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Health Insurance Plan Provisions Main Concern at Town Meeting

March 6, 2006 – Although a couple of business owners expressed concerns about the proposed government-sponsored health insurance, most of a town meeting was spent outlining the plan's proposed provisions. The meeting, sponsored by Sen. Craig Barshinger, was Monday at the Westin Resort and Villas on St. John. Meeting attendees' concerns included whether the plan would go under and how it would deal with seasonal employees.
About a dozen people attended.
Myrtle Barry of E&C gas station wanted to know what assurance she would have that the proposed plan wouldn't go under.
"Not even Cigna can promise you 100 percent," said Jacqueline Hoop-Sinicrope, health insurance reform initiative manager. Cigna writes about 60 percent of the territory's health insurance. Cigna also insures government workers.
Hoop-Sinicrope said the health insurance plan will be professionally managed by EBS, a company with over 20 years experience. Seven percent of the $182 monthly premium will be used to pay for administrative costs.
She said a memorandum of understanding has been executed with the company, but no money has changed hands.
She also said the plan will carry reinsurance to deal with claims over $75,000.
Chris Gagnon, manager at Raintree, which owns restaurants and a car rental agency, wanted to know how the plan would deal with seasonal workers.
Hoop-Sinicrope said "more conversation" with those types of companies as well as construction companies was needed.
Raintree owner Lonnie Willis said that while her company offers health insurance to its employees, it was difficult to get them to sign on because the employee still would have to pay part of the premium.
"They didn't opt till we paid almost the whole thing, especially ages 20 to 35," Willis said. "It's a tremendous burden on us."
The original proposal has been massaged by members of the Governor's Health Initiative, which was charged four years ago with coming up with the plan aimed at providing insurance for about 15,000 of the territory's 24,000 residents that currently have no health insurance.
The bill currently sits in the Legislature's Health, Hospitals and Human Services Committee, which had scheduled a meeting Monday on St. John, until Barshinger cancelled it to hold the town meeting instead.
Barshinger said since the bill needed further input from the public, it was not ready to move on to the Rules Committee.
Hoop-Sinicrope said that the majority of the uninsured fall in the 18 to 44 age group, a group that historically doesn't suffer that many illnesses.
The proposal mandates that companies that do not carry other health insurance policies for their workers sign up for this plan. Hoop- Sinicrope said that currently, 52 percent of the territory's employers provide insurance coverage for their workers.
Under the proposal, the employer and the employee equally split the $182 a month premium. The plan will also be available to self-employed people, who will pay the entire premium themselves.
Hoop-Sinicrope said premium assistance will be available to companies and individuals earning less than $24,000 a year. The government will chip in one-third the premium cost.
The plan works by pooling the premiums from participating companies and individuals.
Hoop-Sinicrope said that when the plan opens for business, it won't implement exclusions for pre-existing conditions for the first 90 days it's in operation.
After that time period, exclusions for pre-existing conditions will apply. However, unlike most insurance policies, people with diabetes and hypertension will not have illnesses arising from those conditions excluded.

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