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The Honolulu Advertiser
Posted on: Thursday, December 1, 2005

Larger firms favoring new type of health plans

By THERESA AGOVINO
Associated Press

NEW YORK — The Banta Corp. is hardly unique in its struggle with healthcare costs rising at double-digit rates, but is taking an unusual step to contain them.

Starting next year, the Menasha, Wis.-based provider of printing and supply chain management services will offer only consumer driven health plans to its 5,000 nonunion employees in the U.S.

Banta began offering consumer driven plans in 2004 and by this year around 70 percent of employees had enrolled in one. As a result, its healthcare costs are expected to rise around 8 percent, down from 12 percent to 15 percent in past years.

"We had tried a lot of cost shifting to employees but there is only so much of that you can do," said Stacy Ryan, Banta's benefit manager.

Consumer driven plans provide employees with a set amount of money to pay for medical expenses. After the fund is exhausted, a deductible applies and when it's met, a traditional plan kicks in. These plans have high deductibles, which are cheaper for employers to purchase and employees pay lower premiums.

But the plans, heralded as an antidote for skyrocketing healthcosts when they arrived on the scene a few years ago, haven't gained traction as expected. They do seem to save money and big employers have embraced them, but they can be too expensive or confusing for some companies.

Blaine Bos, a consultant at Mercer Health & Benefits LLC, said the plans' hype is not justified. "Consumer driven plans are not an easy concept."

The theory behind the plans is that if employees have to spend more of their own money, they will become better consumers. For example, Ryan said people in consumer driven plans used more generic drugs and made fewer trips to the emergency room.

There are two types of consumer driven plans: Health Reimbursement Accounts (HRAs) and Health Savings Accounts (HSAs). One major difference is that in an HRA the employer must fund the pool of money initially used for expenses. In an HSA, the money can come from either the employer, the employee or some combination of the two. Individuals fund the pool with pretax dollars.

Since the employer doesn't have to contribute money to the fund, some had hoped HSAs would be adopted by companies that find healthcare unaffordable.

But adoption has been slow. Two percent of employers offered consumer-driven plans this year, up from 1 percent in 2004, according to Mercer. Very large companies are embracing the idea, however. Among employers with more than 20,000 workers, 22 percent offered them to employees this year, up from 12 percent in 2004.

"We still don't think that small employers see enough savings for them," said Bos.

Larger employers are the early adopters because explaining consumer driven plans to employees takes a significant amount of time and effort, Bos said. Small companies "don't have the staff or money for that."

Opponents of consumer-driven plans worry they may hurt low-income workers or individuals with significant health expenses who will struggle with high deductibles and may put off necessary care as a result.

The total cost per employee for a consumer driven plan annually is $5,480 compared with $6,480 for a preferred provider organization according to Mercer.

The premium for a single person in a company with more than 500 employees in a PPO would be $78 monthly compared to $47 for a consumer driven plan.