Employer-provided benefits packages may be full of options, including managed health-care plans, dental and vision plans, short-term and long-term disability insurance, sick leave, paid vacation, personal days, tuition reimbursement and more.
But besides retirement plans and leave policies, the attentiongetter is healthcare related coverage.
Typically, the more health-plan options that are available, the more coverage costs will be.
The Kaiser Family Foundation said in its July/August 2003 HealthPoll Report that seven to eight of every 10 Americans want plans that offer wide range of benefits and selection of doctors as well as low costs.
Also, the foundation indicated nearly nine of every 10 Americans said it was very important to have a plan that provides high-quality care.
Several types of basic health plans are available to workers. One is traditional insurance, which the California Medical Association suggests is the most flexible plan.
Group plans include health-maintenance organizations, or HMOs; preferred provider organizations, or PPOs; and point-ofservice, or POS. All have deductibles, as well as co-pays and noncovered charges.
According to the West Virginia Insurance Commission's review of the market share of group-policies insurers in 2003, Mountain State Blue Cross/Blue Shield was the largest, at nearly 43 percent, based on premiums written. Others, in descending order of market share, included Carelink, Coventry, HealthPlan of the Upper Ohio Valley, MAMSI, Optimum Choice and United Healthcare.
HMOs are the most restrictive of all plans, said the American Heart Association. HMO members must select primary-care physicians.
'If the member receives care from a provider who isn't in the network, the HMO won't pay for care unless it was preauthorized by the HMO or deemed an emergency,' the association said.
There is very little penetration of HMOs in the state, added Evan Jenkins, the executive director of the West Virginia Medical Association. Reasons include geography, population and provider distribution in the state, he said.
In preferred provider organizations, which are similar to HMOs, members don't necessarily have a primary physician, nor do members necessarily have to use an in-service provider. Users don't have to see a specialist in the network, either, but typically there is a financial incentive to do so.
A hybrid is the point-of-service plan. In it, members choose either HMO or PPO when they need health care. As with the other plans, going outside of the network costs more in deductibles, co-insurance and co-pays, the AHA said.
'POS plans are becoming more popular because they offer more flexibility and freedom of choice than standard HMOs,' the association said.
One popular way employers give access of health plans to employees is through a cafeteria plan.
Known also as a flexible-benefits plan, it allows employees to select which type and level of heath coverage that best fits him or her. Employees pay through pretax contributions.
The cafeteria plan may offer prescription drug coverage, as well as prescription drug plans and flexible spending accounts, or FSAs, into which employees may save money, in anticipation of medical expenses. Such types of accounts are typically useor-lose programs. FSAs can be for either the employee or his or her dependents, or both.
The cafeteria plan also can include dental and vision plans, as well as longterm and short-term disability insurance, accidental death-and-dismemberment coverage and other insurance.
Costs, however, continue to rise.
The Kaiser Family Foundation indicated in its Employer Health Benefits 2004 Annual Survey that the cost of premiums for company-provided health plans grew by more than 10 percent annually from 2000 through 2004.
For companies with health plans, costs rose 11.2 percent in 2004, KFF said.
It also said unmarried employees paid an average of $47 monthly, while family coverage cost an average of $222 monthly.
