The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66441

Lisa Gaarde Hartsock, MPH, Community Health Services, FirstHealth of the Carolinas, 155 Memorial Dr, PO Box 3000, Pinehurst, NC 28374, (910) 215-1922, lhartsock@firsthealth.org

FirstPlan is a community-based health plan for small businesses (50 or fewer employees) within Hoke, Lee, Montgomery, Moore, Richmond and Scotland counties in North Carolina. It is available through FirstCarolinaCare, Inc., a wholly owned subsidiary of FirstHealth of the Carolinas. Many small businesses are unable to offer a health plan, or when they did offer one, the lower wage earner could not afford to participate. By interviewing the business owners and employees, FirstHealth better understood the barriers of the working uninsured. FirstPlan was created in partnership with the provider community.

FirstPlan, an open-access, point of service (POS) benefit plan, provides in-network/out-of-network benefits, pharmaceutical coverage, vision discount program and a 24-hr. nurse helpline. CareCredits are given to employers for high participation and contribution which may reduce group premiums.

FirstPlan was developed to decrease the rate of working uninsured (almost 40% of the local small business workforce), provide access to primary and preventive care. It also reduces financial burdens on employers to provide health care benefits to employees thereby strengthening the local economy.

The benefits to offering an employer-sponsored health plan to employees include recruiting quality employees, reducing employee turnover, maintaining a healthy workforce and may reduce taxable income through pre-tax contributions (through Section 125 Premium Only Plans).

This effort is sustainable because of the high participation requirement at the worksite by those without coverage and a shared responsibility model: employers contribute, employees contribute and providers reduce their reimbursement for the lower wage earner.

Learning Objectives:

• At the end of the session, the participant will be able to:
• 1. Develop strategies for collecting information and data about the uninsured population, with a special emphasis on the working uninsured.
• 2. Identify and engage the necessary partners to develop and sustain a health care coverage program.
• 3. Discuss the perspectives and concerns of the working uninsured, the employers and the providers when developing a local health care coverage program.
• 4. Identify indicators of a successful and sustainable local health care coverage program

Keywords: Access to Health Care, Underserved Populations

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: employment