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Insurers Offer Scaled Down Health Plans for State Firms , Plans Cover Routine Care, Emergency Room Visits and Drugs but Not Major Medical Costs

Posted on: Saturday, 11 March 2006, 00:00 CST

By THE ASSOCIATED PRESS

Several insurers have launched stripped-down health care plans for West Virginia businesses that have not been able to provide coverage to workers in the past.

The plans, known in the insurance industry as "mini-meds," cover routine checkups, emergency room visits and prescription drugs and can cost less than $40 a month for individuals. However, they do not cover major medical expenses as comprehensive health care plans do.

An estimated 300,000 West Virginians have no health insurance but "mini-meds" are just beginning to catch on in the state, said Tom Kostohryz, an insurance agent and president of Athens, Ohio-based Southeastern Agency.

Only a few thousand West Virginians participate in the limited benefits plans, Kostohryz told The Charleston Gazette for a story in today's editions.

"It's kind of a virgin market," Kostohryz told the newspaper.

Southeastern Agency and Chicago-based Acordia Inc. began marketing limited plans in West Virginia in January. Austin, Texas- based Fringe Benefits designed both insurers' plans, which are underwritten by Pan American Life Insurance Co. of New Orleans.

The insurers are targeting employers that haven't been able to provide any health coverage in the past, such as temp agencies, restaurant chains, construction outfits and startup companies.

"There's a whole set of clientele that we've ignored in the past," Kostohryz told the Gazette. "To a lot of people, comprehensive coverage is just not affordable, but there's a way we can provide some coverage as opposed to nothing."

Gov. Joe Manchin has proposed a no-frills insurance plan that would offer limited benefits that include physician, inpatient and outpatient care with emphasis on preventive and primary care. The Insurance Commissioner's Office would oversee the plan and approve insurance companies' proposals to offer coverage.

The Legislature was poised today to approve a bill containing Manchin's proposal along with other provisions that would make health care coverage available to people without insurance.

"Mini-meds" are not marketed as a replacement for comprehensive coverage. They are intended to help people who have no health insurance, said Brian Robertson, executive vice president of Fringe Benefits.

"What you don't want is a race to the bottom - you don't want people with existing comprehensive coverage migrating to limited benefits," said Perry Bryant, executive director of the West Virginians for Affordable Health Care coalition. "But something is better than nothing, and for part-time and seasonal workers, it's probably a better match."

Since the coverage is limited, participants would face hefty bills for a major medical problem. Southeastern's highest coverage for its limited plan is up to 30 days of intensive care, at $1,200 a day.

"It's not for the person who has a lot of medical needs, but it's great for the majority of people," said Marie Lewis, chief financial officer of Manpower Inc.'s West Virginia franchise, which is Southeastern's first corporate customer in West Virginia.

The limited plans are a step in the right direction, as long as their limitations are understood, said Sonia Chambers, chairwoman of the state's Health Care Authority.

"The only debate (over Manchin's health care proposals) is whether we should be doing more," she told the Gazette. "Will this help everyone get comprehensive health coverage? No, so we need now to turn our attention to affordability."

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Source: Charleston Daily Mail

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