Theassociation’s health trust is a not-for-profit entity that usespremiums paid by member companies to finance health benefits forpolicyholders. Companies pay premiums of $3.95 per hour per employeeand are required to provide coverage for all eligible employees. Theassociation’s plan offers portable benefits and carries no premiums forworkers. The plan has a per-person or per-family deductible and covers80% of most expenses beyond the deductible. Policyholders must pay fullprice for prescription drugs and file for reimbursements. The planreimburses 100% for generic drugs.

Martell Hildebrand –director of the trust in Billings, Mont. — said members pay slightlymore for drugs under this approach, but overall usage is less, so theplan saves money. Health care costs for the trust have increased byabout 8% annually over the past several years, which has resulted inhigher rates and reduced benefits, but the plan has added a wellnessbenefit that covers 100% of preventive care.

Hildebrand saidthe simplicity of the model is what makes it a successful program, butit should not be viewed as a way to revamp the state or U.S. insuranceindustry. He said, "There is no silver bullet; there is no quick fix.We need to get more healthy. We’re not very healthy. It’s going to be along-term thing" (Dennison, Billings Gazette, 8/7).
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By: kaisernetwork.org – Fri, 08/10/2007 – 10:23