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I’ll attempt to answer my own question, on how WB Community health fits into all this: The web address for WBCH is http://www.wbcommunityhealth.org/. However, as of as least right now (Nov 11, 2019), that address is offline. We can instead go to https://web.archive.org/web/20170628233941/http://wbcommunityhealth.org/about-us.html. This is an archived page from 2 years ago. This page describes what looks like self-insurance. They say: “WBCH does not pool member funds and each member has a separate account into which that member’s monthly payments are deposited and against which that member’s expenses are charged” and “each member remains responsible for all their own claims and expenses at all times”. However, if you go to the Home page, it says “WB Community Health is dedicated to purchasing high quality, comprehensive health insurance and providing value-added benefit services”. So they also say they are buying health insurance plans, presumably at cheaper group rates. How this scheme is supposed be efficient or cost effective, using “self-insurance” plus standard insurance together simultaneously, has not been explained. It also looks like Blue Cross processes claims, not WBCH.