State insurance program participation hits record

By Jeff Raymond

Published: May 14, 2008

The number of enrollees in the state's health insurance premium assistance program has exceeded 10,000 for the first time in its three-year history.

The Oklahoma Employer/Employee Partnership for Insurance Coverage started small with only 1,557 enrollees 15 months ago. After a media blitz last fall, the program has grown rapidly.

The most recent count of enrollees was 10,776 — up from 9,400 for April.

The Oklahoma Health Care Authority administers the part of the program that deals with individual health plans. Private health plans cover employees through the employer-based program.

Individual plan enrollment began in March 2007. The employer-sponsored plans have been around since early 2005.

Forty-eight percent of Oklahomans received insurance through their employers in 2005-06, according to the Kaiser Family Foundation, a Menlo Park, Calif., health policy nonprofit.

Health Care Authority officials said people often assume they're not eligible when, in fact, they are.

An income of as much as 200 percent of the federal poverty level — as much as $41,300 a year for a family of four — qualifies. The Health Care Authority has requested permission from the federal government to raise the ceiling to 250 percent of the federal poverty level.

"They should apply. They shouldn't just think, ‘I won't qualify,'” said Melinda Jones, who works with the federal Medicaid waivers needed for the program.

Since its inception, the program has expanded from accepting businesses with 25 or fewer employees to welcoming those with 50 or fewer employees. Businesses must offer qualifying health plans and apply with the health care authority for acceptance.

Employees are given cards from their insurance carriers, and the health care authority pays businesses to offset premiums. Employees pay a maximum of 15 percent of the cost. The Health Care Authority pays 60 percent or more. The average premium assistance payment per enrollee in April was $228.

Money for the program comes from tobacco taxes.

Health Care Authority spokeswoman Jo Kilgore said the employer plan has been the focus because the authority wanted to work with the private sector first. The individual plan is the "safety net follow-up.”

Reducing the state's uninsurance rate isn't the program's only draw.

"The businesses feel it's both a recruitment and a retention tool for their businesses. Their employees are thrilled to have access to health coverage,” Jones said.

She noted that the program has no pre-existing condition clauses like most insurance policies.

"That has been a lifesaver for some people,” she said.

Rob Fisher, president of Oklahoma National Stockyards Co. in Oklahoma City, signed his business up for the health insurance program six or seven months ago. The company has about 40 employees.

"I was sitting at home one night and saw the advertisement on TV,” he said. "Then I realized that we would qualify with it for quite a few of our employees.”

The company's accountants put together the application, much of which they did online. Payments have been prompt, and things have gone smoothly.

"It has just worked tremendously,” Fisher said.

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