One avenue this entity could take is to offer itself as a non-profit third party administrator of a self-funded plan for other companies. Large companies typically put up the money for health insurance anyway combined with employee premiums and then pay a TPA company or health insurer to create the benefit plan and administer it for them. They don't actually buy insurance as a product from a health insurer for their employees.
Alternatively, they could pool funds and create an actual insurer.
The trouble with Amazon trying to become THE payer or TPA is that insurance is highly variable across the country. There are many different laws governing insurance in each state, and you need to strike business agreements with literally countless small practices, hospital systems, lab service providers, drug companies, outpatient clinics, etc. It would actually be a massive administrative feat for Amazon to provide solid coverage across the US.
> The trouble with Amazon trying to become THE payer or TPA is that insurance is highly variable across the country. There are many different laws governing insurance in each state, and you need to strike business agreements with literally countless small practices, hospital systems, lab service providers, drug companies, outpatient clinics, etc. It would actually be a massive administrative feat for Amazon to provide solid coverage across the US.
It's possible to start small, no? One metropolitan area at a time, make deals with local orgs, slowly transition local employees over to the new plan. The 75 employees working at the Iowa datacenter may stay on their current insurance for a while, but I don't think that's a terribly difficult obstacle for the idea.
you need to strike business agreements with literally countless small practices, hospital systems, lab service providers, drug companies, outpatient clinics, etc.
This is why the aggregator model described in the article is relevant - the small practices will come to Amazon to plug into their aggregator and access their customers.
In that scenario, Amazon opens up shop in a state, provides cookie cutter TOS agreements to providers that mesh with the state's regulations, and providers on-board themselves in order to access the customer base.
Totally dependent on the locale. If I recall correctly there are coverage laws in certain places which state that you cannot do business as an insurer in an area unless you provide physician and hospital access to people within a certain proximity. If you're a big hospital system or even a small place without much competition, you can tell Amazon to shove their TOS because they literally can't do business legally there without you.
Alternatively, they could pool funds and create an actual insurer.
The trouble with Amazon trying to become THE payer or TPA is that insurance is highly variable across the country. There are many different laws governing insurance in each state, and you need to strike business agreements with literally countless small practices, hospital systems, lab service providers, drug companies, outpatient clinics, etc. It would actually be a massive administrative feat for Amazon to provide solid coverage across the US.