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Oregon's Children's Group Plan

In early 2005, Oregon began offering the Children's Group Plan, which allows small business owners to provide comprehensive coverage for the children of their workers even if they cannot afford to cover their employees (see original snapshot). Participation to date has been disappointing, with the sale of only three policies covering 10 children as of October 2005. Nevertheless, program administrators believe that promotion of the Children's Group Plan (as well as a high-deductible adult plan that is available for adults and may be purchased separately or with the children's coverage) is reducing the state's uninsured population in other ways.

Designed by Oregon's Insurance Pool Governing Board (IPGB), at the direction of the 2003 state legislature, the comprehensive HMO and PPO products are offered as "children only" plans by two insurance carriers in the state. [1] IPGB's Cindy Bowman attributes the low participation to three main obstacles:

  • Eligibility rules require that a business has not offered insurance since July 1, 2003 or it is a new business; the plan is not available to the many businesses contacting IPGB that have been offering insurance, but are seriously considering dropping the coverage because they can no longer afford it.
  • Because of the comprehensive benefit package, the price of the plan has proven to be too high to attract many small firms.
  • There are few effective ways to target the marketing directly to eligible businesses.
IPGB is trying to address these challenges, but this involves tradeoffs. For example, price will be a major component of renewal negotiations with the carriers, and planners hope to find a way to reduce premiums by about 50%, although this will likely require reducing benefits and/or increasing cost-sharing requirements.

Despite the low enrollment, there are some anecdotal indications that interest in the two IPGB plans has led to numerous uninsured businesses purchasing other insurance products, which is viewed as a successful outcome by state planners. Through marketing and outreach by IPGB, the participating carriers have received over 400 requests for price quotes. Each request generally results in a consultation between an uninsured business owner and an insurance agent, who presents the IPGB plans along with other standard market plans. One agent reports that she promoted the IPGB plans to 12 different employers and 10 of them purchased standard market group plans.

According to Cindy Bowman, "This is a clear indication that the plans are helping to reduce the state's uninsured rate one business at a time." IPGB is in the process of developing a reporting tool that will improve its ability to track such sales on a more systematic basis.

Reference:
[1] IPGB is a state agency dedicated to helping small businesses obtain health insurance for themselves, their employees, and their employees' dependents.

For More Information
Contact: Cindy Bowman, Project Coordinator, Insurance Pool Governing Board, (503) 378-4674, [email protected].
Visit: Insurance Pool Governing Board Web site
Alternative Group Plan Manual

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