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Healthy Workers

Healthy Workers offers healthcare coverage to serve the needs of small businesses in Santa Clara County and strengthen our local health care delivery system.

The Healthy Workers Program was created through the collaborative efforts of the Santa Clara Family Health Plan, Working Partnerships USA, and the Santa Clara Valley Health and Hospital System - the same coalition that created the nation’s first universal healthcare program for children, the Children’s Health Initiative(CHI).

Healthy Workers program is for small businesses in Santa Clara County with 2-50 employees that have not offered health coverage for the past year. Eligible employees must live in Santa Clara County and have an income at or below 350% of the Federal Poverty Level, which is roughly $18/hr for an individual. Healthy Workers offers a comprehensive benefit plan that includes preventive care, in-patient and out-patient hospitalization, behavioral health care, emergency care, prescription drugs and specialty care. Medical care is provided by one of the country’s most respected county health systems - Santa Clara Valley Health and Hospital System. Enrollees gain access to a broad network of public and private providers through Valley Medical Center, and the county and community clinics.

Eligibilty

  • Small businesses in Santa Clara County that employ 2-50 employees (including owner)
  • Employer has not offered health insurance for the past 12 months
  • Employees live in Santa Clara County
  • Employees earn less than $38,115 per year (approximately $18.32 per hour)
  • Employees are 19-64 years old
  • Employee coverage only

Summary of Benefits

The Healthy Workers program offers many benefits to members, including:

  • Premium of $225 per month per enrolled employee ($150 contributed by employer, $75 contributed by employee)
  • $0 Preventive Care
  • $10 Physician and Specialist Visits
  • $5 Generic Prescriptions (90 day supply)
  • $15 Brand Name Prescriptions (90 day supply)
  • $50 Urgent Care
  • $200 Emergency Room
  • $200 Inpatient Hospital Stay
  • $750 Annual Maximum Out-of-Pocket
  • No Exclusions for Pre-existing Conditions
  • No Deductible
  • No Annual Increase in Premiums

Here is a list of Health Clinics & Health Centers available to you.

Review the Evidence of Coverage document for details of these and other benefits.

How To Apply

Please contact (408) 874-1400 or email HealthyWorkers@scfhp.com