Small Business Partnership by legalstuff1


									Small Business Partnership

   “Providing affordable primary
  health care to small employers”
             The Relationship
   The SC Primary Health Care Association
    (PCA) met with the SC Small Business
    Chamber Commerce (SBC) while
    participating on a Department of
    Insurance Coalition to address strategies
    to provide insurance coverage for
    employees of small businesses.
         South Carolina Data
 The majority (75%+) of the employers in
  South Carolina are small businesses
 Small businesses are defined as employers
  with 500 or less employees
 Survey of small employers showed 60%
  of small businesses with 100 or less
  employees did not provide any type
  health benefit to their employees
           South Carolina Data
   The average cost of health insurance for
    an individual is $3,700/year according to
    SC Fair Share.
            The Partnership
The PCA and SBC formed an alliance to
address the provision of health care
services as opposed to health care
The PCA and SBC held informational meetings
 across the state of SC, inviting small
 businesses and health center directors.
             The First Pilot
 The first pilot was started in September,
  2005 between Mid-Carolina (small
  employer) and two community health
  centers in the area (Eau Claire and
 Mid-Carolina provided information on their
  employees (age, income category,
                The First Pilot
 The two centers provided visit cost
  information based on the data Mid-
  Carolina provided and developed two
  options: fee-for-service and capitation
 Results:
     Mid-Carolina chose the fee-for-service option.
      Employees are appropriately assessed based
      on income - sliding fee scale.
     Mid-Carolina is billed for the difference after
      the employees $10 co-pay
             The First Pilot
 Mid-Carolina has extended this benefit to
  dependents of their employees
 A MOU was signed between Mid-Carolina
  and each health center (Eau Claire &
  Richland) stating the terms and billing
  procedures (handout)
 Each employee was given a fact sheet
  explaining the benefit (handout)
               The First Pilot
   Each employee was given a membership
    card which clearly states the card is NOT
    an insurance card. (handout)
The Department of Insurance

The DOI is constantly updated
      and consulted.
            The Greenville News
        (Excerpt from February 8, 2006 editorial)

 A small coalition of organizations has offered
  several realistic solutions to this crisis. The S.C.
  Small Business Chamber of Commerce, S.C.
  Appleseed Justice Center, S.C. Fair Share and
  the S.C. Association of Non-Profit Organizations
  have taken steps to move the health-care issue
  onto the state's agenda.
 These organizations believe that a combination
  of public/private hybrid solutions is needed to
  address both the cost of health care and health
     Here is a summary of just two proposals.
 The Small Business Chamber and the S.C.
  Primary Health Care Association have launched
  what appears to be a first-in-the-nation pilot
  program to make health care more affordable
  for small businesses without insurance.
  Affordability results from these community
  health centers being both nonprofits and
  qualified to draw down federal money to
  subsidize services to {uninsured} patients with
  incomes up to 200 percent of poverty.
 Last September, Columbia-based Mid-Carolina
  Steel and Recycling entered into a private sector
  agreement with two community health centers.
  The workers and family members had a $10 co-
  payment and the employer paid the rest of the
  cost on a fee-for-service basis.
 This pilot program has been a tremendous
  success for the employees, the health centers
  and the employer who now can afford to offer
  important health care to all his workers.
   Efforts are under way to help other small
    businesses in the same way and to secure
    $5 million in state funding to enable
    community health centers to serve 12,000
    to 15,000 more similarly uninsured across
    the state.
                   Front of Card
                    SC Health Care Services Partnership
                       This is not an insurance card.

Employer Name: _________________________________________
Employer Code: __________________________________________
Employee Name: ________________________________________
                 First                           Last

Service Type: Employee Only        Employee/Family

 Please check with the health site to determine which services are
                        available at that site.
           Back of Card
Because your employer has partnered with a
 member health care provider organization of
   the South Carolina Primary Health Care
 Association, you can present this card at any
     site of the Eau Claire Cooperative or
      Richland Community Health Care
Association to receive primary and preventive
               health care services.
             Pilot Results
 Total employees 38 (9 managers with
  insurance coverage; 27 employees with no
  insurance coverage)
 Total # visits between 9/28/05 and
  3/28/06 = 21 (10 individuals)
 Of the 21 visits: 13 dependents, 8
 Total cost to-date: $1,907.52
            Expansion of the Pilot
 Long Drugs (DME Department): 35
 SC Manufacturers Extension Program
     400 businesses participate in a catastrophic
      insurance program
     The health centers will provide primary and
      preventive care

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