Coverage Choices
'Less Than Perfect'
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As the president of a small company, Bruce Winter, 46, of Silver Spring chose a consumer-driven plan for 2007 that would be cheap enough to allow the firm to continue paying the full premium for its workers. His equipment-financing firm, FSG Leasing of Laurel, moved to a high-deductible HMO from CareFirst BlueCross BlueShield, requiring workers to pay a $1,200 deductible ($2,400 for families).
That saved the company $10,600. But FSG also offered health savings accounts, or HSAs, tax-advantaged accounts that workers can use to pay out-of-pocket medical expenses. The idea is to make workers more judicious in how they shop for health care. Even after putting $1,200 to $2,400 into each worker's HSA, the firm still managed to save about $5,000. Better yet, no worker spent more on health care last year than his or her deductible amount.
That's why it was disconcerting to see "our premiums increased by 31 percent" when the plan came up for renewal in April, Winter says. The firm considered reverting to its 2006 plan, but that would have "cost us about 43 percent per month more than the HSA/HMO," he says.
Looking at the options "reminds me what a mess the insurance industry has created," he says. FSG stuck with the HSA option this spring. But getting a handle on upfront medical costs is nearly impossible, Winters says. CareFirst offers few consumer-friendly tools, and the technology to tap the HSA funds to pay for services "is less than perfect."
Consumer-driven plans grew substantially this year, with 5.5 million covered workers in these plans, according to the Kaiser Family Foundation. Small firms led that growth.
