September 17, 2007
Calling all employers | Anthem targets Maine's small businesses with a health insurance program offered through chambers of commerce
By Brandi Neal
Foreside Tavern co-owner Anne Verrill thought that once she stopped working for other people and actually opened her own business, she would be able to write her own health insurance plan, enjoy better coverage and offer it to her employees.
Things didn't work out quite the way Verrill expected.
"I didn't realize how many hoops you had to jump through to get [health] insurance," Verrill says.
Prior to June, Verrill and her husband, Peter, were only able to offer health insurance benefits to the two employees they consider management at their Falmouth restaurant, which opened three years ago.
This summer, Verrill's insurance broker mentioned a new health plan called Chamber BlueOptions, offered by Anthem Blue Cross and Blue Shield, which has its Maine headquarters in South Portland. Introduced in January, the plan is available to any business that employs between two and 50 people and is a member of the Maine State Chamber of Commerce or any other regional chamber in the state. Self-employed chamber members also qualify.
"We're really happy that somebody's come around and done it," says Verrill, who adds that she's now able to offer health insurance to all of her 13 full-time employees. "(Insurance) is one of those things ˆ kind of like a never-ending battle."
Verrill says the number of people she employs can vary on any given day, but her long-term employees realize the importance of health care. Prior to Chamber BlueOptions, the Foreside Tavern was not in a financial position to offer health insurance to the bulk of its employees.
For many of Maine's small-business owners, providing insurance has been a challenge. In Maine, 90% of private companies employ fewer than 20 people, many of whom work without health insurance. And not providing that insurance can be bad news for employees and employers alike: According to the National Coalition on Health Care, those without health insurance are as much as 50% more likely to be hospitalized for an avoidable condition. For employees, that can mean an unexpected slew of medical expenses. For employers, it can mean losing a critical staffer to an unexpected illness. Dana Connors, president of the Maine State Chamber of Commerce, wanted to find a solution for small-business owners looking for an affordable health care option. Connors approached Anthem Blue Cross and Blue Shield in 2006, challenging the company to come up with a plan that could be tailored to chamber members.
They responded, and the Chamber and Anthem in Jan. 2007 created an independent affiliate, the Maine State Chamber Purchasing Alliance, which offers small businesses that are members of a chamber of commerce in Maine a suite of five health plans, including three preferred provider organization (PPO) plans with varying deductibles and co-insurance levels, an HMO and a Health Savings Account Plan.
Portland Regional Chamber Director Godfrey Wood says the Anthem plan has filled a need among the Chamber's more than 1,000 members in the greater Portland area. So far, 52 members have signed up for Chamber BlueOptions. The chamber, he says, has been trying to come up with a plan to offer better health care coverage to its members for the past seven years. He calls Chamber BlueOptions "clear progress."
Since January, roughly 2,500 employees of small businesses in Maine have enrolled in the Chamber BlueOptions plan. Before that, around 20% of those people did not have any coverage, according to statistics released by the Maine State Chamber Purchasing Alliance.
"We're very encouraged by it," Connors says. "We're very pleased with the results."
No silver bullet
But while Verrill says that Chamber BlueOptions is a step in the right direction, she admits it's not perfect.
The Chamber BlueOptions plan offers five options, from standard HMO plans to a health savings account ˆ a high-deductible plan that allows employees and employers to contribute tax-deductible dollars to an account that can be used for qualified medical expenses. Those plans are priced at different tiers. And unlike the standard 75% employee participation rate many plans require, Chamber BlueOptions requires 60% participation from eligible employees. Many small businesses did not previously qualify for benefits because not enough of their employees chose to take advantage of the health care offerings.
While Connors agrees with Verrill that Chamber BlueOptions is not the silver-bullet solution to all health care challenges in Maine, he says the plan has filled a niche. With many companies cutting back on costs, and others not offering health insurance at all, Mainers often were left to pay for health insurance out of pocket, or go without any coverage at all.
Connors says that with five plans and the lower participation requirement, Chamber BlueOptions is a step up from the "one size fits all" approach to health care. "What you have that makes it very special is that the company seeking insurance doesn't have to find one product that pleases 75% of its employees," he says. "Both of these ingredients provide flexibility and choice, which is a really strong advantage."
Don Antonucci, director of small group sales at Anthem in South Portland, says choice and flexibility became key components of the program. "Being able to offer five products at once is a huge choice," he says. "As a small employer having trouble meeting the criteria, dropping the [participation] rate 15% is a huge win. That change in percentage can be the difference ˆ it really does help."
Antonucci says small businesses in Maine typically operate with tight budgets. And while bigger companies can offer slick benefits packages to attract employees, he says half of the state's small businesses aren't able to offer any health insurance to employees.
