RIte Share: Premium Assistance in Rhode Island

August 10, 2004

Overview


Rhode Island has pursued a number of strategies to leverage funding and stretch their health care dollars in order to avoid cutting eligibility for RIte Care, its combination Medicaid/CHIP health coverage program. One is an attempt to improve and expand enrollment of RIte Care–eligible families into RIte Share, the state's premium assistance program. RIte Share leverages employer dollars, resulting in savings to the state for every family enrolled in premium assistance instead of in RIte Care, which has a full public subsidy. Both RIte Care and RIte Share are administered by Rhode Island's Center for Child and Family Health, Department of Human Services (DHS).

RIte Share is a premium assistance program for RIte Care–eligible individuals and families with access to "approved" employer-sponsored health insurance. The health plans are approved if they meet the state's coverage and cost-effectiveness criteria. Importantly, DHS determines cost-effectiveness based primarily on the employer's health plan rather than each individual's situation; this is administratively simpler and limits adverse selection against the employer. The income threshold is 185 percent of the federal poverty level for parents, and 250 percent of the federal poverty level for children and pregnant women. Under RIte Share, the state pays the employee's share of work-based insurance premiums (with families above 150 percent of federal poverty level making some contributions according to a sliding scale), copayments, and wrap-around coverage for Medicaid benefits not in the employer's health plan. There is no minimum or maximum employer contribution, though most employers contribute at least half of the premium.

For More Information

Visit RIte Share online at: http://www.dhs.ri.gov/People/FamilieswithChildren/HealthCareCoverage/RIteShare/tabid/212/Default.aspx 

October 2004