Governor Rell Announces Steps Toward

Health Coverage for State’s Uninsured Adults

Insurance Industry Getting Prospectus on New Charter

Oak Health Plan; Joint RFP to be Issued for Charter Oak,

HUSKY Plans in November

Governor M. Jodi Rell today announced major progress in the state’s drive to provide Connecticut’s uninsured with access to health insurance, with the Charter Oak Health Plan taking shape as an affordable way to bring coverage to adults of all incomes.

Governor Rell authorized the Department of Social Services (DSS) to issue a prospectus to the insurance industry in Connecticut and nationwide about the features and design of the Charter Oak Health Plan.

The Governor also authorized DSS to issue a combined request for proposals for the new Charter Oak Health Plan for adults and existing HUSKY Plan for children – a move intended to strengthen both programs through unified purchasing power.  The request for proposals is expected to be released by DSS in mid-November.

 “Connecticut is already known as a national leader in public health coverage for children,” Governor Rell said.  “Now we are looking to attract as many insurers as possible to bid on our exciting new program for adults.  When the full RFP is issued next month, insurers will have the opportunity to join the competitive procurement process for adult coverage, as well as children’s coverage.”

The prospectus, Health Care Contracting Opportunities:  Charter Oak, HUSKY A and B, is on-line at www.ct.gov/dss/charteroak.  Insurance companies selected to participate will coordinate health care benefits, with the state coordinating initial enrollment of members.

First proposed by Governor Rell last December, the Charter Oak Health Plan will bring affordable health coverage to adults who don’t have medical benefits through work and don’t qualify for a public program like the HUSKY Plan, Medicaid or Medicare.  Start date is projected to be July 1, 2008.

“For the first time in Connecticut, Charter Oak will offer affordable choices and coverage options to everyone from young graduates and employees of small business to the self-employed and retirees under the Medicare age threshold,” the Governor said. 

The Charter Oak Health Plan represents a huge step forward for Connecticut in bringing affordable health coverage to a large part of the uninsured population--adults of all incomes (including childless adults who might otherwise be eligible for HUSKY coverage if they had children under 19).

With the General Assembly approving the Governor’s premium assistance component of the Charter Oak Health Plan in the new two-year budget package, Governor Rell directed Social Services Commissioner Michael P. Starkowski to move forward with implementation.  The goal is to offer a menu of credible coverage with monthly premiums as low as $75 for low-income residents and no more than $250 for those with higher incomes.

The legislature approved $11 million for program costs for fiscal 2009.  These costs are based on a sliding scale premium assistance plan for enrollees with incomes up to 300 percent of the federal poverty level (for example, income up to $41,070 for a household of two).  Partial reimbursement may be available from the federal government.

The current plan for Charter Oak includes:

·      Full prescription package with a three-tiered copay. The lowest copay, for a generic drug, would allow a prescription to be filled for $10 – $15.

·      Unlike many other states, coverage would not be restricted for enrollees with pre-existing conditions – the people most in need of coverage and the most difficult to insure.

·      No maximum annual benefits. Instead, a lifetime benefit up to $1 million – ensuring coverage would be available when needed.

·      Laboratory, X-ray and other diagnostics available with 20 percent copay.

·      Assignment of clients to a primary care physician with requirements similar to most health care plans regarding prior authorizations and referrals.

·      Copays for prenatal, postnatal and preventative care would be lower than regular office visits, encouraging clients to seek these cost-effective, health-promoting services.

The HUSKY Plan currently covers nearly 228,000 children and 95,000 parents, relative caregivers and pregnant women.  The state conservatively projects that the Charter Oak Health Plan will cover up to 32,800 by fiscal 2011.