Honor Roll for Coverage Award
HLC’S Honor Roll for Coverage Award
Since 2000, HLC’s Honor Roll for Coverage Award has recognized exemplary community programs that have distinguished themselves as leaders in providing access to health insurance for uninsured Americans. HLC created this award as a way to recognize innovative approaches to improving access to health coverage. HLC looks for creative programs that are making differences in their communities and states. Some are private sector programs, others are public-private partnerships, but all share the characteristic of effectiveness. Honor Roll for Coverage helps provide models of what’s working in communities across the country. The goal is making quality health coverage affordable and accessible for working families. HLC believes this is worth honoring. These awards elevate public and media awareness to a national level, facilitating programs’ duplication in other areas of the country. Additionally, the award ceremonies include congressional representatives and locally elected officials, raising the profile of these programs among federal lawmakers and local policy makers.
Montana Chamber Choices
Montana Chamber Choices, the latest to receive the Honor Roll for Coverage Award, currently insures approximately 1,500 small businesses and 16,000 lives of small business owners, employees and their families across Montana. More than 51% of Chamber Choices businesses were previously uninsured.
Since 2004, the Montana Chamber has partnered with local chambers to promote Chamber Choices and currently 40 local chambers endorse and support Chamber Choices for small businesses in their communities. Small businesses with between 2-99 employees as well as sole-proprietors are eligible for coverage under the program. Chamber Choices has 11 different benefit plan options for small businesses.
Insure Montana received the Honor Roll for Coverage Award in October 2008, for providing health insurance to more than 1,400 small businesses, resulting in coverage of nearly 8,000 previously uninsured employees and dependents.
Insure Montana began in 2005 as a joint initiative of the Governor and State Auditor. The two part program, administered by the State Auditor’s office, is designed to assist small businesses with the cost of health insurance, whether they have provided health insurance previously or not. Small businesses of 2-9 employees who currently provide health insurance to their employees can participate in either a purchasing pool or tax credit program.
Insure Oklahoma, a joint effort supported by insurers, small employers, hospitals, physicians and other committed organizations, received the Honor Roll for Coverage Award in September 2008.
Insure Oklahoma is an employer-sponsored insurance program which was enacted in 2004 and began operations in 2005. As of August 2008, Insure Oklahoma has directly subsidized health coverage for nearly 10,000 employees and dependents. The program provides premium subsidies for existing health plans available in the state of Oklahoma to small employers (2-50) with low wage workers. Through the program, the employer pays only 25% of the premium of the low-wage worker, the employee pays 15% of the premium and the state pays the remainder.
The program is funded by a new tobacco tax and federal funds based on a Medicaid Health Insurance Flexibility and Accountability Waiver.
Business Healthcare Connection
San Diego’s Business Healthcare Connection (BHC), a non-profit corporation which offers no-cost assistance to businesses interested in offering health coverage for uninsured employees and their dependents, is the latest to receive the Honor Roll for Coverage Award.
Started in April 2002, the BHC was funded by The California Endowment to build organizational capacity, develop educational materials, and test outreach strategies. To date, the BHC has offered education and assistance to over 10,000 employers, resulting in coverage to more than 1,000 employees and dependents.
In addition, the BHC is an active participant in numerous chambers and business associations in the County, has conducted several roundtables and forums on health reform, has participated in the design of a coverage expansion program, and has developed a Spanish language guide to health insurance, called Salud Segura.
Chamber Alliance Program
The Arkansas Chamber Alliance Program (ARCAP), was honored with the Honor Roll for Coverage Award, for its exemplary model in providing health insurance coverage for small business in Arkansas.
The Chamber Alliance Program is an exclusive health insurance package designed for small business and offered through the Chamber. The CAP program allows each participating chamber to offer its business members lower large group premiums through aligning all members participants into one larger group. Employers can then provide their employees with health insurance benefits within a budget their company can afford. 20% of the participants currently covered didn’t have any insurance coverage prior to CAP.
FirstPlan, a new health care coverage option offered by FirstCarolinaCare
(www.firstcarolinacare.com), a subsidiary of FirstHealth of the Carolinas is the latest to receive the Honor Roll for Coverage Award, in recognition of providing accessible health care.
FirstPlan, for businesses with 50 or fewer employees, grew out of an initiative by FirstHealth Community Voices Initiative to find ways to improve access to health care for the medically underserved. The initiative was supported by a five-year, $2.5 million Community Voices grant from the W.K. Kellogg Foundation.
Under FirstPlan, subsidies are available from FirstHealth and other sources to help low-wage employees pay for their health coverage. In addition, employers who meet certain criteria can receive discounts on their premiums. Those discounts – which can reduce premiums up to 20 percent – are called CareCredits. An employer can qualify for CareCredits by having a high rate of employee participation in the plan and by paying a larger percentage of the cost of coverage for employees and dependents. As an additional incentive, CareCredits also are given to businesses that have not previously offered coverage.
Hillside Health Access Alliance
Rhode Island’s Hillside Health Access Alliance (www.hillsidefamily.com/access), which allows individuals without health insurance to purchase primary care at a price almost everyone can afford, has provided primary care to over 300 people in about 3 years, and shows how primary care practices can make health care accessible to people and communities while respecting the ability of people to be responsible for their own needs. The Scituate Health Plan (www.scituatehealth.org), has attracted national and international attention because of its architecture, which enables local government to both provide primary care, public health, and health financing for all residents, and is an example of what communities can do to improve health coverage and access.
New York Cities’ HealthPass was awarded the Honor Roll for Coverage Award, in recognition of providing affordable health insurance choices to small businesses.
