Affordable health coverage for small businesses and their employees

Health Share Inc. Executive Director Jenny Peterson and Business Services Representative Wyn Mathews spoke at the March 27, 2013 Business Networking Luncheon at Higher Ed in Grand Marais. Health Share Inc. is a health coverage program for small businesses and their employees in the Northland. The nonprofit offers health benefits at very low cost, and nearly all health care providers in the region are participants in the program.

Small businesses and the people who work for them may be happy to learn that a local, nonprofit health coverage program is available at a cost they might be able to afford.

HealthShare was established four years ago by a group of area health care providers and foundations. Their goal was to reduce the number of uninsured by providing health and wellness services to working families in Cook, Lake, St. Louis, and Carlton counties through an affordable, employer-sponsored health coverage program.

A 2010 survey revealed that 9 percent of people in the Northland were uninsured. Sixty-eight percent of the uninsured were working, and 58 percent of those uninsured worked for small businesses. In 2011, 54 percent of Minnesotans had employer-based health coverage, with small businesses paying about 18 percent more for insurance premiums than large companies. About 500,000 people in Minnesota are currently uninsured.

Health Share Inc. Executive Director Jenny Peterson spoke to a group of businesspeople at a Business Networking Luncheon sponsored by Cook County Higher Education on March 27, 2013. She said funding for the program comes from employers, employees, and the community, including local foundations and health care organizations. “Definitely the health care system sees the value in this,” she said, adding that the Affordable Care Act is only going to cover about 60 percent of uninsured Americans.

Preventative care is a key component of HealthShare, which offers reduced costs for people who go through health risk criteria and set two health goals with a care manager once a year. People who do not take preventative measures, such as taking medication to avoid a health crisis, end up needing higher-costing health care. “We strongly believe in wellness and promoting health,” Peterson said.

Services that are covered include primary and specialty office visits, hospital and emergency care, pharmacy (up to a certain amount), lab, radiology, physical and occupational therapy, equipment and supplies, and up to 20 behavioral health visits a year.

Services not covered by the program include dental, vision, and chiropractic care, air ambulance services, substance abuse programs, and injuries from any motorized vehicles (including cars) or sports considered high-risk such as parasailing, rock climbing, or white-water rafting.

Nearly all health care providers in the Northland participate in the HealthShare program and accept the reduced rates it pays. One drawback is that no coverage is offered for out-of-area providers. Some people use travel insurance to cover themselves outside the Northland.

To be eligible, a business must have 50 or fewer full-time-equivalent employees, pay a median wage of $18.80 or less, be located in Cook, Lake, St. Louis, or Carlton counties, and not offer health benefits to at least some categories of employees (such as waitstaff even if chefs are offered health insurance). Employees must work at least 15½ hours a week to qualify for the program. People who are sole proprietors and independent contractors can qualify, even if they do not work full-time at their businesses. People on the program can also have primary insurance through another company.

The program provides maximum benefits of $100,000 over five years or $200,000 over a lifetime. Some benefits require preauthorization. HealthShare has a clinical committee of six physicians and one nurse. Peterson said protocols are based on sound science and avoiding unnecessary costs.

HealthShare currently has 762 members in 254 businesses.

More information can be found at www.HealthShareMN.com or by calling (218)336-5711 or emailing info@ HealthShareMN.com.

Monthly Cost

The plan requires copays but no deductibles.

www.HealthShareMN.com