What is the 3-Share Plan?
The Galveston 3-Share Plan is a health benefits program (not health insurance) offered to employees of small employers in Galveston County. The program will allow qualified employers to offer affordable health benefits to their employees (no dependent coverage) with a $180 per month cost split three ways. Employers will pay $60 per month per employee, and each participating employee will pay $60 per month. A combination of Houston Endowment grant funds and UTMB funds will pay for the third share of the monthly cost.
Eligibility Requirements Employer eligibility criteria:
• Must be located within Galveston County
• Must have at least two, but not more than 50, W-2 employees
• At least half of eligible employees must enroll in the plan (if a business has exactly two
employees, both must enroll)
• Must have been in business for at least 12 months prior to enrollment, verified by IRS
documentation, and may not have provided group health insurance benefits to employees
during that time period
• Maximum median annual income for all employees is $50,000
Employee eligibility criteria:
• Employer must be enrolled in the plan
• At the time of enrollment, employee may not be covered by any governmental health
insurance benefits plan, such as Medicare or Medicaid
• Employee must work an average annual minimum of 20 hours per week
Plan Benefits
Benefits include primary care, hospitalization, pharmacy, and mental health care as follows:
• Primary or specialty care: 20 visits/year, $15 and $30 co-payments respectively
• Hospitalization: 30 day annual maximum, not to exceed $50,000 annually; $200 co-payment
per hospitalization
• ER visits, scans, and surgery: $75 co-pay per incident
• Outpatient pharmacy: $1,200 per year maximum; $25 co-pay for generics; $50 non- generic
• Outpatient mental health: 12 visits per year, $30 co-payment per visit
• Lifetime maximum benefit: $250,000
• Covered benefits will be provided by the 3-Share Plan network, made up primarily of UTMB
facilities and providers