Utahns formulating plan on insurance strategies

About 130 Utahns have worked with the United Way to formulate a draft plan with recommendations on health care, financial education, housing, income and assets — and the group wants input from more state residents.

United Way officials on Monday urged the public to review the draft at www.uw.org that was compiled by five working groups of its Financial Stability Council.

The draft and public input will be included in a final document that the United Way plans to present to the governor and Legislature. The document will "reflect the best thinking" of the residents of Utah, said Scott Anderson, president and chief executive officer of Zions Bank and chairman of the United Way of Salt Lake's board of directors.

But not everyone is expected to like the recommendations in the draft. Lane Summerhays, president and chief executive officer of the Workers Compensation Fund and chairman of the council, said that about 78 percent of the health-care working group agreed on its recommendations. He called the document "a work-in-process."

"I think we've come as a group to a combined agreement — not unanimous — but a combined agreement that we're on track," Summerhays said.

The objectives of the health-care recommendations are to make health care more affordable, improve health-care outcomes and increase health coverage for the uninsured.

Each health insurer in Utah offering plans to individuals and small groups would be required to offer a minimum or "essential" benefit package that would become more expensive as treatments become more elective. The package would include financial incentives for healthy lifestyles and disincentives for "high-risk choices" such as tobacco and alcohol abuse. A combination of co-payments and co-insurance, tiered based on income, would be applied.

An independent health-benefits commission would define the essential benefit package and provide coverage determination. It also would have an appeals board to mediate disputes.

A not-for-profit Utah Health Insurance Exchange would be formed to facilitate the purchase of insurance. The exchange would emphasize cutting costs, using pre-tax dollars to the maximum and allowing portability of coverage.

The draft stresses that the exchange would not be a government-sponsored insurance or a regulator but would function like a stock exchange for insurance. The exchange "creates a marketplace in which all individuals can purchase insurance, patients have access to quality data and easily comparable essential benefit plan products" and expenses are reduced, including employer expense of managing health benefits, according to the draft.