Higher co-pays product of move to more variety.

In case you hadn't noticed, the days of the one-size-fits-all managed health care plan for all companies is history.

Health plan providers, such as Blue Cross of California, Health Net Inc. and Kaiser Permanente and the brokers who package the deals, are now cobbling together plans to offer employer groups more options to pass on to their workers and to fit the size and needs of those employer groups.

Companies who take advantage of these new hybrid products can benefit from lower premiums because their employees will have to pay for the added choices via higher deductibles and higher co-payments.

But industry experts say the more the consumer knows about what they are getting and the more choices they are given, the more willing they will be to cough up their fair share.

So also expect to see health plan providers playing a larger role in directly educating consumers about these new products.

"What you are seeing now, with innovations in technology and new drugs hitting the marketplace, is growing demand for more choices and workers will be paying more for those choices through higher co-pays," said Callen Lockett, rice president of public affairs for WellPoint Health Networks, Inc., parent company of Blue Cross of California. "But as individuals become more engaged and more responsible for their own premiums, they will also be demanding more. So we as an industry have to begin looking at providing more education directly to the consumer about what's available. It's no longer up to the employer."

Lockett was selected as the Business Journal's honoree for the Health Care Leadership award for public policy advocate.

Blue Cross recently introduced a new HMO plan called Power Select, which is said to be priced at about 15 percent below other products on the market, including its own, and geared toward employers with more than 51 workers. Although the network of physicians on the plan is said to be smaller than Blue Cross's other plans, Power Select offers three different plan options with three different co-payments to choose from.

While details are still being hammered out, Kaiser Permanente, one of the original players in managed care, is putting the finishing touches on its own new cost-sharing products.

"Historically, employers have, on a percentage basis, had to spend more than their employees on health care, but that's changing," said Matthew Gerlach, senior vice president and Valleys Service Area Manager for Kaiser. "We are looking to introduce new products into the market just before next year's open enrollment that break out different options for our members, but they will be paying higher co-pays for them. With premiums going up and costs on the rise for care, we are seeing these cost-sharing programs as a way for businesses to cope."

Gerlach was chosen as the Business Journal's honoree for the Health Care Leadership award for health plan executive.

Smaller clients

But it's not just the consumer who'll need educating on these new hybrids. In-house health insurance brokers and independents who previously stuck to traditional open-system plans now must get a handle on this new frontier.

That includes taking a larger interest in the little guys.

"No one person has the same needs," said Renee Glickman-Cohn, founder and executive vice president of RGEB Inc., which provides health insurance for small to mid-sized companies. "It's just no longer fair for an employer to say to their employees 'this is what you'll have because this is what I think I can afford, or this is all there is to chose from.'"

According to Glickman-Cohn, many brokers have shied away from smaller companies because they either don't know how to sell the products that are out there for smaller firms, of they just don't see the payoff.

"People in my industry have ignored small businesses for a long time," said Glickman-Cohn, chosen as the honoree for the Health Cave Leadership award for health insurance. "The insurance agents out there believe they won't make enough money out of the smaller guys so they just don't think it's worth their while. But it is, because those are businesses that will become loyal clients and it's naive to think they will always be small."

Steve Tough, president and CEO of the California Association of Health Plans, which represents 28 member plans with roughly 21 million enrollees, says, while price points for products and what consumers are willing to pay will likely be out of step for years to come, educating and engaging the consumer will be the new strategy for bridging the gap.

"In today's environment, a good portion of the payment for health care is made by the employer, so the employee doesn't really have any sense of what it costs, service by service. So, we'll see more plan providers getting directly involved with that process, and we'll continue to see more choices on the table."