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How to decide on a company health plan

Your Money / Your Health

Cost and coverage needs vary, so choose wisely, healthcare expert says.

January 26, 2009|Francesca Lunzer Kritz

By and large, the chance to change insurance plans came and went for many people several months ago. But new employees of companies offering healthcare get a second chance to choose a plan that best suits them in terms of coverage and cost.

Note to those folks: Don't blow it.


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Employees who opt for employer-sponsored health insurance for 2009 will pay an average of $3,826 in out-of-pocket costs, including premiums, according to data from benefits consulting firm Hewitt Associates, based in Lincolnshire, Ill. That's an 8% increase over 2008, according to Sara Taylor, annual enrollment leader at Hewitt.

Despite that cost, however, most employees "continue to take a passive role when choosing their benefits," Taylor says. Even when changing jobs, many people simply choose coverage similar to what they had before. "To truly manage costs, Americans need to put as much deliberate thought into their benefits choices as they would for any big-ticket item," she says.

We talked with Kirby Bosley, a healthcare consultant in the L.A. office of benefits consulting firm Watson Wyatt, about how to choose wisely.

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What advice do you have for someone with the chance to evaluate new employer-sponsored health insurance this year?

Employer-based medical coverage is often a better deal than what you can obtain on the open market, but not always. If you're young and healthy, and if you've purchased an individual health insurance policy while between jobs, you should certainly check which plan is cheaper. You might want to hang onto your own policy. However, if you've continued your coverage from your prior employer under COBRA, then your new company's plan is very likely to be a better deal.

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How do you go about evaluating your options?

Most companies continue to offer choices among health plans for their employees. In Southern California, it's common to have a choice between an HMO [where you select a primary-care physician] and a PPO plan [where there is a choice of physician at the point of care]. Many large companies have also added "high-deductible health plans" which cost less in premiums but require larger payments for those who actually obtain care. [Before signing on for coverage] any employee, whether a new hire or an old-timer, needs to think about questions such as:

* What coverage is offered, if anything, through a spouse's employer's plan?

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