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Health Insurance On Sale July 1, 2005
Source:
Albuquerque Journal
Publication date: 2005-06-24
Plan Subsidized For Working Poor
A
long-awaited government-subsidized health
insurance product for low-income employees
of businesses goes on sale July 1, 2005
the Human Services Department announced
Thursday.
The department expects 10,000 employees
will get health insurance in the first
year of the State Coverage Initiative's
operation from one of three managed-care
companies with state contracts to offer
the Health
Insurance Coverage. Molina Health
Care, Presbyterian Health Plan and
Lovelace Community Health Plan will sell
the insurance.
Employers can begin applying for
coverage July 1, and the first employees
should receive coverage by September, said
SCI program manager Mari Spaulding-Bynon.
The state and federal government will
pay $20 million of the cost in the fiscal
year beginning July 1. Employers and
employees are expected to pay $7 million
for the insurance.
Uninsured adults age 19 to 65 with
family incomes up to 200 percent of the
federal poverty level ($2,681 a month for
a family of three) are eligible for
coverage.
"The product looks like a basic
commercial health plan in terms of
services provided," Spaulding-Bynon said.
It includes pharmaceutical benefits,
hospitalization, office visits, mental
health and substance-abuse benefits, and
preventive and diagnostic services.
Employers will pay $75 per employee per
month for insurance. Employees will pay
premiums and co-payments on a sliding
scale, depending on income. Those making
100 percent of the poverty level or less
will pay a co-payment of only $3 per
prescription for medications. Workers
making 200 percent of the poverty level
will pay $7 for most services, $3 for
medications and a $35 premium.
The federal government in 2002 gave the
state permission to use unspent Medicaid
State Children's Health Insurance Program
funds on the State Coverage Initiative.
Because of low enrollment in the program,
the state has regularly had to return
funds to the federal government.
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