With experts predicting yet another year of big increases in private health insurance costs nationwide, some of Washington's major businesses say their workers generally won't get hammered with higher expenses or pinched with trimmed benefits for 2006. These firms say new products and health-conscious habits are helping keep costs down.

"Pretty significant changes" are in the works at Marriott International, where open season for changing health insurance plans begins next week, said spokeswoman Stephanie Hampton. The company is dropping one of the health maintenance organizations (HMOs) now serving area Marriott workers and replacing it with an HMO the company has used in other markets, Hampton said.

"We're also offering a build-your-own PPO plan, which gives employees flexibility to design a plan that meets their needs," she said. "They have three options they can choose from for deductible, prescription drug benefit and co-pays. . . . And based on what they create, it would be a flat to a single-digit percent increase" over their current premiums.

Hampton said this range of options allows workers to ask themselves, "Do you need the Cadillac of service, or is the Camry sufficient?"

Like many other health plan sponsors, Marriott is encouraging workers to enroll in a voluntary program for people with diabetes and other chronic conditions, said Hampton. "Nurse-care coaches work with the employees to teach them about the disease, make sure that they are following a treatment plan and talking with their physicians about different courses of treatment."

At Sprint Nextel, the Reston-based telecommunications firm, benefits director Collier Case said employees will have many choices.

"We've had a good 2005 in terms of health plan performance, and so in 2006 we really are seeing no change for employees in cost-sharing. . . . That's a huge change from what we've experienced [previously], and we're very pleased that we're able to do that."

Among the options, Case said, is a "high-performance" network of doctors organized by Aetna that "is going to provide access to, we think, the best care because the providers have been credentialed based upon their outcomes as well as their efficiency . . . It provides the greatest benefit and has the lowest cost of our traditional plan options."

Unlike many employers, Case said, "we've carved out prescription drugs from the medical plans and offered ours as a stand-alone choice" that gives workers three options. This permits them to choose a plan that best meets their needs, he said.

For example, "there are requirements for mail service for certain chronic conditions under some of the plans; there are other plans where there is total freedom of choice of where you get the prescription filled, but obviously the greater flexibility you have, the more cost you're going to have."

In all three plans, Case said, generic drugs are available for a co-payment of only $5 for a month's prescription from a retail pharmacy.

"Our desire is to incent employees to be good consumers and to reach out to the generic options, and we'd like to see even higher use of generics," Case said. With brand-name drugs, employees will pay 20 to 30 percent of the drug's cost rather than a fixed co-pay, he said. For workers considering which drug plan to join, Case said the company provides a decision-making tool on the Web.

Freddie Mac, the housing finance firm based in McLean, reports that its workers will be able to avoid major increases in health insurance spending for the coming year.

"We offer about six different options to employees," said Shawn Flaherty, a company spokeswoman, and only two of them have higher employee premiums this year.

"Last year one of the improvements we made is we added a wellness center to Freddie Mac, and that has helped us manage our costs," Flaherty said. The facility has a nurse practitioner available every day, a doctor two days per week and a nutritionist. "People have been using that, it saves them time, it's good for morale, and it's a money-saver also. . . . One of the outcomes is obviously we didn't have to raise our contribution rates."

There have been slight increases in some drug co-pays and deductibles, she said.

What's new for Pepco workers this year? Not a whole lot, according to Ernest Jenkins, the utility's vice president for people strategy and human resources. Employees should see little impact this year even as costs of medical care continue to rise, he said. But contracts negotiated with some of the company's unionized workers call for them to pay progressively more for health insurance over the next five years, Jenkins said. Management personnel are seeing no such changes for 2006.

"What we're trying to do, and it's going to take a little bit of time," he said, "is to bring in the wellness aspect of benefits" as a means of managing health costs.

Jenkins cited a fitness assessment that is offered to Pepco employees at no charge. "They come in, and over the course of an hour they use calipers to measure body fat, we do pushups, sit-ups . . . seeing how limber people are, how flexible they are. So they go through an assessment of this sort and they get a report showing where they fall in their age group. . . . They're able to have this report with some recommendations as to how they could improve their overall health."

Jenkins says both workers and Pepco gain from this program as well as from others, including an arrangement where the company subsidizes health club memberships.

"I think studies have found there's a direct correlation to healthier employees being more productive employees -- just from sick time days, you get a reduction in lost time because if they're healthier they're at work more," he said. "They have more stamina, they have more energy, they're really able to be more productive."

In contrast to prices at Pepco, Marriott and other firms, rates are going up considerably for many Lockheed Martin workers in the Washington area. "We're seeing just under 10 percent cost increases for the average of the plan options that we offer," said spokesman Tom Grier, "which is pretty consistent with the national trend.

"This is the first time in over half a decade that we've seen the cost increases at less than the double-digit range overall, so hopefully it's a sign that perhaps there's some moderation in the overall costs," said Grier, who noted that the corporation continues to pay about 80 percent of the total cost of those plans.

In addition to several HMO choices, Lockheed Martin offers a high-deductible plan that replaced two indemnity plans and a PPO. This option, called the Total Health Plan and administered by Aetna, features a $1,000 deductible and an annual company contribution of $500 that the worker can use for covered treatment. "It's bit of a step into the consumer-directed health care," said Grier.

While the great majority of workers insured through Lockheed Martin opt for an HMO, those who have joined the Total Health Plan are giving the company "very favorable feedback," he said, and its premiums have declined somewhat.

In the Public Sector . . .

As for the area's largest employer, the average premium in the Federal Employees Health Benefit Program will rise 6.6 percent for 2006, according to the Office of Personnel Management (OPM). Many plans will be unchanged. But more people may switch plans this year due to a hefty price increase in the most popular plan.

"The normal amount of plan switching is just a few percent for retirees and somewhere around 5 percent for employees," said Walton Francis, who writes an annual guide to federal health plans in association with the publisher of Washington Consumers' Checkbook magazine.

"Whatever we had last year, I would assume there would be a little more this year because of the relative jump in the premiums" in the Blue Cross Blue Shield standard option, whose charges are rising almost 15 percent.

"The story, I think, for federal employees is, it's a year to reconsider whether you want to be in Blue Cross -- not that Blue Cross is bad," but because "its relative value has decreased compared to some of the other popular plans," he said. (Francis emphasized that he was referring to the Blue Cross standard plan, not to its cheaper cousin, the basic plan, whose premium is not changing.)

For 2006, federal workers will be offered 21 high-deductible health plans, paired with savings accounts that people can use to pay their medical expenses. Francis marveled at the low enrollment that these plans attracted last year.

"Those plans by and large were very good deals," Francis said. "Particularly for people in the higher [tax] brackets, it's an extra tax-deferred savings account, if you will, if nothing else, and they didn't switch" in great numbers. "I think this is an indication of the incredible conservatism of federal employees."

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At Freddie Mac in McLean, Rachelle Clark works out in the fitness center. The new facility has helped the firm hold down health costs, the company says.At Freddie Mac's Wellness and Fitness Center in McLean, nurse practitioner Heather L. Bonshock, above, does a pressure check; below, James Basye and co-workers keep fit. Most of the firm's '06 plan premiums aren't rising.