Universal coverage and the commercial insurance market: The West Virginia Small Business Plan

Background: The West Virginia Small Business Plan (WVSBP) is a comprehensive insurance product distributed by Mountain State Blue Cross and Blue Shield. The WVSBP product came out of a Robert Wood Johnson Foundation State Coverage Initiative. Legislation was passed to enable interested insurers to use the Public Employees Insurance Agency provider reimbursement schedule. WVSBP premiums are estimated to be approximately 20% lower due to the state's negotiated reimbursement rates.

To be eligible, an employer cannot have provided health care insurance to its employees in the year preceding enrollment, employ fewer than 50 staff, must have been in business for at least 12 months, and must agree to pay at least 50% of the cost of individual coverage. A minimum of 75% of eligible employees must sign up for the WVSBP.

An evaluation of the demonstration is a requirement of the SCI. This presentation will focus on one facet of the evaluation, a survey of employees enrolled in the plan.

Objectives: To learn who is being reached by the WVSBP, their experience and satisfaction with this product.

Methodology: All employees, representing 247 employers, enrolled in the WVSBP through June 30, 2006 have received a mailed, self-administered survey. The Dillman Method for Survey Research is being employed to increase response rate. Data collection began in January and is scheduled for completion in February 2007.

Survey questions cover the demographics of enrollees, date of enrollment, the nature of their coverage (individual, employee and child, family), their satisfaction with the cost of the product and benefits covered, insurance status prior to enrolling, their use of services since enrolling, current enrollment, barriers to accessing care since enrolling, etc.

Respondents are also invited to participate in a panel that will be contacted by telephone quarterly up to 2 more times over the next year. Panelists will be asked an abbreviated set of questions that focus on utilization, health status, satisfaction and enrollment status.

Analysis will involve descriptive statistics.

Discussion: West Virginia is one of many states looking to cover some of their uninsured by expanding employer–based health insurance coverage. Results from this survey as part of the larger evaluation will be used to inform the Governor's Office, State legislators, agency heads, advocates, academics and others about the response of employees to this product.