News & Events

  • The Affordable Care Act introduced numerous reforms aimed at helping small businesses provide health benefits for their employees—and it’s poised to take those reforms a step further next year by expanding the definition of small group to include mid-sized employers.

  • This webinar explored health plan strategies for improving pediatric preventive care by promoting Bright Futures guidelines through provider networks and directly to members.

  • We’ve all heard about the eye-popping price tags: cancer drugs that cost $14,000 a month, new hepatitis C drugs pegged at $84,000 for a course of treatment.

  • Each year millions of children miss screenings, immunizations and well visits despite the lifelong benefits of preventive care in childhood. The Affordable Care Act expands coverage of all preventive services recommended by the American Academy of Pediatrics in the Bright Futures guidelines.

  • Blue Cross Blue Shield of Massachusetts Foundation has published a report evaluating the evidence base for interventions to address the social determinants of health.

  • The emergence of new online tools—built by journalists, for journalists—has made it easier than ever to visualize health care data. With the power to build charts comes the responsibility to portray information accurately and in a way that enhances the story for your readers.

WellPoint, Inc.

February 2009 Issue Brief:

Increasing Access to Health Insurance for Children and Families: Innovative Health Plan Outreach and Enrollment Efforts


WellPoint Foundation (WLPF) is a private, nonprofit foundation funded by WellPoint, Inc. (WellPoint). The Foundation, established in 2000, is one of the largest corporate foundations in the United States with net assets of about $150 million. WLPF operates primarily in the 14 states covered by WellPoint, providing funding for programs at the state, local and national levels. Efforts to reduce the number of uninsured comprise one of the Foundation’s two Signature Programs. The other Signature Program (“Healthy Generations”) supports programs to improve specific state public health measures.


WellPoint’s interest in expanding access to health care is two-fold. First, as a health care organization, the company seeks to provide health insurance to optimize individuals’ health and well-being. Second, it recognizes lack of health insurance as a business problem as well as a social problem: failure to address health problems early results in increased health care costs to consumers and society and drives up the costs of health insurance premiums.


WellPoint’s strategic plan provides specific targets for reducing the rate of uninsured in states where the company operates. While WellPoint is focusing on moderate to higher income uninsured people who are not eligible for public coverage, WLPF focuses its funding and programs on the 12 million individuals below the federal poverty level (FPL) who are eligible for public programs.


Following this vision, WellPoint announced a company-wide Uninsured Initiative in January 2007 with three major components:


1) Affordable benefit plans, 2) Public policy lobbying (state and federal levels), and 3) WLPF funding commitment of $30 million over three years.


In addition, an Uninsured Task Force comprised of key associates throughout the company was appointed to lead WellPoint’s uninsured efforts. During 2007, the task force conducted extensive research to identify community-based programs with the greatest potential to reduce the number of uninsured. As a result, WLPF approved $10.6 million (of the $30M commitment) to support organizations providing health-related services, including eligibility and enrollment assistance, to low-income, ethnically diverse and underserved communities with predominantly uninsured populations. These grants accounted for 46 percent of the Foundation’s total 2007 grant budget ($23 million). In February 2008 the task force recommended funding three organizations:


1) Foundation for Health Coverage Education (FHCE), 2) The CoverMe Foundation, and 3) Prevention Partners.


From 2004 through 2007, WLPF was the primary funder of FHCE with a total contribution of $1.33M. FHCE is a California-based nonprofit organization that provides education and services to assist uninsured individuals in obtaining coverage. FHCE operates a 24/7 call center and produces and disseminates printed Health Coverage Matrices that outline state specific public and private insurance options for individuals. Individuals can call FHCE operators who will guide them through their insurance options, determine whether they are eligible for public programs, and refer them to the appropriate agency to apply for coverage. Individuals can also access state-specific information on the FHCE website at www. Over the four years of WLPF funding, FHCE’s outreach efforts have shown value, reflected in increased call volume and hits to the FHCE website. In 2008 WLPF approved two additional grants totaling $112,000 to continue funding the FHCE call center.


The other two organizations — The CoverMe Foundation and Prevention Partners — are both working to identify uninsured individuals eligible for government programs and helping them get enrolled.


The CoverMe Foundation (CMF) is the nonprofit arm of MedAssist, a national company that specializes in eligibility and enrollment assistance. Through outreach at community events, national public relations, advertising, mailings, a nationwide call center, and referrals from SCHIP, School Lunch Programs, FHCE, Prevention


Partners, and WellPoint network physicians, CMF identifies and guides uninsured individuals to enroll in coverage. Once an uninsured individual is identified, CMF conducts comprehensive eligibility screening to determine which coverage type is best suited to an individual’s personal circumstances. For public programs, CMF will provide hands-on counseling and instruction through the application process and ongoing assistance as individuals access public benefits. For individuals not eligible for public coverage, CMF provides education and means to access other free or discounted medical resources. In the first year, WLPF will provide up to $2.5 million to CMF with total funding dependant on their success in enrolling uninsured individuals. WLPF expects CMF to enroll approximately 39,000 individuals each year.


Prevention Partners’ outreach model utilizes churches as a safe site to bring health education, awareness and services to the uninsured populations in underserved communities. The program provides direct access to on-site health care services, such as screening tests, education, and access to medical follow-up and treatment. In addition, on-site enrollment specialists from the CoverMe Foundation assist individuals in completing applications for appropriate public programs. The populations impacted are predominantly African American and Hispanic. WLPF provided $1.2 million in funding for one year. The goal is to secure 9,264 enrollees in five of WellPoint’s major markets.


WLPF monitors the progress of current grantees as they seek to reach WellPoint’s goal of reducing the number of uninsured. At the start of each funding cycle, WLPF and each grantee jointly establish metrics upon which the program will be evaluated. Evaluation reports submitted at the completion of a grant period assist WLPF in determining the impact of their grants.


July 2010 Issue Brief

1225 19th St. NW, Suite 710, Washington, DC 20036 · Tel: 202-296-4426 · Fax: 202-296-4319