Tuesday, August 07, 2007
Health Insurance Partnership to focus on employees of Georgia’s small businesses
Governor Sonny Perdue announced preliminary details on a major new health care initiative for working uninsured Georgians called the Health Insurance Partnership for Georgia...
Under Governor Perdue’s proposal, small businesses will be able to voluntarily join the program and offer private health insurance to employees. The cost of the insurance plan will be shared by the employee, employer and a combination of state and federal funds. Because of Medicaid initiatives that have realized savings in both state and federal funds, the state anticipates federal approval of using saved federal dollars to help cover its share of the cost.
More than 1.7 million Georgians lack health insurance. Approximately 380,000 of Georgia’s uninsured work for employers with less than 50 employees, and earn less than 300 percent of the FPL. The Health Insurance Partnership will enable sole proprietors and small businesses that have not been able to offer health insurance in the past the opportunity to offer a menu of private benefits options to employees.
The goal is to offer this segment of Georgia’s uninsured a variety of options for private health care coverage. The options vary based mostly on the level of premium the employee chooses to pay, such as:
Benchmark benefit plan comparable to the plan offered to state employees
Basic benefit package meeting the requirements of the Small Business Employee Choice of Benefits Health Insurance Plan Act: a basic employee health option authorized through SB 174 which went into effect July 1, 2005.
High Deductible Health Plan with a Health Savings Account (HSA).
Health Insurance Partnership FACT SHEET
Small Business Challenge:
Georgia is home to more than 800,000 small businesses, many of whom have been priced out of the health insurance market because of their small number of employees or pre-existing conditions within their group
An estimated 62,000 small businesses have less than 50 employees and do not currently offer health insurance coverage for employees, which accounts for approximately 380,000 uninsured Georgians earning less than 300 percent of the federal poverty level (FPL)
Georgia’s Solution:
Allows small business to join together in a larger group plan and offer private insurance to their employees through the free market
Insurance cost shared by Employee, Employer and State and Federal Funds
Implement by July 1, 2008 and administered by DCH
Financing the program:
State to apply for an 1115 Medicaid Waiver:
Waiver period of 5 years, but can be renewed if meeting objectives
o Allows changes to benefits, reimbursement and coverage of expansion groups
o State commits to a policy pilot that can be formally evaluated
o Anticipate federal approval of waiver because of savings from Medicaid program efficiencies
o Obtain federal match from the Centers for Medicare and Medicaid Services (CMS)
Eligibility for the plan:
Income less than or equal to 300 percent of FPL
Employed by a small business with less than 50 employees or a sole proprietor.
Works a minimum of 20 hours a week
Resident of Georgia for at least six months
Citizen or qualified legal alien
Who is NOT eligible for the plan:
Employees who have had health insurance during the past 6 months
Spouses with access to health insurance coverage through their employer even if he/she chooses not to enroll
Individuals covered by Medicare or TRICARE, or another insurance plan
Businesses are eligible to offer the plan if:
Business is located in Georgia
Employs fewer than 50 employees or a sole proprietor
Insurance must be offered to all eligible employees
Have not offered coverage within the last six months, or agrees to maintain existing contribution levels for the first 12 months of being on the program
Health Plans may participate in the plan if:
Agree to not impose a pre-existing exclusion clause
Agree to offer a premium consistent with State requirements
Agree to other participation criteria established by the State
To access the entire article, please click here.
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