Memphis Business Journal:

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A survey by America's Health Insurance Plans, an industryu trade group in Washington, D.C., found small-grouop coverage in 2006 averaged $312 per montbh for single coverageand $814 per month for family coverage. Helen Darling, president of the National Business Grouo on Healthin Washington, D.C., said that when evaluatinb plan options, employers shoule consider the quality of care provided to its membersw and not just the premium First on her list is checkinbg to make sure the insurer is accredited by the Nationao Committee for Quality Assurance.
Next would be readingh throughthe plans' HEDIS (Health Plan Employer Data and Information Set) which the NCQA accumulateds to track plans on varioua performance measures. "You can find out thingzs like what percentage of theid members receivea beta-blocker after suffering a heart attack," Darling said. "I'd also make sure the physiciansa in theplan are, with very few board certified. And I'd want to see that the plan hasa 'centerd of excellence' program for certain procedurez such as organ transplants and cardiovascular care.
" When evaluating Darling suggested businesses ask for a breakdown of all prices to determinre whether it might be cheaper to outsourcew certain part of the such as prescription pharmacy benefits. Among the variou s types of employer-sponsored health insurance plans, managed-care optionsa dominate the landscape. In its national survey of employee-sponsored health plans, the consulting firm Mercee Human Resource Consulting found that preferrer providerorganizations (PPOs) were the most popular option in 2006, at 61 followed by health maintenance organizations (HMOs) at 24 Both HMOs and PPOs have contracts with networks of physicians, hospitalsw and other health-care networks.
Members pay less for servicesxprovided "in-network," but typically have the options of paying higher "out-of-network" fees to goiny to providers not in the network. HMOs are more restrictivre by having members selecta primary-care physiciahn who must approve visits to specialists. PPOs typically carrt slightly higher deductiblesand co-payments, but no restrictions on visits to specialists - making the option generallg more favorable to members. In order to hold down managed care plans are increasingly offering customeras a tie red pricing planfor pharmaceuticals.
Membersx pay the least for generic slightly morefor brand-name products in the plan's formularh of approved drugs, and the most for brandd names drug not on the formulary Traditional indemnity coverage, which accounted for aboutr 50 percent of employer-sponsored plansw in the early 1990s, has steadily plungeed during the past decade and hit just 3 percent last year accordingy to the Mercer survey.
The newest option is consumer-directesd or consumer-driven health plans, abbreviated as Chaps, which feature high deductiblee along with health savings accounts or health reimbursement Withsuch plans, employees and employerx can make a pre-tax contributiomn to a health savings which is used to pay for routinr medical care. Any fundz left in the account at the end of the year can be used insubsequentg years. If the fund is depleted, the employee's coveragew converts to a high-deductible managed-care plan.
Proponents of Chapsx say they help people becomebetter health-cared consumers because their own money is Critics fear people will put off necessary treatment to avoide emptying their accounts. "They are not the right choice for every employer oreveryt employee, but they can help both employers and employeee save money," said Jessica Waltman, vice president of policy and stat affairs for the National Association of Healtbh Underwriters in Arlington, Va. Waltma said some younger, childless employees decide to opt out ofan employer'sx plan because they typically don' get sick or even go to a doctor'a office.
"A consumer-directed plan is a way to enticd younger workers to go into the company healthyinsurance plan," she said, noting the featurwe that allows people to rollover unused funds for futuree health-care services. "There really are a wide array of health plansout there, but most peopld (in employer-sponsored plans) end up with a PPO product becausw of pricing," Waltman said. Waltmaj also said employees are attracted to PPOs because they allowa members the ability to go to any docto r inthe plan's network withougt a referral. "Employers will gravitate to whatemployeees like," she said.