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Kaiser Daily Health Policy Report
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State Watch | Rhode Island Health Insurance Commissioner Unveils Low-Premium Health Plans
[Apr 05, 2007]

      Rhode Island Health Insurance Commissioner Christopher Koller on Tuesday unveiled new low-premium "wellness health benefit plans" that are intended to encourage small businesses to offer health coverage to workers, the Providence Journal reports. The plans, which will be offered by Blue Cross & Blue Shield of Rhode Island and UnitedHealthcare of New England, will include coverage for physician visits, hospitalization, preventive services and prescription drugs. Under a law passed last year, the insurers must offer the plans to businesses with 50 or fewer employees beginning Oct. 1. The law requires premiums to equal no more than 10% of the average annual wages in the state. Premiums for individual coverage will average $322 per month for Blue Cross plans and $309 per month for UnitedHealthcare plans -- 18% lower than similar plans currently on the market. The two insurers will offer a "basic plan" and an "advantage plan," which will have the same premiums. Advantage plan members will have lower deductibles, copayments and out-of-pocket contributions, but they will be required to participate in a wellness program, such as smoking cessation, weight-loss and disease-management programs, if it is deemed necessary. In the second year, advantage plan beneficiaries will be required to prove that they participated in required programs. Details on methods to confirm participation still are being determined. Advantage plan beneficiaries also will be required to obtain a primary care physician, undergo a health assessment and follow recommendations from that assessment. The plans will cover annual physicals, mammograms and prostate cancer screenings without applying the deductible. Another aspect of the plan, which will not go into effect until after Jan. 1, 2009, will offer financial incentives to beneficiaries who choose high-quality and efficient care providers. A similar plan eventually will be developed for individuals who are self-employed or purchase insurance on their own rather than through a group plan. Koller estimated that between 5,000 and 10,000 small-business employees will enroll in the plans (Freyer, Providence Journal, 4/4).


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