An innovative health insurance plan is taking shape in Maine.
It's called Dirigo, the state motto meaning "I lead."
Under the plan, state, employer and worker contributions will combine with federal Medicaid funds to help provide low-cost health insurance.
Backers, including Governor John Baldacci, say it will eventually ensure that every Maine resident has coverage.
Maine Public Radio's Fred Bever reports.
The Dirigo plan passed the Maine legislature last year.
Since then its board has been designing a package of benefits that would be affordable for small businesses and their workers.
It also had to be be profitable enough to attract an insurance carrier to underwrite the program.
Late last month, Governor John Baldacci and the board rolled out the result.
It's called Careworks, and it would cap workers' out of pocket expenses at 4,000 dollars a year for individuals, and 8,000 dollars for families.
In many cases, the costs for enrollees would be far less, depending on their income level.
"Dirigo Health Careworks plan is an innovative, exciting product tailor-fit for small businesses, independent enterpreneurs and individuals. It's an affordable solution for the uninsured and those struggling to maintain coverage. Careworks will offer small businesses a quality plan and discounts for individuals to help them afford it."
Gov. Baldacci touted elements of the plan which make it notably different from private insurance products.
There will be strong incentives for preventive care, for instance.
So routine physicals, mammograms, pap tests and well baby care vists will be paid completely by the insurance plan, with no copayemnts required.
And says Baldacci, there will be further incentives for people who agressively pursue improvements in their health.
"Members are going to be able to receive a hundred dollars cash reward for meeting health care goals like smoking cessation, and losing weight. So it's going to have fitness club discounts, to incentivize and encourage people to participate."
The program's designers believe up to 32,000 Mainers will sign up for Careworks in the programs first year.
To reach that mark, small employers will have to participate as well - and they will have to contribute 60 percent of the premium cost for individual employees.
For a basic plan with a 1,250 dollar deductible, that would mean 170 dollars a month to the employer, and 112 dollars to the employee.
Workers who make less than 300 percent of the federal poverty level -- that's $28,000 dollars for an individual, would get a rebate on their premium payments from the state.
Those who earned the least would get the biggest rebate, on a sliding income scale.
There will also be varying levels of deductible that individual employees would be reponsible for, depending on their income.
That could create some challenges for any insurer that might want to underwrite the program.
Joe Mackie is a lobbyist for CIGNA, an insurance carrier.
"Couple of problems: One is potentially six deductuibles in each plan. If you're doing a small group product it's very hard to price that. The other negative I heard -- and it's sort of the nature of this -- is you have people in the same workplace with different deductibles, and you may get a few problems internally."
Still, Mackie and other skeptics in the insurance and business community said the Dirigo product appears to be workable.
They especially like the plan since its designers backed off trying to make employers pay premiums not only for workers, but for family members as well.
Limiting employer contributions to individual worker's policies should make the program more attractive to small businesses.
And their participation is essential, because without those employer contributions, the program's financial plan could fall apart.
Dirigo board members plan to circulate a request for proposals from insurance carriers within a month.
They hope to put the new product on the market by summer.
For NHPR News, I'm Fred Bever in Augusta.(?)
