phone calls we call back folks who leave leave their numbers we don't make them go through wild phone trees if you will  to get an answer so it really is about the member and in the outrage we talk about that i mean i've been at street fairs with some of my staff where i just explain things to people and they say you know we haven't gotten that from anybody else we haven't seen anyone else out here not only talking about who they are but talking about what's going on in health reform how does it affect me you know i have people asking all kinds of questions i'm out of work i'm sort of in a gap i don't have insurance can i get it and then get covered by an employer if i if i read a good question and i end up working with somebody absolutely you can sign up for an individual policy and then if you get covered by an employer and they offer insurance to you you can you can sign up for that if it's more fordable or or whatever can i sign up anytime or can i only sign up in the enrollment period or you can sign up when we have an open enrollment period which is now right which is right now through march thirty first and then after that period it starts back up again in october of two thousand and fourteen ok so i got it right so during this time you can actually sign up and and change  what about in june it's in the market rallies or on the exchanges need to be remembered and that will that windows scheduled to close march thirty first however we will be offering off exchange oh so that and find out what the plans are and to actually get an idea if you're eligible for subsidy and then you would have to go over to the marketplace to enroll to get those i think some people may think that they're for do health care act is only for people who are low income and my understanding that's not true and that's the not sure you know and i think that one of the things that is a component of the co op and who we target we're looking at people who are individuals that may be self employed self employed people have never had the card dreyer potpourri of benefits that you get off times through an employer if you sign up for health policies expensive oh yes i know friends that have extend their working but maybe they're not making as my actions and what the benefits are offered a lot of times a very sterile they would be limited these are more comprehensive now and so we're looking at those individuals who are self employed those individuals to who are not covered by their employer because their employer just can't afford to cover these are usually very small businesses cover them so will you get those people also we're looking at small businesses that may want to do good and and cover their employer's employees and and underwrite a policy for them so we're looking at those businesses also so a lot of the people who don't have health insurance i think there's a statistic in new jersey that  about three hundred thousand self employed people in just in general and many of them don't have policies or their policies are very expensive now and they'd like to get a more formal one and this could be the hairdresser and there are real estate agent it could be creative type it could be an abject fear an add junk faculty member but isn't that really the point of the fordable how her act is to be able to vide quality health insurance for as many people so that it would reduce the and it's also the point of the affordable care act to try to get everyone insured in one way or another through some program or another and so my answer cynthia's was much more thorough and comprehensive a better their target population the other answer to the target that we hope to enroll is anybody not covered by a government program if your income precludes you from medicaid which is fine and you're not right doesn't cover what they really need how are you going to address that i mean i know it's forward thinking our approach is us and he was mentioning is so much oriented to the engagement oh of the consumer in their own health care and working with qual care they've taken a very strong stance on quality management we're going to be working with case managers in the case be engaged in a way to try to facilitate that person getting the best care that they can get so if there is some kind of it than i am involved it might be you know that's either not covered or maybe the question that you and i should have is is that what you need resists what you need ok have you seen your primary care physician your primary care physician recommend that or is that something you neighbor told you you should do and we would strongly encourage you in fact yesterday plans before part of the plan is designed  that answers a little bit of question and we will have case managers and kira managers more of what we're thinking about is care managers so that they can work with the individual who's calling and i quote here they said they're going to be one in the same person you used to be that in some companies was received by one handed off to somebody else and and as a consumer you were hoping you got back to the original person baby so now they're going to work as a team so that they'll have right there with them what they need to be able to answer people's questions redirect of it that's what's necessary so that's why we thought they were great part i like that approach so how does someone because we heard all these stories about the website the government health care once i had a someone who is now shopping right and they're in new jersey and they're shopping do they have to go to health the website can they go or if not can they figure out who is in the marketplace and go to the website i mean how does someone do the nuts and bolts and trying to figure out how to get to you or the other carriers but i think there's a couple of things going on right now you're right you know there are stuff like she's in health care out of but we are seeing just in general that initially people  on october first they started shopping around a lot of people didn't hurry to just sign up they wanted to see what was out there so i think right now i would urge people to continue thinking about what they want to do who they may want to select as a carrier looking at all the options continuing to look at health care dot gov but you know let's wait till it's actually ready to to piece so you won't get frustrated in case you and frustrated but also you can call numbers you can call phone numbers you can call us as a carrier i'm sure you can call the other carriers we have people that spend  know call links maybe as long as you know ten minutes with folks just kind of explaining what the v a is telling them the options i would suggest that i would also i would also say make sure that are your own way or what's going on as far as when the marketplace is going to relaunch and what are some of the key deadlines what we're hearing right now is that november thirtieth it should be ready to re looking on the web site googling navigators seeing where the navigators are you want to talk to them all so anyway going back to the time table for when everything will be working it's supposed to be november thirtieth then they're at