The health insurance system is sick. From 1993 to 2004 some 143,000 small employers in Florida - half of all those insured - dropped coverage entirely, according to a recent study.
While price increases are making it harder to find affordable plans, there are still deals, says Ann Travis, of Miami's Travis Agency, which has helped hundreds of small businesses design employee benefit packages. Here are some of the tips she has gleaned over the past 25 years: * Shop Around: Just a few years ago, HMOs, or health insurance maintenance organizations, which provide a wide array of benefits but limited choice of providers, could be counted on to be the cheapest solution. But the advent of consumer-driven healthcare plans that feature lower premiums but higher deductibles, co-pays and co-insurance are starting to flatten the prices between HMOs and other plans - such as preferred provider options and point of service plans. Most insurance companies have websites that make it easier than ever to explore options and hunt for bargains. * Consider Your Staff: The makeup of your workers could determine the plan you choose. Travis said small companies with a predominantly young and male workforce might look into consumer-driven plans with health savings accounts (HSAs) and health reimbursement accounts (HRAs). Similar to 401(k) plans, they allow employees or the employer to sock away pre-tax money for future health expenses. The plans keep premiums low, but have high deductibles and co-pays. Best of all: if the money isn't used one year, it rolls over to the next.
Companies with lots of young women might look into HMOs that cover more benefits, including maternity costs and mammograms, which are required by state law. * Consider Gender: In general young men are cheaper to insure than young women, and older women are cheaper to insure than older men. While the premium on a 20- to 30-year-old male may be about $150 a month, the premium for a woman of the same age can be as high as $400, Travis said. While costs for men increase as they age, the premiums for women stay about the same, until sometime in their 50s or 60s, when men's premiums tend to surpass women's. * Plan on 50 Percent: Most insurance companies require employers to cover at least 50 percent of eligible workers' premiums. Companies that want to cover 100 percent are required to cover all eligible employees - even if they can get insurance elsewhere, Travis said. While many small companies do offer benefits to a workers' spouse and children, in most cases the employee is paying full premium for dependents. * Study the Choices: While many small companies operate like ``a happy family'' and make decisions on a consensus basis, business owners need to study the costs before presenting options to their employees, Travis said.
``Everyone is going to look for what's best for them,'' she explained. ``But you have to decide what's best for the company.''
