What will the exact cost be for the employer?

Employers must pay at least 50 percent of the employee’s premium. The exact dollar amount of the premium depends on several factors. The best way to be certain of your costs is to talk with an insurance representative. 

I will have to pay a portion of my employee's premiums - what are the advantages to me?

Here's what this program can do for you:

• Attract and retain qualified employees by giving them access to affordable health insurance.
• Improve employee satisfaction and health.
• Decrease absenteeism and increase productivity.
• Increase participation rates in the company health plan, which might help maintain qualification for group insurance coverage.

What does this cost the employee?

The exact cost of the health insurance plan you will be offered is difficult to predict. However, here are some things you can count on:

• Your employer must pay at least 50 percent of your premium. 
• The Access to Health Insurance program pays the insurance carrier up to $100 a month for you and up to $100 for your spouse, if you qualify for premium assistance.
• Each minor child you enroll is qualified for up to $100 a month in premium assistance, with a maximum assistance of $300 a month for all children.
• You are responsible for paying any premium that remains after the premium assistance and your employer’s portion of your premium are paid.
• You are responsible for any deductibles and co-pays outlined in your plan.

Can you give an example of what this may cost?

Here’s an example of what this might cost if you, your spouse, and two children choose to participate.

What out-of-pocket expenses will there be for the employee?

In addition to any part of the premium you must pay for the health insurance you receive through your employer, there may also be out-of-pocket costs like deductibles or co-payments for some health care services. The exact amount of these out-of-pocket expenses are difficult to predict. However, here are some areas the employee should consider: 

Sometimes the out-of-pocket costs (such as deductibles and co-payments) that a family pays for their private health coverage may be more than if they participated in the Idaho Health Plan (Medicaid/CHIP).  To find out how much you may have to pay if you chose private health insurance coverage, ask your employer (or insurance agent) for a SPD that includes specific cost sharing amounts for services.   You should also be aware that Federal rules prohibit the Idaho Health Plan from charging you cost sharing amounts that exceed five percent of your family’s income for you or your child in a given year. In comparison, the limit on the cost-sharing under your private health insurance coverage may be more or less than five percent of your income, depending on the plan.