Newspaper article THE JOURNAL RECORD

Affordable Health Insurance -- Is It Really an Oxymoron?

Newspaper article THE JOURNAL RECORD

Affordable Health Insurance -- Is It Really an Oxymoron?

Article excerpt

"Affordable health insurance."

Is this an oxymoron?

You bet it is. There is nothing about health insurance that is affordable.

There are a lot of reasons for this -- none of which really matter to an employer who is struggling to provide a benefit package that will be attractive in today's job market. Employees who are paying more to cover health insurance for their families than they used to earn in a month don't really care about the reasons either.

But anyone who has spent more than two hours in an emergency room lately will tell you that health insurance is something that you absolutely cannot be without -- because as much as the insurance costs, the cost of receiving medical care is incredibly higher.

So what is the answer?

In today's tight job market employers who are struggling to keep quality employees find that many times the group health insurance plan is as important as the salary level.

But what if you are a small employer faced with the choice of providing health insurance or providing jobs?

Finding a balance is hard.

The good news is that today's employer has an incredible array of choices available in the area of group health insurance. It is through these choices that the balance may lie.

Gone are the days of "one plan fits all" from either the employer or the employee standpoint.

In addressing the issue of cost vs. benefit, many employers are coming to grips with the fact that to continue to provide quality benefit programs there must be more cost sharing for those programs. Employers are asking employees to pay more of the cost of the health insurance out of their pockets. Since the employees are being asked to pay more, employers are looking for programs that give employees the flexibility to make choices.

Through these choices, the employee can select the plan most meaningful in their particular situation.

So what kinds of choices are available in today's group health insurance marketplace?

The plan offering the most flexibility is one with a "triple option." Each employee has a choice between:

* A PPO plan with a large network of providers and few restrictions.

* A PPO plan with a smaller network of providers -- usually with fewer restrictions.

* An HMO plan.

Many times the employer will agree to pay for the least expensive plan, then an employee pays the difference to "buy up" to one of the other plans. In this way, the employees have a greater say in how their money is spent, while at the same time the employer is able to keep a better handle on costs.

Dual option PPO programs offer flexibility as well.

There are many plans available that allow an employee to make choices of plan design in the areas of deductibles, co-payment levels and co-insurance levels. Again, it is very common for the employer to pay the cost of the least expensive plan in full while allowing employees the opportunity of "buying-up" to a richer plan. …

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