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 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 170,000 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.

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.

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.

Insure Montana Implementation Purchasing Pool Coverage began January 1, 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, businesses received a credit for businesses enrolled for ,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 dollars has been allocated (FY 2008, 2009)

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

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

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

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

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

Insure Montana Examples Employee #1: Single Coverage, Total Monthly Premium: $ –Employer contribution: $ –Employer incentive payment: $53.69 –Employee contribution: $ –Employee assistance: $64.42 (60%) –Employee total: $42.95 Employee #2: Family+ Child, Total Monthly Premium: $ –Employer contribution: $ –Employer incentive: $76.39 –Employee contribution: $ –Employee assistance: $ (80% assistance) –Employee total: $117.86

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 Legislation allows for up to 3 carriers and 6 plans to be offered

Insure Montana Contact Information Lisa Crowley, Program Director (406)