ARTICLES MODERN

It is the annual “open enrollment” Corporate America season, when employees choose their health plans for next year. But this time, even if they are lucky enough to get a job at a company that still offers health benefits, many workers are finding that the buffet of options was trimmed in a very short menu.
And usually, the offer now includes a health facility with a financial scare: a high-deductible annually, which is likely to be $ 1100 or more for a person, and much more for family coverage. Under conventional insurance deductible annually - the amount an employee is obliged to spend on health care insurance before you start - may be only about one third higher.
Employers generally try to offset the high deductible, somehow, with a monthly premium of less than workers with conventional pay for insurance. Another sweetener business is the possibility of a worker to put money into a tax-sheltered savings account for health whose balance can increase year after year. Many also make employers contributions to these accounts worker.

Despite these lures, deductible plans than they have received only tepid acceptance by the employees since they were introduced in 2002. But this year, more than 100 large companies and hundreds of smaller ones, high-deductible plans are single employee take it-or-leave-it option.

One of these companies is the automaker Nissan, which is offering only high-deductible plans to its 15,000 employees to the United States next year. Another is Delta Airlines.

Most big companies still do not offer a choice between deductible plans and more than conventional insurance, which means workers must try to decide which approach is best for them.

Typically, if consumers run the numbers, they will find high-deductible plans are most attractive to healthy workers only, which does not expect many medical costs - or their families know that medical costs will exceed the annual out quickly -of-pocket maximum, after which their medical care is covered 100 percent. But even for those people, the lower the premium no compensation was much higher out-of-pocket payments will be made before reaching that high deductible.

Such plans “put a lot of financial burden on employees in a way, have not felt in the past,” said Peter V. Lee, executive director for health policy at Pacific, the Health Business Group, a West Coast employers group. “If you’re a heavy user of health,” he said, “organizations maintenance have generous health coverage.”

In a variation of the plan Nissan, a family deductibles are for 2500 U.S. dollars for each person, with a maximum of $ 7500 for the family. Monthly premiums are about $ 100 for a family - or 35 dollars for a single worker.

As an enticement, the company will store up to 1,600 U.S. dollars in a family health savings account. Checkups and annual physical, well-immunizations and child care, and influenza have been pulled from cancer and screenings of films are covered 100 percent, even before the deductible has been reached - a feature similar to many traditional health plans.

Marlin Chapman, benefits director at Nissan, says the high-deductible plans are “aimed at ensuring people to focus on their health.”

“When you are spending on your own money,” said Mr. Chapman, “are more careful in the way you spend it.”

Betsy Talton, a Delta spokeswoman, offered this reason, in part, to make a big deductible plans for employees of choice only: “I felt it was important to offer a plan that encourages participants to manage their health and maintain their health and offers the opportunity to get the most from their health care dollar. We’ve found that when people get engaged their health in general, they get healthier. ”

As a cost savings for employers, high deductibles are meant to believe that workers spend hard before out-of-pocket money on doctors, emergency room visits and expensive diagnostic tests. President Bush pleaded for the plans as a “consumer-directed” in a way to curb health costs.

Under President-elect Barack Obama, plans can not have a White House lawyer. A spokesman for Mr. Obama to the transition team declined to comment on the matter. But an adviser to Obama, who was not authorized to speak publicly for Mr. Obama, said that the benefits of medical costs of change to employees would not be consistent with Mr. Obama’s position on health.

Jeffrey D. Munn, an expert in the benefits of the design consulting firm Hewitt Associates, notes that “employers have seen some good initial cost savings from the consumer-driven plans,” as a high deductible , Plans are called.

But Mr. Munn said, “there is a concern longer term about the economy, they are wiser coming from consumers, or are simply not going to the doctor because they would have to spend more of your pocket. ”

Because health plans now have been designed to offer at the beginning of this year, long before the full magnitude of the global financial market meltdown and recession were evident, experts predict that the benefit offers a year from now during the season to sign up could require employees to dig even deeper in their pockets.

“Many larger companies will be dramatic changes in their health plans next year as the economic crisis becomes clear,” said Helen Darling, president of the National Business Group, a national association of large employers.

Current field during registration, the number of workers and their families covered by high-deductible plans has been growing at 20 to 30 percent per year, to about 12 million, said Steve Davis, managing editor of Consumer In - Directed Care, a trade newsletter. Not while a small number, did it represent only about 7.5 percent of 158 million people with employer-sponsored coverage.

More telling, perhaps, is that of the 12 million people covered by high-deductible plans, less than one quarter of them have a savings account for health is not, in fact, money, according Mr. Davis. To help compensate for their high out-of-pocket costs, most employees receiving a contribution savings-plan from their employers by burning it in the same year, the bank, rather than o.

Tennant, a maker of cleaning equipment based in Minneapolis, individual contributes $ 750 to workers to help offset the accounts of 1,500 U.S. dollars deductible. For families, the company contributes $ 2250, which the employees can put to $ 4500 deductible for family coverage.

But about one in four companies with high-deductible plans to make any contribution to employee account, in accordance with this year a survey conducted jointly by the Kaiser Family Foundation and Health Research and Educational Trust.

“If you put the money to employees, all they have is a high-deductible plan, health, which most people do not want to buy,” said Bill Sharon a senior consultant at AON Consulting.

Mr. Lee, the Pacific Business Group, urges employees to obtain as much information as possible before deciding between a high-deductible plan or traditional. “They should be sure to ask their employer if they have a Web site that will help you make a budget and compare costs,”