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Bottom Line Health

By Ronald J. Berding

Choosing a health insurance plan is not as easy as it used to be. The distinctions among health plans have begun to blur as health benefits companies compete for your business.

Although there is no "best health benefits plan, there are carriers that are a better fit than others for your business and your employees health care needs.

As chief executive officer of VISTA, a health benefits company, I am not immune to the skyrocketing cost of health care. As an employer, I face the same challenge you do of keeping health care costs affordable for VISTA's 1,000 Florida employees. My responsibility

also extends to more than 10,000 South Florida employer groups and 330,000 VISTA members.

While many CEOs, presidents and CFOs complain about the cost of providing health benefits for their employees, they are rarely

engaged in the process of selecting a health benefits company.

Fortunately, South Florida employers enjoy a highly competitive marketplace when it comes to purchasing health benefits. While

there are many carriers to choose from, the differences among each are few. The network of providers, plan designs and services are all very similar.

So all things being equal, why pay more? How do you know which health benefits company is the right fit for your business? Ask yourself these questions.

As an employer, how much can I afford to contribute to the premium?

What benefits will serve the majority of my employees?

Will offering employees more choices save or cost me money?

Does the plan have an adequate number of providers?

Evaluating cost

Business owners are searching for ways to reduce their health care expenses. Look for a carrier that administers your health benefits

plan efficiently.

Administrative charges are a carrier's overhead costs. They are included in your premium and can vary significantly. These charges

include processing and paying claims, answering customer calls, marketing and advertising costs, and broker commission payments. Carriers with lower administrative costs usually are much more affordable than those with high administrative costs. When reviewing proposals from health benefits companies, ask what they will

charge you for administrative expenses.

Offering employees a choice

Giving employees the freedom to choose their health plan will help educate them about the valuable benefit you offer, satisfy their need for health benefits and keep your premium contributions within your budget. Plan choices may vary by co-payment, network access and employee contribution. It will be the employee, not the employer, who

is responsible for evaluating and choosing his or her health benefits plan.

Employees will have to determine how often they use health care services, what they estimate those costs to be and how they want

to access and pay for those services.

An adequate provider network

No health benefits plan covers every health expense an employee may have or includes every physician. You are purchasing group coverage. As a business owner, you must evaluate whether the health benefits pIan you are considering offers an affordable level of benefits and a network that provides adequate accessibility for your employees.

Your bottom line

In South Florida, there can be as much as a 15 percent difference in cost among the health benefits companies you have to choose from. The health plan you select should be cost-competitive and offer a choice of health plans and an extensive provider network to meet the needs of your group.

Whether your company has 20 employees or 1,000, your level of engagement in the decision-making process is vital in determining

how health care costs will impact your company's bottom line. Standing on the sidelines could be a price you cannot afford to pay.

About The Author

RONALD J. BERDING is CEO of VISTA, a health benefits company headquartered in South Florida with more than 330,000 members. His expertise in health care and insurance spans 30 years. Berding was a member of the Gov. Chiles Task Force on Claims Payment and the Small Group Insurance Reform Committee under Florida Insurance Commissioner Tom Gallagher. He also served as chair of Florida's Consumer Assistance Plan. VISTA, through its affiliated companies, Vista Healthplan Inc., Vista Healthplan of South Florida Inc. and Vista Insurance Plan Inc., offers a choice of health benefit plans including health maintenance organization (HMO), preferred provider organization (PPO) and point-of-service (POS). Contact Berding through VISTA's Web site, www.vistahealthplan.com, or at (954) 858-3000.

© 2004 Smart Business Network Inc. Reprinted from the September 2004 issue of Smart Business Broward/Palm Beach.


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