State health plan a boon for low-income employees

Friday, August 27, 2010
Spreading the news about an affordable, state subsidized health insurance plan that costs as little as $25 a month were Harry Wilk and Richard Williams, who stopped by the Carroll County News office in Berryville recently. Anna Mathews / Carroll County News

CARROLL COUNTY -- When he first came across a $25-a-month health insurance plan for low income employees and $35-a-month for the self-employed, former county judge Richard Williams thought it was a scam.

As a small business owner with low income employees, Williams was interested -- but dubious.

He is now a staunch advocate who has employees and family enrolled -- and he wants to share the good news with others.

"Health insurance is a big concern for many people these days and this plan has been around a couple of years," he said. "It's a great opportunity for the people of Carroll County -- even farmers can qualify!"

Williams was talking about ARHealthNetworks, an innovative State of Arkansas low-cost health benefits plan subsidized by state tobacco settlement funds and federal matching funds.

According to the Arkansas Center for Health Improvement (ACHI), a nonpartisan, independent health policy center, a profile of the uninsured in 2005 showed that more than 70 percent of Arkansas small businesses did not offer health insurance and nearly 400,000 adults did not have coverage because of high premiums.

ACHI took on the challenge beginning in 2000 and developed a 21-member coalition made up of health care purchasers and providers, consumers and insurers who developed the safety net program now known as ARHealthNetworks.

"I first received information from an insurance agent based in Little Rock," Williams recalled. "He wouldn't come here to talk to me about it, so I thought it was a scam."

Williams said he checked with Harry Wilk next, the county's former insurance agent.

Wilk said he was not familiar with the plan, but after checking it out on the web, he became convinced that it was an "ideal plan for areas with low incomes."

It is administered through NovaSys, one of the largest health plan administrators in the state, it is sponsored by the state, and most area doctors are in the network, said Wilk.

Wilk added that he now is one of the few agents in this area to offer ARHealthNetworks.

Both Williams and Wilk praised the plan's benefits and its affordability.

As the owner of a gas station/convenience store at Holiday Island, Williams said he can offer the plan to his qualifying employees.

This is how it works, he said.

An employer offering the plan must have a minimum of two full-time employees, but no more than 500. The employer deducts the monthly premium from the employees' pay and remits it to the state each month. There is no cost to the employer, only paperwork.

Employees must be an Arkansas resident, a U.S. citizen, work 30 hours or more per week, be between the ages of 19-64, and have a household income no greater than 200 percent of the federal poverty level.

As an example, a single person can make up to $1,805 per month to qualify for the subsidy, or $2,428 if they are a family of two.

Those who earn more can still get insurance through the plan. They pay $255 a month, which Williams says is still a great deal, especially for those with high priced prescription drugs.

He said his wife is on the $255-a-month plan and they have already realized savings because of her knee problems. He also noted that pre-existing conditions are "covered from day one!"

Wilk described it as a "moderate" plan, meaning a person is limited to $100,000 in services per year. It wouldn't cover the high price of cancer related treatments, he said, but it does provide a basic benefits package that most people need.

He said the plan covers six office visits, seven inpatient hospital days, two major outpatient services, and six provider visits per year, along with two prescriptions per month.

"It's very affordable," he said.

In addition to employee coverage, spouses are also covered at the same rate.

Children are not included, Wilk said, because they are covered under the state's ARKids First plan.

Those who do apply must be an Arkansas resident, Wilk said, and show a driver's license and one other form of identification, such as a passport or birth certificate.

Employers wishing to offer the plan must be an Arkansas business with less than 500 employees, have no group plan, and have at least one employee who qualifies for the subsidized premiums.

Williams said employers who offer the plan have "a good way to retain employees" since the insurance is not transferable.

Wilk said he has signed up Williams' business so far, along with two others, the Grand Central Hotel and Sleepy's Cabin Decor, and one of those two is paying its employees' premiums, he noted.

Williams summed up his perception of the plan.

"You have $100,000 coverage per year at $25 a month," he said. "That's pretty unique -- and a real opportunity for the people of Carroll County."

For more information, contact Wilk, a licensed agent, at (479) 253-7343 or (877) 225-0521.

Additional information is also available online at ARHealthNetworks.com or by calling (800) 540-7566.

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