TheBakersfieldCalifornian.com

Another year, another big jump in health insurance premiums. Like death and taxes, right?

Maybe not.

These days local business owners are doing more to control the cost of employee health insurance -- often to the benefit of their staff as well as the company itself. Some employers have begun offering additional plan options, for example, or raising co-payments for doctor visits.

"The smarter employers are looking at their options," Bakersfield employee benefits consultant Clay Koerner said.

Added Jim Barks, a principal at FSIS Insurance Services in Bakersfield: "We're all being creative. We're doing greater co-pays, we're paying greater deductibles."

There's every reason for employers to consider their options. Across the country commercial insurers are raising their rates, which is nothing new except that it's happening at a time when businesses and workers can least afford it.

What's different this year is that U.S. employers overall are shifting health premium increases to their employees. A new study by Kaiser Family Foundation found that workers this year are paying 14 percent more on average than they paid last year for their family health coverage, while employers' contributions did not increase.

No comparable data was available locally, and it remains unclear to what degree this cost-shifting trend is happening here. But Bakersfield benefits consultants and insurance brokers noted that so many insurers offer health coverage in Kern County -- 10 or more, in fact, as compared with one or two in some parts of the country -- that employers here are generally in a better position to bargain for a good deal.

That's notable partly because California companies with 50 or fewer employees are not required to offer health benefits. If they do it's by choice.

"Businesses are just trying to keep their doors open and still want to maintain and attract the best employees, so they will try to provide health insurance," said Bill Georgenton, a Bakersfield-based employee benefits consultant.

At Advanced Distribution Co., co-pays have never been as high as they are now, about $40 per doctor visit, up from $30 previously. The owner of the Bakersfield maintenance, repair and operations supply company, Terry Hearron, said this change in co-payments has helped shield the company and its workers from double-digit premium increases.

"They (employees) are going to see their costs, as far as deductibles and co-pays, go up," Hearron said. "The part of that that they don't see is the premium increase as much."

Another Bakersfield outfit, ARRC Technology, has been able to hold down its benefits costs by moving its payroll services to an outside company that "co-employs" most of ARRC's work force.

As a result of the switch about two years ago, workers at the computer systems installation and maintenance company have access to various "tiered" health plan options that can be customized according to employees' needs. And because the payroll company, Automatic Data Processing Inc., has a large number of "co-employees," it has greater bargaining power and is able to offer a relatively strong benefits package.

No matter what plan they choose, ARRC's cost is no more than $150 a month per worker, said ARRC's corporate administrator, Monique Rogers.

"It lowered our administrative costs and it broadened our ability to offer tiered benefits," Rogers said.

Keeping costs down

Bakersfield insurance brokers and benefits consultants described strategies put in place recently to keep health coverage affordable in the face of rising insurance costs.

The most commonly cited strategies were the simple ones: Increase co-pays and raise deductibles. These directly limit insurers' costs and have the effect of discouraging insurance subscribers from going to the doctor unless it's absolutely necessary. In exchange, this tends to lower monthly premiums.

"A lot of employers have pushed off increases by increasing co-pays and deductibles," Bakersfield benefits consultant Don Kuhns said.

Renewed emphasis on employees' health has also become more widespread. When companies are able to show their workers are improving their fitness, insurers are more likely to see them as less of a financial risk, and may pass along some of the perceived savings.

Another approach has been to shop around in hopes that a different insurance carrier will offer a better deal.

"If you're a smart business owner or a smart HR person, you'll usually want to shop," Georgenton said, noting that whether they actually switch depends on companies' needs.

A potential downside: This strategy could upset employees whose preferred doctors or other medical providers are not part of the new insurer's network.

Some employers have stuck with the same insurance company but offered a broader menu of plans for employees to choose from. For example, workers expecting to make liberal use of their medical coverage might want to enroll in a plan that comes with a lower deductible but costs them more per month.

Moneywise Wealth Management went with that strategy earlier this year. Instead of offering a single plan through Kaiser Permanente, the Bakersfield employer of about a dozen workers opted to make differently priced plans available through the same insurer.

The understanding was that the company would contribute a set amount, and employees who wanted a pricier plan could cover the added costs themselves.

"It made our cost fixed," said Sherod Waite, a principal at Moneywise.

Although employees mostly kept to the same plan as before, it offered them an opportunity to customize their insurance coverage without increasing the company's financial burden.

"What went up, though, is employee satisfaction," he said.