Originally created 11/18/02

Right health care plan is vital



Q: It's open enrollment time at my company, when employees must choose health care plans for the coming year. How can I determine which coverage is right for me?

A: You're smart to be thinking about your health care coverage. Health care benefits consultants say there have been a lot of changes to employer-sponsored plans.

"With health care costs going up an average 15.4 percent (in 2003), employers are not going to be able to shoulder all of that and are going to pass it on to their employees," said Ken Sperling, of Hewitt Associates, a consulting firm.

In selecting your health insurance coverage, there are basically two factors to consider: access and cost.

Benefits consultants say to deal with access first.

That means making sure that the doctors you and your family use now will continue to participate in your plan or that they take part in any new plan you are considering. Remember to take into account all your doctors - pediatricians, gynecologists and other specialists - not just your general practitioner.

The next step is to calculate and compare costs.

Figure out what you spent on health care this year by adding up your premiums and your out-of-pocket expenses, such as doctor's office and prescription drug co-payments and hospital or emergency room deductibles.

Then compare that cost with what your current plan - if it is available - will run you next year. Also run those numbers against other plans offered through your employer. If you are married, you'll want to weigh the cost of coverage through your employer against that of your spouse's.

Next, adjust those numbers to reflect other medical expenses that you anticipate next year, said Rich Niemeyer, a benefits consultant with Scheller Bradford Group.

Also, check to see whether your company has a medical savings account program, which allows you to designate pre-tax dollars for certain medical expenses that might not be covered in your plan.

Lastly, take the enrollment period seriously. These are important decisions, and in most cases, an employee who misses a deadline can't request changes later.