State Employer-Based Reforms

West Virginia

Employer-Based:

• West Virginia Small Business Plan, passed in 2004
• Participating carriers to access Public Employee health plan reimbursement rates, enabling the new small business coverage cost to be reduced (20-25% below market rates)
• All groups assume equal responsibility in providing affordable health insurance to uninsured employees and employers are responsible for at least 50 percent of the premium
• As of 2005; 500 individuals representing approximately 100 small businesses were enrolled

Eligibility: Small employers (2 to 50 employees) to use purchasing advantage of state employee health plan

Financing: The major state commitment was enabling the Public Employee health plan reimbursement rates to be the rate of payment for the product

For more information: West Virgina Small Business Plan website
 

New Mexico

Employer-Based:

• State Employer Insurance Program (SEIP), passed in 2005
• Administered by the state but is a separate risk pool, funded by employer/employee premiums and includes a reinsurance provision
   
  

Eligibility:

• Employers, with 50 or fewer employees who had not been offered health insurance in at least 12 months can buy into the state employee health plan
• Enrollment is estimated at 3,000 for first year of implementation

Financing: SEIP had general fund start-up but no continued state funds

For more information: New Mexico Human Services Department website

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