Enrollment Experience of Select State Small Business Subsidy Programs
|
Program (Start date)
|
Eligibility
|
Enrollment Updates Fall 2008 (Individuals)
|
|
CoverTN
(2007)
|
Businesses must have less than 25 employees with 50 percent earning $43,000 a year or less. The plan is available for businesses who have not offered insurance for six consecutive months, or if offered, the employer has not paid 50 percent or more of the premiums. The plan must be offered to all employees.
|
16,020
|
|
ARHealthNet
(2006)
|
Employers with 2-500 employees who have not offered a health plan to employees within the past twelve months. At least one employee must qualify for subsidized premiums and have a household income at or below 200 percent FPL, and all employees must participate in the program or provide documentation of coverage.
|
5,000
|
|
Insure Montana
(2006)
|
Uninsured firms (2-9 employees) that have not offered insurance for 24 months and have no employees who earn more than $75,000 per year.
For employers of small businesses with 2-9 employees offering health plans, a tax credit of up to 50 percent of paid premiums is available.
|
5,500
5,000
|
|
New Mexico State
Coverage Insurance
(2005)
|
Low-income, uninsured, working adults with family income below 200 percent FPL. Participating employers must have ≤50 employees and have not voluntarily dropped a commercial health insurance in past 12 months.
|
33,200
|
|
Insure Oklahoma
(Previously known
as O-EPIC)
(2005)
|
Workers and their spouses, who work in firms with 50 or fewer workers and contribute up to 15 percent of premium costs; self-employed; unemployed individuals currently seeking work; and individuals whose employers do not offer health coverage with household incomes at or below 200 percent FPL.
Small employers must contribute at least 25 percent of eligible employee’s premium costs and offer an Insure Oklahoma-qualified health plan.
|
11,000
+ 5,000 in the
Individual Plan
|
|
West Virginia Small
Business Plan (2005)
|
Small businesses (2–50 employees) that have not offered health benefit coverage to their employees during the preceding 12 months are eligible to participate. Employers must pay at least 50 percent of the premium cost. At least 75 percent of employees must participate.
|
1,500
|
|
Healthy New York
(2001)
|
Small employers that have previously not offered insurance and with 30 percent of workers earning less than
$34,000 annually.
Sole proprietors and working individuals without access to ESI who earn less than 250 percent FPL and have been uninsured 12 months.
|
153,080
|
|
Idaho Access to Health
Insurance (2005)
|
Income Eligibility up to 185 percent FPL with an employer contributing 50 percent of the premium. The subsidy has a maximum of $100 per month per person or $500 per month per family.
|
400
|
|
The Massachusetts
Insurance Partnership
(2000)
|
Individuals with income below 300 percent FPL are eligible. Employers contribute 50 percent of the premium. Businesses with 1-50 employees are eligible. Coverage must qualify as comprehensive.
Enrollees must show that they have been uninsured for at least six months.
|
15,600
|
|
Maryland Health
Insurance Partnership
(2008)
|
Employers can receive a subsidy of up to 50 percent of the premium if the following criteria are met:
• The business has between two and nine employees;
• The average employee wage is below $50,000; and
• The employer did not offer health insurance to employees during the 12 months prior to application.
For a health plan to be eligible for a subsidy it must encourage wellness by providing employees with a health risk assessment and incentives for health-promoting activities, preventive care and chronic care management.
|
420*
|
|
Maine Dirigo Choice
(2003)
|
Individual must earn below 300 percent FPL and the employer must contribute 60 percent of the premium. The program offers subsidies to the individual on a sliding scale.
Dirigo Choice is currently closed to subsized employers and all individuals.
|
10,663
|
|
Arizona Health
Insurance Premium
Tax Credit (2006)
|
The state pledged up to $5 million in tax credits to subsidize private insurance premiums. Employers must have from 2-25 employees and have not offered coverage for 6 months. Eligible individuals must earn below 250 percent FPL. The state pays 50 percent of the premium, up to $1,000 for individuals and $3,000 for a family.
|
2,110
|
|
North Carolina Small
Business Health
Insurance Tax Credit
(2006)
|
Small businesses are eligible for a $250 per year per employee tax credit to off-set their share of health insurance premiums. The business must have 1-25 eligible employees, the employer must cover 50 percent of the premium and the employee’s income must be less than $40,000 per year.
|
N/A
|
For additional information on these programs and other state initiatives, visit http://www.statecoverage.org/node/23
* 420 individuals and 80 businesses were enrolled as of December 1, 2008. The program began enrollment in October, 2008.
