Painless plans Featured

9:37am EDT July 22, 2002

Dianne Moore is all too familiar with the challenges of securing a good health insurance plan for the 55 full- and part-time workers employed by Austin Tape & Label Inc. in Cuyahoga Falls.

There was a time when Moore faced daily complaints from employees who, fearing their credit histories might be damaged, paid long-overdue doctor and hospital bills simply because the company's former insurance provider hadn't.

"We've had some nightmares," admits the company's office manager of eight years.

But those nightmares disappeared three years ago, after a former employee of that insurance company introduced Moore to her new employer, Akron-based Summa Health Care. The plan Austin Tape & Label selected requires a biweekly employee contribution of $7.26 for single coverage and $27.94 for family coverage.

For their nominal payroll deductions, workers get $10 office visits to their primary care physician of choice in the extensive Summa network. The $10 co-payment applies for visits to any specialists to whom employees are referred, as well as eye exams performed by ophthalmologists listed in the Summa directory.

"Virtually, if you could have open heart surgery in a doctor's office, it would cost 10 bucks," Moore says.

Those admitted to the hospital incur no out-of-pocket expenses.

A prescription card cuts co-payments to $5 per prescription for generic drugs and $10 for name-brand drugs, while another Summa discount card provides a 10 to 35 percent price break on glasses and contact lenses purchased at select opticians and optical centers.

The company offers dental insurance through another insurance carrier, at no cost to employees, that covers 100 percent of the cost for twice-yearly cleanings and exams and 50 to 80 percent of the tab for dental work after a $50 annual deductible is fulfilled.

Austin Tape & Label isn't the only small business in the area that still manages to provide a "rich" health care plan for its employees, while others -- some much larger in size -- continue to cut benefits and increase payroll contributions. Just how does it do it?

"It starts with basic compassion for people," says Dana Shoff, vice president and secretary of DA-Stirling Inc., a Cuyahoga Falls producer of dyes for molded rubber and plastics.

Smart shopping also helps. Moore points out that at one point, Austin was paying far more than the approximately $23,000 a month (including short-term disability and life insurance premiums) it now shells out -- and getting far less for its money. She says this year's rate increase was about 3 percent.

Like Moore, Shoff has encountered the problems inherent in purchasing insurance for DA-Stirling's five employees. During her 18 years with the company, there have been insurance companies that hiked premiums as much as 40 percent from one year to the next.

"A lot of (plans) are rated by the size of your company vs. your usage, that kind of thing," she explains. "It's a killer if you're a small company and you have one thing happen, a fairly major illness or incident."

About six years ago, an independent insurance agent gave Shoff a quote from Summa for a plan similar to the one enjoyed by Austin employees. Office visit co-payments are $5 more, and there are deductibles of $500 for inpatient hospital procedures and $100 for outpatient procedures. However, workers pay nothing for their insurance.

According to Shoff, modest premium increases have, in part, allowed DA-Stirling to continue to offer the coverage, for which it pays about $2,000 a month.

"You play around with your plans when you can," she says.

For example, she switched prescription plans this year to avoid a rate increase. Employees now pay $10 instead of $8 per prescription for generic drugs; $20 instead of $15 for name-brand drugs; and $40 for highly advertised "designer" drugs not listed on Summa's preferred drug list.

"By going to that three-tiered plan, I feel I still gave everyone choices," Shoff says

Kent Clark, marketing director and group benefits coordinator for the Akron-based land surveying company Bock & Clark Corp., says it's a challenge to pay the health insurance bills for the company's 55 employees. Nevertheless, conversations about health care there usually focus on adding perks -- Clark mentions the prescription drug card added last year -- not eliminating them.

"We are fortunate to be profitable and able to maintain that coverage level," he says.

Clark estimates the firm spends $10,000 to $15,000 a month for a comprehensive preferred provider plan offered by Anthem Blue Cross and Blue Shield. The plan features an annual deductible of $300 for singles, $600 for families, and a 20 percent co-payment until the maximum for out-of-pocket expenses -- $1,000 for singles and $2,000 for families -- is met. (Deductibles and maximum out-of-pocket expenses are higher for those who choose providers outside the network.)

The coverage costs employees $18 per biweekly pay period for single coverage, $36 per pay period for family coverage.

The payoff for providing a good health care plan? The ability to retain and attract good workers.

"Sometimes that's tough to measure," Clark admits.

But he adds that Bock & Clark counts on the costs of providing good health insurance to offset those of hiring and training new employees. Moore, on the other hand, says employees have told her they've looked for work elsewhere and decided to stay at Austin because of the low contributions and comprehensive coverage.

"Our group is reasonably young, but they realize medical insurance is important," she says.

Shoff agrees. She says DA-Stirling employees have come to realize just how much their health care benefits are worth -- so much so that they've come to accept the fact that raises aren't as frequent because of the plan's cost to their employer.

"The fact that we've continued to absorb that cost, that's part of an annual increase that maybe you would see as an employee somewhere else that you won't see here," she says.

How to reach: Summacare Health Plan, (330) 996-8410; Anthem Blue Cross and Blue Shield, (800) 443-6722