As a collaboration between New York City’s Mayor’s office and the New York Business Group on Health, HealthPass operates as a health insurance purchasing alliance for small businesses in New York City and surrounding suburbs. The program offers a variety of different health plans to choose from, including health maintenance organizations, preferred provider organizations, exclusive provider organizations, and point-of-service plans offered by several different insurers. Notably, the majority of businesses enrolled in HealthPass did not previously offer health coverage to their employees.
Commun-I-Care was awarded the Honor Roll for Coverage Award for its efforts to put cost effective health care within the reach of residents of South Carolina who were low income but did not qualify for Medicare or Medicaid.
Commun-I-Care, launched in 1993, provides free doctor visits and free prescription medication to adults in South Carolina who have no health insurance and can’t afford to see a doctor. The program has grown to be regarded nationwide as a model health care program and has received numerous accolades for its effort to provide health care to deserving individuals.
Some of the key reasons why Commun-I-Care is unique and successful are that private contributions and volunteers support it almost entirely. The contribution of free pharmaceuticals by manufactures is also key to the programs success. Half the doctors in South Carolina (over 2000) participate in Commun-I-Care. Not only primary care physicians participate, but specialists do too.
Commun-I-Care takes on many responsibilities of a managed health care plan, including: (1) Determining whether an individual is eligible for the program, (2) Issuing “coverage” and an identification card to participants that they present to providers, (3) Processing prescriptions, and (4) Performing numerous managed care functions as a “gatekeeper” such as approving hospitals visits, specialty appointments etc, establishing formularies, establishing networks of providers. Commum-I-Care does not actually take on risk because there are no provider payments.
SacAdvantage was awarded the Honor Roll for Coverage Award, in recognition of their efforts to provide coverage to the working families of Sacramento County.
In 2002, Sacramento County unveiled its SacAdvantage program based upon the FOCUS model in San Diego. HLC participated in their kick-off event. SacAdvantage provides a subsidy to employees of small businesses for health insurance coverage.
Sacramento County set aside funds from its Tobacco Litigation Settlement for the SacAdvantage program. $500,000 will be used from July 2002 to June 2003 and $500,000 from July 2003 to June 2004. SacAdvantage also received a $700,000 federal appropriation as part of the 2003 omnibus package. SacAdvantage is continuously searching for additional funds for future years. SacAdvantage staff estimate that approximately 100 businesses and 500 uninsured individuals will be enrolled in the program.
FAMIS (Family Access to Medical Insurance Security), the state of Virginia’s Children’s Health Insurance program, was awarded the Honor Roll for Coverage Award for their efforts to expand coverage to Virginia’s children and their parents that was the equivalent of private sector coverage.
FAMIS is a federal/state program that provides low-cost health insurance for children in families that earn too much for Medicaid, but do not have private health insurance. Many working families qualify.
A family would pay for coverage based on their income and the number of children they have enrolled in the program. Income guidelines are based on the Federal Poverty Level (FPL) which is adjusted each spring. The FAMIS income limit is 200% of the FPL. The highest fee any family pays is $45 per month, which covers three or more children. All families are also required to make nominal co-payments for medical services and prescriptions. Most co-payments are $2-$5.
FOCUS (Financially Obtainable Coverage for Uninsured San Diegans) was awarded the Honor Roll for Coverage Award, for their outstanding accomplishment in providing health care coverage to 1,700 of the working uninsured of San Diego County, California.
FOCUS is a two-year demonstration project made possible in part by a grant from the Alliance Healthcare Foundation (Alliance), a San Diego-based philanthropic organization that uses grant making, fund raising, education and advocacy to increase access to healthcare for the uninsured in the state of California. Sharp Health Plan (Sharp), a San Diego-based health plan that combines comprehensive medical services and preventive care, administers the FOCUS program.
FOCUS is designed to encourage local small businesses to offer health insurance to their employees. Businesses with two to fifty employees may participate in the program. FOCUS offers subsidized health coverage to employees earning between 100 and 300 percent of the Federal Poverty Level (FPL) annually and their dependents. Employees contribute between 1 and 4 percent of their incomes to the premiums, based on a sliding scale, and employers contribute as well. Participating employees must be uninsured at the time of enrollment, and must not have been insured for the entire year prior. Also, they must not be eligible for the state’s Medi-Cal or Healthy Families program.
HealthChoice in Wayne County, Michigan received HLC’s Honor Roll for Coverage Award for its successful provision of health care coverage to 18,000 of the working uninsured of Wayne County through their small employers.
Formed under the Municipal Health Corporation Act of 1987, HealthChoice began enrolling individuals in 1994. HealthChoice was established to manage a health care program benefiting employees of county businesses that were unable to provide health benefits to their employees. The program is funded equally through monthly contributions by employers, employees and Urban Hospital Care Plus (UHCP), a philanthropic, non-profit Michigan corporation. The corporation administers the program in conjunction with Patient Care Management system (PCMS), a division of the county’s Department of Health and Community Services. HealthChoice contracts with qualified medical providers to service HealthChoice members.
HealthChoice is available to any business with 90% of its business based in Wayne County that has at least three employees who qualify for coverage, has not offered insurance coverage in the past 12 months, and has 50% of its qualified employees earning $10 an hour or less. Eligible employees must have an anticipated work future of five months or more, work at least 20 hours per week, and be ineligible for and without healthcare coverage.
HONOR ROLL FOR COVERAGE – PHOTOS AND CAPTIONS
Montana Chamber Choices – October 28, 2009
Insure Oklahoma Award Ceremony
Insure Oklahoma and Oklahoma Health Care Authority are presented with HLC’s Honor Roll for Coverage award on Tuesday, September 30th. The ceremony took place at Hutchinson Products, in Tulsa, OK. Governor Jari Askins, State Senator Tom Adelson, and State Representative Kris Steele were among the dignitaries on hand.