Dallas Business Journal:

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A survey by America's Healtgh Insurance Plans, an industry trade group in Washington, found small-group coverage in 2006 averagee $312 per month for single coverageeand $814 per month for familyh coverage. Helen Darling, president of the National Business Group on Healtbin Washington, D.C., said that when evaluatinvg plan options, employers should consider the quality of care providede to its members and not just the premiu prices. First on her list is checking to make sure the insureer is accredited by the National Committee forQuality Assurance.
Next wouled be reading throughthe plans'' HEDIS (Health Plan Employer Data and Information Set) which the NCQA accumulates to track planx on various performance measures. "You can find out thinge like what percentage of their members receiveea beta-blocker after suffering a heart attack,"" Darling said. "I'd also make sure the physicianss in theplan are, with very few board certified. And I'd want to see that the plan hasa 'centerss of excellence' program for certain proceduresx such as organ transplants and cardiovasculad care.
" When evaluating premiums, Darling suggested businessews ask for a breakdown of all prices to determinse whether it might be cheaper to outsource certain part of the such as prescription pharmacy benefits. Amont the various types of employer-sponsored health insurancew plans, managed-care options dominate the In its national surveyof employee-sponsored healtn plans, the consulting firm Mercer Human Resourcwe Consulting found that preferred provider organizations (PPOs) were the most popular optiobn in 2006, at 61 percent, followed by health maintenancew organizations (HMOs) at 24 percent.
Both HMOs and PPOs have contractds with networksof physicians, hospitals and other health-care Members pay less for services providex "in-network," but typically have the options of payinvg higher "out-of-network" fees to going to providers not in the network. HMOs are more restrictives by having members selecta primary-care physician who must approvw visits to specialists. PPOs typically carry slightly higher deductiblesand co-payments, but no restrictions on visitse to specialists - making the optionm generally more favorable to members. In order to hold down managed care plans are increasingly offering customerx a tie red pricing planfor pharmaceuticals.
Membersx pay the least for generic slightly morefor brand-name products in the plan's formulary of approved drugs, and the most for brand name s drug not on the formulary list. Traditional indemnitu coverage, which accounted for abou t 50 percentof employer-sponsored planx in the early 1990s, has steadily plunge during the past decade and hit just 3 percent last year accordinyg to the Mercer survey.
The newest option is consumer-directed or consumer-driven health plans, abbreviatee as Chaps, which feature high deductibles along with healtjh savings accounts or health reimbursement Withsuch plans, employees and employerss can make a pre-tax contribution to a healt h savings account, which is used to pay for routined medical care. Any funds left in the accoungt at the end of the year can be used insubsequenr years. If the fund is depleted, the employee's coverage converta to a high-deductible managed-care plan.
Proponents of Chapw say they help people becomebetter health-care consumers becausse their own money is Critics fear people will put off necessaryt treatment to avoid emptying their accounts. "Theh are not the right choice for everuy employer orevery employee, but they can help both employers and employee save money," said Jessica Waltman, vice presidenyt of policy and statew affairs for the National Association of Healt Underwriters in Arlington, Va. Waltman said some childless employees decide to opt out ofan employer'xs plan because they typically don't get sick or even go to a doctor's office.
"A consumer-directed plan is a way to enticer younger workers to go into the companhy healthinsurance plan," she said, noting the featurse that allows people to rollover unusedx funds for future health-care services. "There really are a wide arrau of health plans out but mostpeople (in employer-sponsored plans) end up with a PPO producgt because of pricing," Waltman said. Waltman also said employeese are attracted to PPOs because they alloa members the ability to go to any doctor inthe plan'ss network without a referral. "Employers will gravitate to whatemployeeas like," she said.