Insure Oklahoma will be expanding

Governor Mary Fallin and the Oklahoma Health Care Authority (OHCA) announced that the Insure Oklahoma program is increasing its employer size limit from 99 to 250 employees.

The change is effective immediately.

Insure Oklahoma is the state’s premium assistance program that helps businesses and their middle- to low-income employees afford health insurance coverage.

Insure Oklahoma’s funding levels can support premium assistance for about 30,000 individuals. Increasing the employer size limit to 250 employees, which is authorized under the program’s federal waiver, would allow Insure Oklahoma to maximize program usage.

Insure Oklahoma launched in 2005 with an initial employer size limit of 25 employees. This is the third time the size limit has been increased.

Fallin said increasing the eligibility limit to 250 employees is part of the state’s efforts to be more business-friendly, improve health outcomes and responsibly expand access to health care.

“Raising the eligibility cap allows the state to partner with more businesses to provide affordable health insurance to their employees,” said Fallin. “The money that Insure Oklahoma saves employers can be reinvested in more jobs and other employee benefits.”

OHCA Chief Executive Officer Nico Gomez said the Insure Oklahoma program has the capacity and funding in place to serve more businesses.

“Insure Oklahoma has the capacity to serve more businesses and thousands more working Oklahomans,” said Gomez. “We are ready to accept applications from newly-qualified businesses and employees and look forward to serving them.”

Insure Oklahoma currently has both employer-based and individual health insurance options.

The employer-sponsored insurance (ESI) option of Insure Oklahoma pays at least 60 percent of the premiums for private market health insurance policies.

Participating employers pay at least 25 percent of the qualified employee’s monthly premiums, and the employee pays no more than 15 percent of their health premium. The program also assists with premiums for the employee’s spouse and children.

Insure Oklahoma’s Individual Plan (IP) is for working Oklahomans who do not have access to group coverage and earn less than the federal poverty level, as well as those who are temporarily unemployed and seeking work.

The program currently serves 17,098 Oklahomans with more than 3,500 businesses participating.

Insure Oklahoma is funded by the state tobacco tax matched by federal Medicaid dollars. Funding is secured through 2016, while state leaders continue to discuss a long-term funding agreement.