West Virginia

SCI Demonstration Grant

In 2003 the West Virginia Health Care Authority was awarded a SCI Demonstration Grant to design a coverage expansion to small businesses with 50 or fewer employees. The West Virginia Public Employees Insurance Agency (PEIA) operates an insurance pool for approximately 8,000 local government employees and dependents. The original objective of the grant was to expand the existing small group insurance risk pool within PEIA. A year into the grant, the grant management shifted from PEIA to the West Virginia Health Care Authority after the passage of Senate Bill (SB) 143 during the 2004 legislative session.

SB 143 created the West Virginia Small Business Plan, a public-private partnership between PEIA and participating insurance carriers by allowing carriers access to PEIA's provider reimbursement rates. The design of the Small Business Plan included coverage in both primary care and major medical at a cost that is 20-25 percent lower than the retail rates. The state sought to expand the pool of covered working persons and their families accomplish this at no cost or risk to the state.

Grant Highlights:

• Senate Bill 134 passed on March 13, 2004.
• Mountain State Blue Cross Blue Shield filed to be a participating carrier.
• West Virginia Small Business Plan began enrollment on January 1, 2005.
• Advertising campaign for Small Business Plan rolled out on July 1, 2005