CARRBORO - A collaboration between the Chapel Hill-Carrboro Chamber of Commerce and a local clinic, Piedmont Health Services, could expand medical-care options for small-business employees in Orange County.

Under the proposed program, the employees could go to the clinic, at 301 Lloyd St. in Carrboro, for low-cost primary care, such as physicals, routine visits, blood pressure checks and gynecological exams.

"Our job is to get access to care for everybody," said Piedmont Health Services' CEO, Brian Toomey.

The clinic is considering two price options.

Under a flat-fee plan, employees would pay $60 to $65 a month for unlimited medical visits, plus small co-payments for prescriptions and lab work, according to preliminary figures.

Under the other plan, employees would pay $100 a year to subscribe to clinic services, plus $59 to $79 for each medical visit.

The average monthly premium for a self-purchased, high-deductible insurance plan in North Carolina is $129, according to a 2007 report by the Vimo Research Group.

The Piedmont Health program, which will be marketed to Chamber of Commerce members, is in the planning stage. Students at the UNC Kenan-Flagler Business School interviewed chamber members in the spring of 2007. Next, the clinic will conduct a tryout with 50 participants. The program would need the approval of the state Department of Insurance, Toomey said.

Aaron Nelson, president of the Chamber of Commerce, said even if the program goes forward, small-business employees should still purchase catastrophic health insurance, which would pay for care in case of major illness or accident. "It's not a solution for health insurance," he said.

A 2005 report by the N.C. Institute of Medicine found that more than a third of North Carolina employees at businesses with fewer than 25 workers did not have health insurance.

In contrast, at companies of more than 1,000 workers, only 10 percent were uninsured.

Health insurance companies typically distribute the risk of providing medical coverage by collecting premiums from a large group of people, not all of whom will fall ill.

But many small businesses don't have enough employees to effectively distribute that risk, said Curtis McLaughlin, an adjunct professor emeritus at Kenan-Flagler.

"Because they're very small pools of people, they tend to have very high insurance rates," he said.

Barbara Jessie-Black, executive director of the PTA Thrift Shop, said 8.5 percent of the organization's personnel costs go to health insurance.

"It's a real challenge every year for us to make that work," she said.

The thrift shop employs 16 full-time workers, 13 of whom participate in the organization's insurance program.

Gene Wolf, owner of Great Earth Vitamins in Meadowmont, said he hasn't had health insurance since he was laid off from a telecommunications company five years ago. He, his wife and two sons pay out of pocket when they need to see a doctor.

Wolf said he will consider joining the health program if the price is right.

"Piedmont is a good solution for businesses where health insurance has gone past their means," he said.

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