Getting insurance assistance

Mini-med plan will help cover area's seasonal workers

— Seasonal resort workers in the region now have a new option in the struggle to get and retain minimum health benefits.

The Human Resources Cooperative has arranged with a private insurance provider to offer a "mini-med" plan for employees of local businesses. It will allow participants to go to the doctor's office and get a throat culture at no charge, and it will lower the cost of prescriptions among other things.

The mini-med plan won't provide all of the health insurance coverage an individual would have in an ideal situation. And it may not be right for everyone, Kathy Coates said. But many seasonal workers who have struggled to keep health insurance in place while transitioning from their winter to summer jobs, now have an alternative.

"It's for a slice of people," Coates said. "It allows someone who doesn't (otherwise) have any health insurance to go to the doctor and get asthma medication," for example.

Coates is the membership director of the Steamboat Springs Chamber Resort Association. Employers don't need to be Chamber members to get the benefit for their employees. Individuals must get initial coverage through an employer, but they may retain the coverage when they leave their job.

She said the mini-med plan grew out of a discussion that took place at the Economic Summit in the spring of 2000, when people in the field of human resources came together to form the cooperative.

"They surveyed seasonal employees and they decided the most critical issue in terms of stabilizing the season workplace was to be able to offer health insurance to those individuals," Coates said.

The initial intent was to achieve a plan that was similar to that offered by the Steamboat Ski & Resort Corp. allowing winter employees to hang onto benefits over the summer until they returned to their jobs in late fall.

After investigating the challenge further, the cooperative determined that kind of plan wasn't really what small employers in the area desired.

Alternatively, the cooperative turned to Ed Pittaway of the Community Benefits Group of Colorado. Community Benefits, based in Englewood, has been a Chamber member since 1996, Coates said.

The cooperative asked him to search for an insurance product that would allow seasonal workers to arrange health coverage through their employers, but retain those benefits even if they quit their jobs and moved on.

Colorado insurance law and regulations made it a challenge, Coates said.

But working with a third party, Pittaway was able to put together the mini-med plan with three levels of coverage. It is not an off-the-shelf plan that can be arranged anywhere else, Coates said.

Employee groups with less than two "lives" are not eligible for the plan.

Employer groups with less than 51 members can select from among three plans, employer groups with 51 to 250 members may choose from two programs, and groups with more than 250 insured may offer three plans.

The plan does not meet all the needs of people needing catastrophic health care or major surgeries -- it covers 100 percent of surgical services within limits of $1,000 to $2,000 per event. That means it would only make a small dent in the cost of knee surgery for example.

But Coates said the mini-med in combination with a full health policy carrying a relatively high deductible, might offer individuals lower premiums than a policy with lower deductibles Cotes said.

"The mini-med might cover a portion of the deductible of the other plan," Coates said.

People who will enjoy the most benefit from the mini-med include those who must regularly fill prescriptions because of an ongoing medical condition, Coates said. The plan offers a $5 generic drug co-payment.

The mini-med also offers the potential to help the entire community in terms of preventative medicine, Coates said.

"We're looking to take some of the pressure off unpaid visits to the hospital," she said.

The theory is that if all disincentives for going to the doctor are removed, more people will go to the doctor to have a sore throat checked out, and fewer low-income household members will show up at the emergency room three weeks later with a case of pneumonia.

The monthly cost of the mini-med will vary from individual to individual, but no one will be excluded because of pre-existing conditions, Coates said.

Her hope is that monthly premiums will all be under $200. And some people will play as little as $150 a month for the mini-med coverage.

Interested employers may contact Pittaway at 1-800-838-0070.

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