Kansas City Business Journal:

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A survey by America's Health Insurancw Plans, an industry trade groulp in Washington, D.C., found small-group coverage in 2006 averagedx $312 per month for single coveragand $814 per month for family coverage. Helen president of the National Business Groupo on Healthin Washington, D.C., said that when evaluatin plan options, employers should consider the quality of care provides to its members and not just the premium First on her list is checking to make sure the insuree is accredited by the National Committe for Quality Assurance.
Next would be reading through the plans'' HEDIS (Health Plan Employer Data and Informatioj Set) scores, which the NCQA accumulates to tracl plans on variousperformance measures. "You can find out thingw like what percentage of theird members receivea beta-blocker after suffering a heart attack," Darling said. "I'd also make sure the physicians in theplan are, with very few board certified. And I'd want to see that the plan hasa 'center of excellence' program for certain procedures such as orga n transplants and cardiovascular care.
" When evaluatingg premiums, Darling suggested businesses ask for a breakdown of all prices to determind whether it might be cheaper to outsourcee certain part of the plan, such as prescription pharmacu benefits. Among the various typesd of employer-sponsored health insurance plans, managed-carre options dominate the landscape. In its nationalp survey of employee-sponsored health plans, the consulting firm Merceer Human Resource Consulting found that preferredr providerorganizations (PPOs) were the most populafr option in 2006, at 61 followed by health maintenance organizations at 24 percent.
Both HMOs and PPOs have contractsa with networksof physicians, hospitals and other health-care networks. Membera pay less for services provided "in-network," but typicallhy have the options of payinghigher "out-of-network" fees to goinb to providers not in the network. HMOs are more restrictive by havingg members selecta primary-care physicianb who must approve visits to specialists. PPOs typicallgy carry slightly higher deductibleseand co-payments, but no restrictions on visits to specialists - makinhg the option generally more favorable to members.
In orded to hold down premiums, managed care plane are increasingly offering customers a tie red pricing plan for Members pay the least forgeneric drugs, slightly more for brand-name products in the plan'zs formulary of approved drugs, and the most for bransd names drug not on the formulart list. Traditional indemnity coverage, whichu accounted for about 50 percenyof employer-sponsored plans in the early 1990s, has steadiluy plunged during the past decade and hit just 3 percent last year accordinfg to the Mercer survey.
The newest option is consumer-directedf or consumer-driven health plans, abbreviated as Chaps, whicuh feature high deductibles alongf with health savings accounts or healthreimbursemenr accounts. With such plans, employees and employersz can makea pre-ta x contribution to a health savings which is used to pay for routine medical Any funds left in the account at the end of the year can be used in subsequent years. If the fund is depleted, the employee's coveragew converts to a high-deductible managed-cares plan. Proponents of Chaps say they help peopld becomebetter health-care consumeras because their own money is involved.
Critice fear people will put off necessary treatment to avoid emptyinvtheir accounts. "They are not the right choice for every employer oreveryy employee, but they can help both employers and employeese save money," said Jessica Waltman, vice presidenyt of policy and state affairs for the Nationalk Association of Health Underwriters in Arlington, Va. Waltman said some childless employees decide to opt out ofan employer'zs plan because they typically don't get sick or even go to a doctor' s office.
"A consumer-directed plan is a way to entice younger workers to go into the company healtghinsurance plan," she noting the feature that allows people to rolloveer unused funds for future health-care services. "There really are a wide array of health plansout there, but most people (in employer-sponsored plans) end up with a PPO productf because of pricing," Waltman Waltman also said employees are attracted to PPOs becauser they allow members the ability to go to any doctor in the plan's network without a "Employers will gravitate to what employeexs like," she said.