June 25, 2018
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Interest in new employer health insurance option ‘off the charts’

By Jackie Farwell, BDN Staff

PORTLAND, Maine — Maine’s first foray into a new model for employer-based health care has attracted more interest than the program can accommodate.

Known as MaineSense, the program allows employers to join forces to offer health insurance through a “captive,” which is a member-owned insurance company that does not offer policies to the public.

“The interest is just off the charts,” said Joseph Edwards, president of the Maine Wellness Association, a nonprofit employer group that chartered the MaineSense captive. “We haven’t been able to keep up with quotes.”

The association launched MaineSense in August and since has signed on 15 Maine employers, with another 15-20 quotes in the pipeline, according to Edwards. Roughly 2,800 employees and their dependents are covered through the program.

Maine appears to be the first state in the nation to allow captives to offer health insurance, Edwards said. Lawmakers made that possible earlier this year by including a little-debated provision in the state’s health care reform law.

While Maine already is home to a workers’ compensation captive, MaineSense represents a pioneering move to cover medical costs through the complex structure, according to its organizers. Critics of captives cite the joint liability members must bear, under which one company’s inability to pay claims could drag down other members. Former Bureau of Insurance Superintendent Mila Kofman was quoted in press reports earlier this year saying she worried that captives could destabilize Maine’s health insurance market.

Shared liability is nothing new to many of the program’s members, who’ve had success pooling risk for workers’ compensation, said Steve Hutchins of Hutchins Trucking and Atlantic Great Dane in South Portland, MaineSense’s first member. Joint liability is palatable “as long as you go into it with the right number of people and everyone pulling in the same direction,” he said. Hutchins said he has no doubt MaineSense will benefit his company, though it’s too early to cite any savings.

The program, administered by Martin’s Point Health Care, is designed to give employers and employees more control over costs by rewarding healthful habits and quality care. While premiums may not initially beat those for traditional plans, empowering employees to shop for the best care and rewarding high-value providers will result in lower premiums down the road, said Edwards, a former superintendent of the state’s Bureau of Insurance.

“The real value of this program is creating a mechanism for dealing with problems and issues going forward that’s never existed before,” he said.

Employers have lost patience with insurance companies failing to offer wellness, chronic disease support and other services, said David Howes, president and CEO of Martin’s Point, which is also a MaineSense member.

“With health plans, the employer is their customer, but they haven’t really been attuned to what [employers] want,” he said.

Employees can choose from a variety of plans through MaineSense. All will rely on a primary care physician to help navigate their health care needs and have the ability to shop for nonemergency procedures through a cost-comparison website.

Correction: This story has been updated to reflect that former insurance superintendent Mila Kofman's position on health captives was sourced from earlier press reports, not on an interview with the BDN.

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