You want to know whether any state owns or sponsors a nonprofit insurance company to offer its residents health insurance.

While state ownership of insurance companies is quite common in Central and Eastern Europe, the Middle East, Africa, China, and the Philippines, it is not common in the United States. We could not identify any state that owns or sponsors an insurance company in the traditional sense, but some have established hybrid-type state funds that function like state-owned insurance companies in which the state underwrites the risk.

Additionally, states have established special insurance plans, programs, or pools in response to availability and affordability problems in the voluntary private insurance market.

Often, state programs are designed to address specific problems such as high-risk drivers who cannot get insurance from the standard market or insurers who refuse to write homeowners' insurance in certain urban areas. The programs vary, but their purpose is the same to provide coverage where it is otherwise unavailable.

In 1911, Wisconsin established the State Life Insurance Fund (Fund), a state-sponsored, nonprofit tax-exempt life insurance program, for the benefit of Wisconsin residents.

In 1987, the Oregon legislature created the Oregon Medical Insurance Pool (OMIP) to provide health insurance coverage to state residents who were unable to obtain coverage because of adverse medical conditions.

The nonprofit Ingham Health Plan Corp. administers discount prescription programs for 23 counties and medical plans in four.

With a free discount cards provided by Pharmacare, a pharmacy benefit management company, participating pharmacies give members an average discount of 25 percent from retail prescription prices. The health-care portion of Ingham's program costs participants up to $ 45 a month.

By qualifying for certain federal Medicaid matching funds, in 2001 Ingham County was able to send $ 2 million in county money to the state, which used it as seed money to obtain other state and federal funds. The state returned $ 10 million to the community for health-care services.

The leveraging is possible because the county plans include people who qualify for Medicaid's State Medical Program, indigent adults served by the state's former general assistance welfare program.

As in Ingham, each community must create a nonprofit corporation with a volunteer board to oversee the programs. The Ingham Health Plan now serves some 16,500 people - about half of Ingham County's estimated uninsured. About 100,000 people statewide are served under similar county care programs.

Automobile Assigned Risk plans, common in most states, assign drivers who have been turned down by the voluntary market to a specific insurer. The plans may provide only limited coverage at higher rates, but they offer high-risk drivers access to coverage that would otherwise not be available.

A number of states established Joint Underwriting Associations (JUAs) to address the availability and affordability of medical malpractice insurance during the mid-1990s. A JUA involves a limited number of insurers who sell and service policies. All insurers based on their market share share premiums and losses of the pool. As with other state programs, JUAs typically provide limited coverage at high rates.

California, Florida, and Hawaii established catastrophe programs to address hurricane and earthquake disasters.

The California Earthquake Authority is a privately financed, state-run insurance program that provides a limited earthquake policy (15% of loss and limited living expense coverage). It is funded through premiums, a one-time contribution of $ 700 million from participating insurers (and an additional $ 3. 5 billion if needed to pay claims), reinsurers, debt authority, and capital from private investors.

Florida established the Florida Hurricane Catastrophe Fund, which acts as reinsurer to insurers for hurricane losses. The fund is tax-exempt and is able to use bonding and other financing arrangements if it has a shortfall. Premiums insurers pay for reinsurance can be passed onto policyholders.

The Hawaii Hurricane Relief Fund, a state-run insurance company-like entity provides hurricane insurance to Hawaiians. The fund is made up of premiums paid, loans from the federal government, bond proceeds, mortgage fees, and insurers assessments.

Risk pools, known as Fair Plans, operated by 29 states and the District of Columbia provide insurance to homeowners who cannot get coverage in the standard market. Policies are expensive and coverage is usually more limited.

While state programs provide hurricane and earthquake coverage, the National Flood Insurance Program is an example of the federal government providing insurance for losses from floods the private market refuses to cover. The federal government established the program in 1970 to provide flood insurance to homeowners in flood-prone areas. Taxpayers carry the risk and must pay for any losses that exceed the premiums that have been paid in by policyholders.

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