Gordon Holman, who runs a Portland Web design firm, SlickFish Studios, is in his first month of coverage with Chamber BlueOptions. Holman is the company's only employee, but says his business is growing, and hiring employees is a possibility. Even though he is paying $40 more per month now than when he was paying for coverage on his own, he feels it will benefit him in the long run. One benefit: The Chamber BlueOptions program is deductible through his business, while his previous health insurance plan wasn't. "The Chamber BlueOptions allowed me to set up something that would not only be deductible through the business, but [offer] better coverage for a little more per month," Holman says. "I feel confident I can offer a great health plan to future employees and ultimately to my family if needed."
Nearing a crisis point
Meanwhile, Wood says the plan has been a selling point for the Portland Regional Chamber. "We've had a lot of companies join the chamber because of the availability of the plan," he says, including a number of law firms that sought out chamber memberships.
This is true for Verrill, too, who previously wasn't a member of the chamber. "We joined the chamber solely to get the plan," she says. "We wanted to be able to offer healthcare to everyone [who works full-time]."
Wood says that while Chamber BlueOptions has provided an alternative to traditional health insurance, there's still more work to be done. He envisions a regional health alliance that would benefit members of the Portland Regional Chamber because health care costs tend to be about 20% less in the Portland area than in the rest of the state.
Meanwhile, whether Chamber BlueOptions can succeed is anyone's guess. The difficulty of addressing the uninsured population has fallen to programs like DirigoChoice, the state-sponsored insurance program that had been administered by Anthem. The program, which covers roughly 15,000 Mainers, has gotten mixed reviews. (Anthem and the Dirigo Health Agency on Sept. 5 announced they had concluded their contract because they were unable to agree on financial terms for another contract year. On Sept. 6, Dirigo announced a new partnership with Harvard Pilgrim Health Care, a Massachusetts-based nonprofit health insurer.)
Connors says Dirigo failed to reach its potential and costs more than many people assumed it would, but says attempting to tackle the difficult issue of health care coverage in Maine is a step in the right direction. Both Wood and Connors say health care in Maine is nearing a crisis point and they're looking for ways to keep health insurance affordable.
"With costs going up, we are working as hard as we can to find a solution," says Wood.
Connors agrees the cost of health care is a major issue in the state. And, while the issue of cost hasn't diminished, he says more flexibility among plans have made health care benefits more attractive to both employers and employees.
"We're well above the national average [for health care costs]. What do we do about it?" Connors asks. "It's a struggle. While this doesn't solve the problem, it's recognized for what it is ˆ a choice. You don't have to choose one size fits all."
Things didn't work out quite the way Verrill expected.
"I didn't realize how many hoops you had to jump through to get [health] insurance," Verrill says.
Prior to June, Verrill and her husband, Peter, were only able to offer health insurance benefits to the two employees they consider management at their Falmouth restaurant, which opened three years ago.
This summer, Verrill's insurance broker mentioned a new health plan called Chamber BlueOptions, offered by Anthem Blue Cross and Blue Shield, which has its Maine headquarters in South Portland. Introduced in January, the plan is available to any business that employs between two and 50 people and is a member of the Maine State Chamber of Commerce or any other regional chamber in the state. Self-employed chamber members also qualify.
"We're really happy that somebody's come around and done it," says Verrill, who adds that she's now able to offer health insurance to all of her 13 full-time employees. "(Insurance) is one of those things ˆ kind of like a never-ending battle."
Verrill says the number of people she employs can vary on any given day, but her long-term employees realize the importance of health care. Prior to Chamber BlueOptions, the Foreside Tavern was not in a financial position to offer health insurance to the bulk of its employees.
For many of Maine's small-business owners, providing insurance has been a challenge. In Maine, 90% of private companies employ fewer than 20 people, many of whom work without health insurance. And not providing that insurance can be bad news for employees and employers alike: According to the National Coalition on Health Care, those without health insurance are as much as 50% more likely to be hospitalized for an avoidable condition. For employees, that can mean an unexpected slew of medical expenses. For employers, it can mean losing a critical staffer to an unexpected illness. Dana Connors, president of the Maine State Chamber of Commerce, wanted to find a solution for small-business owners looking for an affordable health care option. Connors approached Anthem Blue Cross and Blue Shield in 2006, challenging the company to come up with a plan that could be tailored to chamber members.
They responded, and the Chamber and Anthem in Jan. 2007 created an independent affiliate, the Maine State Chamber Purchasing Alliance, which offers small businesses that are members of a chamber of commerce in Maine a suite of five health plans, including three preferred provider organization (PPO) plans with varying deductibles and co-insurance levels, an HMO and a Health Savings Account Plan.
