Nonprofit health insurer expands statewide; adds Boulder providers to list

GRAND JUNCTION – For Boulder Valley companies and individuals seeking health insurance, Rocky Mountain Health Plans is trying to make itself an easy choice.

Headquartered in Grand Junction and long considered a Western Slope health insurer, the company began a push in 2001 to garner clients statewide.

In May it added the Boulder Medical Center to its provider list, and physicians who are members of the Boulder Valley Individual Practice Association are included among its approved providers.

It also does business with all the hospitals in Colorado.

Rocky Mountain Health Plans also has expanded its product line in recent years. Originally founded in 1974 as Rocky Mountain HMO, it since has added PPO, self-insured, high-deductible health savings accounts, and Medicaid and Medicare plans.Rocky Mountain is the only statewide insurer that isn’t owned by an out-of-state insurance company, said Jim Swayze, vice president and general manager of Front Range operations. And it’s the third largest Medicare provider in the state, he said.

The company began to offer self-insured plans in 2004, available to employer groups with 75 or more enrollees, when it purchased CNIC Health Solutions, an independent third-party administrator of self-insured plans.
Rocky Mountain has about 30 to 40 percent of the health-insurance market on the Western Slope, Swayze said. It has grown to about 50,000 insured and 25,000 self-funded customers east of the Great Divide, making it the sixth- or seventh-largest health plan in Colorado, he estimated.

“We’ve been doing a lot of advertising on the Front Range, emphasizing that we’re not-for-profit and statewide in a time when health care is getting more corporatized,” Swayze said.

RMHP is launching a new suite of products in August targeting two of the biggest segments it sees buying individual health plans: 20-somethings and those in their early 60s.

The products are designed for people who are working but whose employers’ plans charge high rates to cover their families.

“People are looking at the individual market and opting out of their employer program and going it alone,” Swayze said. “We may see some growth there.”

It doesn’t offer dental coverage, “But we are looking at it down the road,” he said. It offers vision coverage by contracting with third parties.

The 555-employee company (400 at Rocky Mountain and 155 at CNIC) had revenues of $300 million in 2005 and expects $350 million this year. It sees 15 percent growth each year on average, he said. “As a not-for-profit we try to set our prices appropriately. We feel we are growing at a responsible rate.”

As a 501 c (4) – a type of nonprofit operated exclusively for the promotion of social welfare – Rocky Mountain isn’t shareholder driven. “We try to make a 3 percent margin, Swayze said. “That’s appropriate to reinvest in the company’s infrastructure. A for-profit is trying to make as much as the market will bear; we set our pricing to make 3 percent.”

In addition to attracting customers because of its product line, people sign up with Rocky Mountain because they haven’t been satisfied with their insurance company’s service, Swayze said. “We pride ourselves that when you call us you get someone who lives in Colorado.”

The company also gives back to the community through its Rocky Mountain Health Foundation, he said. Among the foundation’s programs are a school-based asthma program to help children manage their asthma and a school-based fitness program called Stepping Up.

Contact Caron Schwartz Ellis at 303-440-4950 or csellis@bcbr.com.

Rocky Mountain Health Plans
2775 Crossroads Blvd., P.O. Box 10600, Grand Junction, CO 81502
www.rmhp.org
John Hopkins, president and chief executive
Employees: 555
Primary service: health insurance
Founded: 1974

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