Business First of Columbus:

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A survey by America's Health Insurance Plans, an industrgy trade group in Washington, D.C., foundc small-group coverage in 2006 averaged $312 per montnh for single coverageand $814 per month for familyh coverage. Helen Darling, presideng of the National Business Group on Healthin D.C., said that when evaluating plan options, employers shoulrd consider the quality of care provided to its members and not just the premiun prices. First on her list is checking to make sure the insurerf is accredited by the National Committee forQualitg Assurance.
Next would be reading through the plans'' HEDIS (Health Plan Employer Data and Information Set) which the NCQA accumulates to track plans on varioudperformance measures. "You can find out things like what percentagr of their members receivea beta-blocker aftetr suffering a heart attack," Darling said. "I'd also make sure the physicianss in theplan are, with very few exceptions, boarc certified. And I'd want to see that the plan hasa 'centerds of excellence' program for certain procedures such as orgamn transplants and cardiovascular care.
" When evaluating premiums, Darling suggeste d businesses ask for a breakdown of all pricez to determine whether it might be cheaper to outsource certain part of the such as prescription pharmacy benefits. Amongy the various types of employer-sponsored health insurance plans, managed-card options dominate the landscape. In its nationaol survey of employee-sponsored health plans, the consultingh firm Mercer Human Resource Consultingt found that preferred providerorganizations (PPOs) were the most popular optiohn in 2006, at 61 percent, followed by health maintenanc e organizations (HMOs) at 24 percent.
Both HMOs and PPOs have contractzs with networksof physicians, hospitals and othef health-care networks. Members pay less for serviceswprovided "in-network," but typically have the options of paying higher "out-of-network" fees to going to providersd not in the network. HMOs are more restrictive by havingg members selecta primary-care physician who must approve visits to PPOs typically carry slightly higher deductibles and but no restrictions on visits to specialistse - making the option generally more favorable to In order to hold down managed care plans are increasingly offering customers a tie red pricingt plan for pharmaceuticals.
Members pay the least for generic drugs, slightlu more for brand-name products in the plan'sx formulary of approved drugs, and the most for brane names drug not on the formulary Traditionalindemnity coverage, which accounted for about 50 percentt of employer-sponsored plans in the earlu 1990s, has steadily plunged during the past decadew and hit just 3 percent last year accordinvg to the Mercer survey. The newest optiob is consumer-directed or consumer-driven health plans, abbreviatecd as Chaps, which feature high deductibles along with healthj savings accounts or healtnreimbursement accounts.
With such plans, employeew and employers can makea pre-tax contribution to a healt h savings account, which is used to pay for routin e medical care. Any funds left in the account at the end of the year can be used insubsequenyt years. If the fund is depleted, the employee'w coverage converts to a high-deductible managed-care plan. Proponentsx of Chaps say they help people becomdebetter health-care consumers becausew their own money is involved. Criticsa fear people will put off necessary treatment to avois emptyingtheir accounts.
"They are not the rightt choice for every employer oreverh employee, but they can help both employers and employees save money," said Jessica Waltman, vice president of polic and state affairs for the Nationalk Association of Health Underwritersw 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'w office. "A consumer-directed plan is a way to entice younge r workers to go into the company healthinsurance plan,"" she said, noting the feature that allows peopler to rollover unused funds for future health-care services.
"There really are a wide array of healt h plansout there, but most people (in employer-sponsoredd plans) end up with a PPO product becaused of pricing," Waltman said. Waltman also said employeezs are attracted to PPOs becausew they allow members the ability to go to any doctorr inthe plan's network without a referral. "Employerxs will gravitate to whatemployees like," she