Portland Regional Chamber Director Godfrey Wood says the Anthem plan has filled a need among the Chamber's more than 1,000 members in the greater Portland area. So far, 52 members have signed up for Chamber BlueOptions. The chamber, he says, has been trying to come up with a plan to offer better health care coverage to its members for the past seven years. He calls Chamber BlueOptions "clear progress."
Since January, roughly 2,500 employees of small businesses in Maine have enrolled in the Chamber BlueOptions plan. Before that, around 20% of those people did not have any coverage, according to statistics released by the Maine State Chamber Purchasing Alliance.
"We're very encouraged by it," Connors says. "We're very pleased with the results."
No silver bullet
But while Verrill says that Chamber BlueOptions is a step in the right direction, she admits it's not perfect.
The Chamber BlueOptions plan offers five options, from standard HMO plans to a health savings account ˆ a high-deductible plan that allows employees and employers to contribute tax-deductible dollars to an account that can be used for qualified medical expenses. Those plans are priced at different tiers. And unlike the standard 75% employee participation rate many plans require, Chamber BlueOptions requires 60% participation from eligible employees. Many small businesses did not previously qualify for benefits because not enough of their employees chose to take advantage of the health care offerings.
While Connors agrees with Verrill that Chamber BlueOptions is not the silver-bullet solution to all health care challenges in Maine, he says the plan has filled a niche. With many companies cutting back on costs, and others not offering health insurance at all, Mainers often were left to pay for health insurance out of pocket, or go without any coverage at all.
Connors says that with five plans and the lower participation requirement, Chamber BlueOptions is a step up from the "one size fits all" approach to health care. "What you have that makes it very special is that the company seeking insurance doesn't have to find one product that pleases 75% of its employees," he says. "Both of these ingredients provide flexibility and choice, which is a really strong advantage."
Don Antonucci, director of small group sales at Anthem in South Portland, says choice and flexibility became key components of the program. "Being able to offer five products at once is a huge choice," he says. "As a small employer having trouble meeting the criteria, dropping the [participation] rate 15% is a huge win. That change in percentage can be the difference ˆ it really does help."
Antonucci says small businesses in Maine typically operate with tight budgets. And while bigger companies can offer slick benefits packages to attract employees, he says half of the state's small businesses aren't able to offer any health insurance to employees.
Gordon Holman, who runs a Portland Web design firm, SlickFish Studios, is in his first month of coverage with Chamber BlueOptions. Holman is the company's only employee, but says his business is growing, and hiring employees is a possibility. Even though he is paying $40 more per month now than when he was paying for coverage on his own, he feels it will benefit him in the long run. One benefit: The Chamber BlueOptions program is deductible through his business, while his previous health insurance plan wasn't. "The Chamber BlueOptions allowed me to set up something that would not only be deductible through the business, but [offer] better coverage for a little more per month," Holman says. "I feel confident I can offer a great health plan to future employees and ultimately to my family if needed."
Nearing a crisis point
Meanwhile, Wood says the plan has been a selling point for the Portland Regional Chamber. "We've had a lot of companies join the chamber because of the availability of the plan," he says, including a number of law firms that sought out chamber memberships.
This is true for Verrill, too, who previously wasn't a member of the chamber. "We joined the chamber solely to get the plan," she says. "We wanted to be able to offer healthcare to everyone [who works full-time]."
Wood says that while Chamber BlueOptions has provided an alternative to traditional health insurance, there's still more work to be done. He envisions a regional health alliance that would benefit members of the Portland Regional Chamber because health care costs tend to be about 20% less in the Portland area than in the rest of the state.
Meanwhile, whether Chamber BlueOptions can succeed is anyone's guess. The difficulty of addressing the uninsured population has fallen to programs like DirigoChoice, the state-sponsored insurance program that had been administered by Anthem. The program, which covers roughly 15,000 Mainers, has gotten mixed reviews. (Anthem and the Dirigo Health Agency on Sept. 5 announced they had concluded their contract because they were unable to agree on financial terms for another contract year. On Sept. 6, Dirigo announced a new partnership with Harvard Pilgrim Health Care, a Massachusetts-based nonprofit health insurer.)
Connors says Dirigo failed to reach its potential and costs more than many people assumed it would, but says attempting to tackle the difficult issue of health care coverage in Maine is a step in the right direction. Both Wood and Connors say health care in Maine is nearing a crisis point and they're looking for ways to keep health insurance affordable.
"With costs going up, we are working as hard as we can to find a solution," says Wood.
Connors agrees the cost of health care is a major issue in the state. And, while the issue of cost hasn't diminished, he says more flexibility among plans have made health care benefits more attractive to both employers and employees.
"We're well above the national average [for health care costs]. What do we do about it?" Connors asks. "It's a struggle. While this doesn't solve the problem, it's recognized for what it is ˆ a choice. You don't have to choose one size fits all."
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