A new program designed to provide affordable health insurance coverage to the uninsured beginning in September 2005 was introduced in late January at the World Health Congress in Washington, DC.
The program, called National Health Access, could benefit up to 3 million employees and their dependents, according to figures presented by the HR Policy Association, an organization of chief human resource officers from more than 240 companies in the Fortune 500, which created the plan.
Responding to a Need
In 2003, the association formed the Health Care Policy Roundtable to address health care issues faced by their companies and the country as a whole.
“The primary focus of the Roundtable has been to address the issue of the uninsured in America,” said Greg Lee, senior vice president of human resources for Sears, Roebuck and Co. and chairman of the HR Policy Association’s Affordable Health Care Solutions, at the Washington meeting. Affordable Health Care Solutions is a coalition representing more than 50 Fortune 500 companies.
“As business leaders,” Lee told conference attendees, “we have come to understand that this problem drives lower U.S. labor productivity [and] higher private-sector health care cost, and will ultimately lead us to state and/or federal mandates if we don’t take action.”
In 2004, the coalition published a set of detailed policy recommendations regarding the uninsured.
“At the same time,’ said Lee, “because we are a group with a strong bias towards action, we decided to determine whether the nation’s largest employers could join together to create improved coverage options for a subset of the uninsured population, namely the working uninsured, and simultaneously drive improvement on the provider transparency front.” The result of that effort is the National Health Access program.
Will Benefit Working Uninsured
Through National Health Access, eligible participants will have access to a range of health insurance products.
According to Lee, “These benefits are all very clear and transparent. There are no hidden limits or hidden coverage exclusions–what the consumer sees is what he or she will get. Equally important, most of the benefits are guaranteed issue, more affordable and present fewer roadblocks to health care coverage.
“A person’s health status will not affect premium levels nor will access change because of health status,” said Lee at the conference. “In addition, patients will have access to a core set of provider and facility measures that will bring much-needed transparency.”
Large Employers Involved
Sears employs almost 250,000 people nationwide, and the majority of those workers are part-time with no employer-provided health insurance. Other companies participating in the program include IBM, General Electric, and McDonald’s.
National Health Access will be available to employees and other individuals connected to the coalition’s participating companies. Groups eligible to participate include part-time workers, temporary and seasonal employees, contract workers, workers at franchises with more than 50 employees, and pre-Medicare retirees without employer-sponsored coverage.
“National Health Access is the first of what we hope to be several steps by employers to give uninsured working Americans greater access to health care,” said Lee.
“The problem of the uninsured is a national one that requires national solutions. We can begin that process by building a structure that the nation’s largest employers can use to offer health benefits to hundreds of thousands of working Americans without employer-provided care.”
“Affordable, Flexible Coverage”
William J. Conaty, senior vice president of corporate human resources for General Electric Company and chairman of the HR Policy Association, said in an association news release, “National Health Access is the beginning of a process to bring together the nation’s largest employers to work together effectively in developing meaningful health care market reforms. It deserves the strong support of America’s largest employers.”
Mirroring many of the advantages of a traditional group policy, National Health Access offers lower premium costs and more flexibility in health insurance coverage than most people can obtain on their own in the individual insurance market. The program includes a choice of up to six levels of coverage at different prices that can be tailored to fit individual needs.
For example, participants have options to choose major medical coverage (in most states), inpatient and outpatient benefits, and discounts for in-network medical care. Wellness benefits and dental and vision benefits also have been incorporated into the program. Pending state-by-state regulatory approval, open enrollment is targeted to begin September 1 of this year.
The coalition selected the Uniprise division of UnitedHealth Group as the primary provider of the National Health Access plans. Insurers CIGNA and Humana are participating in more targeted, regionalized programs. The association retained Hewitt Associates to administer the program and track results, to ensure consistent implementation, and to reduce the administrative burden on the association and participating employers.
“National Health Access begins to address the inadequate state of our health care system for individuals without group health insurance, where people who had no health insurance now have access to affordable, flexible coverage,” said Lee.
“By pooling our purchasing power and developing a plan that is adaptable to various needs and income levels, we can give people the option of obtaining coverage that is more comprehensive and affordable than what is available to them on the open market,” he said.
Susan Konig ([email protected]) is managing editor of Health Care News.