Small group health insurance reform in Rhode Island: promises and pitfalls of the HEALTHpact plan.
OBJECTIVE
This study analyzes what design elements inhibited enrollment in HEALTHpact.


METHODS
HEALTHpact is a high deductible plan with a premium capped at 10 percent of the average Rhode Island wage. Deductibles are reduced if enrollees meet wellness criteria.


METHODS
Qualitative case study.


METHODS
Archival documents and 23 interviews.


RESULTS
Inclusion of a subsidy would have led to lower premiums and more generous coverage. Although priced lower than other plans, HEALTHpact still did not offer good value for most firms. Wellness incentives also were too complex.


CONCLUSIONS
Subsidies for purchase of insurance coverage are critical to national reform of the small group market. Designers also will need to carefully balance program complexity with innovation in encouraging wellness and product appeal.
Department of Gerontology, John W. McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, MA 02125, USA. edward.miller@umb.edu
Edward Alan
EA
Miller
Amal
A
Trivedi
Sylvia
S
Kuo
Vincent
V
Mor
D003669:Deductibles and Coinsurance; D018166:Health Care Reform / Q000191:economics / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000458:organization & administration*; D009042:Motivation; D036301:Qualitative Research; D012237:Rhode Island; D058012:Small Business / Q000458:organization & administration; D013221:State Health Plans / Q000191:economics / Q000458:organization & administration*