Reaction Positive to Health Coalition’s Plan

By Staff Report

Feb. 2, 2005

There has been favorable reaction so far to a groundbreaking plan that’s aimed at offering affordable health care insurance to 3 million uninsured workers and their families. The program involves a coalition of 60 Fortune 500 companies, and is sponsored by the HR Policy Association.

The program is “a noble effort” to tackle a formidable problem, says Pat Schoeni, executive director of the National Coalition on Health Care. The problem is coming up with an affordable package of benefits on the one hand, and convincing uninsured workers to buy into it on the other.

“We don’t think it’s the answer to the uninsured, but we certainly think it’s a positive step,” Schoeni says. Some 44 million Americans are living without health insurance.

The plan offers six tiers of service and six levels of price, ranging from a $5 a month discount card to a $400 a month major medical policy offered by a health maintenance organization.

Eligibility will be limited to part-time employees, contract workers, pre-65 retirees and some franchise employees with ties to one of the participating companies. Regulatory hurdles in some states must be overcome. Open enrollment is scheduled to begin Sept. 1.

Companies in the coalition will not help workers pay health plan premiums, but will use their existing provider networks and bargaining power to generate deep physician and hospital discounts. With 3 million eligible workers and their families in a single pool, employees are promised better price breaks than they’d get on their own. Sears Roebuck and Co., IBM and General Electric Co. are helping lead the coalition.

“Even a low-paid part-time worker will have something that fits their budget,” says Tom Beauregard, a health care consultant at Hewitt Associates, which will administer the program.

UnitedHealth Group will be the primary health care provider. Humana and Cigna Healthcare will also participate on a regional basis.

Alan Slavitt, managing director of UnitedHealth’s Center for Affordable Consumer Health, says it’s hard to predict what kind of acceptance the program will receive. “Nothing like this has ever been done,” he says. “We are trying to reach a population that we’ve never sold to before.”

Karen Davis, president of the Commonwealth Fund, a private health care research foundation, says offerings like a “wellness benefit” priced at $50 a month will help sell the program. The benefit pays $20 toward each prescription up to five a year, covers two dental visits and one vision visit annually, and covers 80 percent of in-network office visits costs and 100 percent of preventative care.

“For $50 a month they get a reasonable set of services,” she says. “Its not comprehensive health insurance, but it is certainly a set of primary and preventive care services.”

Even though the plan is not perfect, Paul Fronstin, a research associate with the Employee Benefits Research Institute, says just getting a plan off the ground can be considered a success. “You’ve created something where nothing existed before,” he says.

Best case, Fronstin says, the plan could take off and have a snowball effect.

Worst case, it’s back to square one.

Douglas P. Shuit, staff writer

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