Introducing affordable group health insurance for lower-income employees

As employers, individuals, carriers, and the federal government continue to grapple with the increasing cost of health insurance, the private sector must come up with unique solutions to reduce cost and make health insurance more accessible.

This is important for all employers, and especially those in industries with lower-wage earners: home health care agencies, restaurants, manufacturing, and some staffing companies. How can these businesses support their workers’ needs while grappling with the rising cost of labor?

In many states, individuals are eligible for Medicaid at 138% of the Federal Poverty Level (FPL) or less. The key problem is for employees who make between 139% and 400% of the FPL. These are the workers who cannot afford the employee contribution required to participate in the employer’s group health benefits. 

Family SizeFederal Poverty Level (FPL)138% of FPL400% of FPL
1$12,880 $17,774.40 $51,520 
2$17,420 $24,039.60 $69,680 
3$21,960 $30,304.80 $87,840 
4$26,500 $36,570.00 $106,000 

Enter Highlight Health, which was designed as an affordable solution for these employees and their employers. 

Research by the Kaiser Family Foundation shows that 73% of the uninsured remain that way because the cost of coverage is too high. Their employers can simply not afford to subsidize premiums any more than they already do. 

Even workers with insurance often don’t use it because of the rising cost of deductibles. There has been a 49% increase in single coverage deductibles from $1,097 in 2012 to $1,644 in 2020.

Different from traditional insurance programs

Highlight Health offers a unique way to experience healthcare access. The program connects employees with cost-effective and high-quality care solutions tailored to the individual. The key is a personal advocate who coordinates care, and an easy-to-use app for information at the employees’ fingertips. There are no deductibles and no copays.

What does Highlight Health offer?

It provides lower-wage employees with a full range of benefits for a very affordable price.

  • Minimum Essential Coverage – This satisfies the employer’s ACA offering of a health plan. It provides 100% coverage for eligible preventive services with in-network providers. 
  • Full-service advocacy program – The Advocate assists employees before and after care, guiding them through the healthcare system.
  • Primary care doctor – Employees can choose their own virtual primary care doctor from a wide network of physicians. All virtual care visits are zero copay, zero cost. 
  • Prescription drugs – Acute-care medications for short-term illness or injury, psychiatric medications, diabetes medications and supplies and maintenance drugs to manage chronic conditions are all offered at a low price. Medications can either be mailed to the home or picked up at a local pharmacy.
  • Free or discounted hospital coverage – The Advocate can help employees find the right provider, schedule their visit and provide information on community programs that the individual might be eligible for. This can provide free or discounted care at eligible providers.
  • Mental health – Employees have access to 24/7 virtual support including coaching, counseling services and crisis resources.

What about costs?

The cost of Highlight Health is between $125 -$150 per month for this comprehensive health care package.  It’s a very affordable alternative to traditional health insurance.

What is the cost to the employer? The employee?

Background on Highlight Health – When was it created? How many members do they have? What do people using the program have to say?

 “Employee engagement is an investment we make for the privilege of staying in business.”

Ian Hutchinson – Life & Work engagement strategist