For more information on AcademyHealth's State Health Policy and Technical Assistance work, visit the AcademyHealth website.
The Wellness Health Benefit Plan (HEALTHpact)
In 2006, Governor Donald Carcieri signed into law a new health initiative focused on providing premium relief for small businesses. Under this law, the Health Insurance Commissioner was empowered to work with business, insurance, and other stakeholders to develop a new, affordable health plan, called The Wellness Health Benefit Plan. For this new product, the Commissioner was given additional regulatory authority for product and rate approval. The legislation set a target premium of 10 percent of wages, while at the same time requiring the benefit design to meet certain affordability principles.
Meeting this legislatively-defined price point meant creating a product that would be priced approximately 25 percent below typical market rates[1]. As such, it was intended to slow the erosion in the small group offer rate by providing an alternative to high deductible health plans for low wage small businesses. The new product, called HEALTHpact, achieves this price point through a combination of innovative Wellness elements that create financial incentives for individual enrollees to make healthier choices[2].
The carriers began offering the HEALTHpact plans beginning in October, 2007. As of March, 2008 there were approximately 500 enrollees across 130 small employer groups. Enrollment is capped at 5,000 lives per insurer.
Other important early lessons learned from the HEALTHpact development process that states should consider are as follows:
[1]The average monthly premium for United for the first year for
individual plans is $309. For BC its $322.
[2]Plan design summaries for United are available on-line at http://www.uhc.com/live/uhc_com/Assets/Documents/RIPledgeAdvBS.pdf [1]
(advantage level cost sharing benefits summary), and
http://www.uhc.com/live/uhc_com/Assets/Documents/RIPledgeCOC.pdf [2] (full
certificate of coverage for Pledge Plan - UHC's Healthpact plan)
http://www.uhc.com/live/uhc_com/Assets/Documents/RIPledgeBasicBS.pdf [3]
(benefits summary for basic level cost sharing on the pledge plan. Blue Cross Blue Shield of Rhode Island offers a similar plan design option.
Links:
[1] http://www.uhc.com/live/uhc_com/Assets/Documents/RIPledgeAdvBS.pdf
[2] http://www.uhc.com/live/uhc_com/Assets/Documents/RIPledgeCOC.pdf
[3] http://www.uhc.com/live/uhc_com/Assets/Documents/RIPledgeBasicBS.pdf