Insure Montana Small Business Health Insurance Program

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Insure Montana Small Business Health Insurance
Program

• The Small Business Health Care Affordability Act,
  was requested by State Auditor John Morrison and
  Governor Brian Schweitzer and was signed into
  law in May of 2005.
• The program is designed to give tax credits to
  small businesses already offering health coverage
  and to provide monthly assistance and membership
  in a purchasing pool to businesses that have not
  offered health insurance in the past.

About Montanas Population
Montanas uninsured rate ranks among the worst in
the nation. One in five Montanans or about 170,00
0 residents have no health insurance.
53 of Montanas uninsured population works for a
small business. 80 of small firms not offering
insurance would do so if they could afford the
premiums.
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Popularity of Insure Montana

• 740 previously uninsured businesses are enrolled
  in the purchasing pool covering 5,100 lives
  
• 655 small businesses are receiving a tax credit
  through Insure Montana, covering 3,800 lives
  
• Over 500 small businesses are on a waiting list
  to participate in the program, either through the
  purchasing pool or a tax credit.
  
• Lee Newspapers Poll, reported on 12/20/06
  showed
  
• A program that provide subsidies and income
  tax-breaks to help small businesses provide
  health insurance for employees (Insure Montana)
  was supported by 87 percent of those surveyed,
  while only 6 percent opposed an expansion. Seven
  percent were undecided.

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Insure Montana Purchasing Pool and Tax Credits

• Eligibility Requirements
• Businesses with 2-9 full time employees where no
  employee earns more than 75,000 (excluding the
  owner) meet the initial criteria.
  
• In order to be eligible for the Purchasing Pool,
  a business must NOT have offered group health
  insurance in the past 24 months.
  
• Purchasing Pool participants receive monthly
  employer incentive payments and employee
  assistance payments
  
• In order to be eligible for a Tax Credit, a
  business must currently pay some or all of the
  cost of group health insurance for their
  employees. The program also provides additional
  Tax Credits when employers pay insurance premiums
  for the employees spouse or their dependents.

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Insure Montana Implementation

• Purchasing Pool
• Coverage began January 1, 2006
• 740 previously uninsured businesses enrolled
• 5,130 lives covered
• Average monthly assistance amount 158 (per
  employee)
  
• Average monthly incentive amount 203 (per
  employer)
  
• Funding available for approximately 760
  businesses
  

• Tax Credits
• Credit effective January 1, 2006
• 725 businesses received a credit for 2006
• 655 businesses enrolled for 2007
• 3,800 lives covered
• Average yearly tax credit 5,300

Insure Montana Funding
Funded by 1 per pack cigarette tax passed by
voters. Insure Montana was allocated 13 million
dollars for the first two years. (FY 2006,
2007) For the upcoming biennium 20 million dolla
rs has been allocated (FY 2008, 2009)
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Insure Montanas Governing Board

• Insure Montana Mission Statement
• Increase the well-being of all Montanans by
  enabling access to comprehensive healthcare for
  the members of the small business workforce and
  their families.
• Insure Montana has a Governing Board consisting
  of 7 members
  
• 3 members are appointed by the Commissioner
• 4 members are appointed by the Governor

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Premium Incentive and Assistance Payments

• Employer Incentive Payment Employer receives a
  monthly incentive payment for a portion of their
  contribution
  
• Employee Assistance Payment Individual employee
  receive a monthly assistance payment based upon
  household income
  
• Employees can receive anywhere from 20- 90
  assistance on their share of the premium
  
• Additional assistance is provided if an employee
  is covering dependents

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Benefits of Pool Coverage

• Coverage available through Blue Cross Blue Shield
  of Montana
  
• Two comprehensive plans offered
• Standard Healthlink Plan
• 1000/2000 Deductible
• Coinsurance 70/30
• 2 office visits paid at 100
• Preventative Benefits paid at 70
• Dental coverage included- 2 cleanings per year
• RX 100 deductible
• Premier Healthlink Plan
• 500/1000 deductible
• Coinsurance at 80/20
• 2 office visits paid at 100
• Preventative Benefits paid at 80
• Dental coverage included- 2 cleanings per year
• RX 0 deductible

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How the Employer Incentive Payment Works

• Employers are required to contribute 50 of the
  employee-only premium
  
• Insure Montana (IM) reimburses the employer 50
  of their contribution amount through a monthly
  incentive payment, based on the Standard
  Healthlink plan (subject to rate tier 6, and age
  54)
• If an employer contributes more than 50,the
  incentive payment will not increase
  

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How the Employee Assistance Payments Work

• Employees are responsible for other half of their
  premium, plus dependents if they are covering
  them
  
• Premium assistance payment is determined by
  annual household income amounts based on a
  sliding fee scale
  
• Employees receive 20-90 assistance monthly
• If an employee is covering dependents the amount
  of assistance will be greater
  

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Insure Montana Examples

• Employee 1 Single Coverage, 35-39
• Total Monthly Premium 214.74
• Employer contribution 107.37
• Employer incentive payment 53.69
• Employee contribution 107.37
• Employee assistance 64.42 (60)
• Employee total 42.95
• Employee 2 Family Child, 35-39
• Total Monthly Premium 742.07
• Employer contribution 152.78
• Employer incentive 76.39
• Employee contribution 589.29
• Employee assistance 471.43 (80 assistance)
• Employee total 117.86

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Looking Forward

• Insure Montana anticipates enrolling an
  additional 25 businesses in the purchasing pool
  
• Governor Schweitzer proposed an additional 1
  million for the program which passed the 2007
  Montana Legislature
  
• Insure Montana will be submitting a Request for
  Proposal (RFP) for additional carriers this
  summer to participate in 2008. Legislation allows
  for up to 3 carriers and 6 plans to be offered

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Insure Montana Contact Information

• www.insuremontana.org
• Lisa Crowley, Program Director [phone]