Well, when the CEO of AT&T recently stated in Fortune that eliminating the health insurance plan is not necessarily off the table, many of us New Yorkers wonder what that means for our employers? Well if you are employed by a Fortune 1,000 company or just a large employer of the likes of JPMorganChase, IBM, Bank of America, AT&T, or perhaps a large law firm like White & Case, or even a hospital system like Columbia Presbyterian....what will reform do to what many now feel entitled to as far as benefits?

Well many argue the employer-sponsored delivery system will die....others thing a single-payor system is inevitable, yet others think everything will pretty much stay private and the same, while pushing more of the costs to employees, as employer's costs will invariable continue to rise.

We probably need a little bit of both. What are some of the plans, and sponsoring carriers that offer them? Well I will shoto a few from the hip that many of our clients are headed towards:

Oxford Health Plans - Liberty HMO; Oxford Health Plans Metro products (EPO-based) incorporating both Liberty products and Freedom products - different networks; Aetna's High-Deductible Health Plans which can be used with an HRA, or an H.S.A.; Empire Blue Cross Blue Shield's Value EPO series (open access to their national PPO network, though no out-of-network coverage); for folks in New Jersey though the customer service can be negligible, Horizon Blue Cross Blue Shield of NJ's open-access HMO, high-deductible health plans, and even their direct-access point-of-service plans; for employers up north in Connecticut Anthem, Aetna, and Oxford seem to make up most of the mix, and we are seeing loads of employers migrate to EPO-based benefits with increasingly higher deductibles for major services even in-network.

So what does this all really mean? It means we need to become smarter shoppers, because if we do not we are going to end up with much bigger bills than we are used to especially for Rx coverage, lab and xray services (yep MRIs, CT Scans too). Most of the plans that are not self-funded and not experience rated with enormously good experience (to non-insurance savvy readers that means small employers/community rated business where claims do not influence price) are continue to introduce deductible and coinsurance for just about every costly service outside of an actual doctor's office visit. So when our providers write a prescription for a brand name medicine, we will need to check at perhaps CVS first, see what the cost is going to be, and if too great (as it may go to a deductible or have a cost share % rather than a copay) ask the provider to re-write with generic....generic meds are the savior to our out of pocket expenses, because we do not pay for the hundreds of millions of dollars in advertising/promotion on TV, print, internet, along with incentive trips for physicians to Bora Bora....

So let's get with it in New York, as we claim to be the best, brightest and most stubborn. We need to shop differently for health insurance, we need to use efficient purchasing models (self-promotion here as www.healthinsurancegeeks.com utilizes smart technology to provider best in breed customer service, speed to action, accuracy and expertise...because we do not drive around all day in Lexus's visiting our clients over drinks at Westchester Country Club....that model of insurance brokerage is long dead....brokers need to wake up) and we need to be ready to introduce plan designs that feel different, share costs with employees differently, incent folks to focus on wellness initiatives and preventative/disease prevention, and by the way all of the plans I have outlined above have great programs in this area. Especially here in 2010, the first date of any milestone for Health Reform is September 23, 2010, when lifetime limits on benefits, and costs associated with essential health benefits (preventative OB GYN, wellness, child care) become law. I think in 2011 we are going to see someone as far as the big 3 - Aetna Health, Blue Cross Blue Shield (whether Empire in NY or Horizon in NJ, or Anthem in CT), Oxford Health Plans (owned by United Healthcare) - step to the plate with new plan designs that will stabalize pricing, incent the good behavior and ding us when our behavior is bad/costly as it should be.