Kaiser lets companies
share cost burden
with employees

The HMO is allowing employers
to pick a plan that would charge
workers higher fees for services

Kaiser Permanente Hawaii is offering employers a new option designed to provide relief from rising medical costs.

If employers accept the new plan, some Kaiser members could see fees rise 10 percent for some outpatient services such as laboratory, X-ray and diagnostic procedures. Inpatient services are not affected. Co-payments for office visits for all members went up $2 to $12 on Jan. 1.

The state's largest health maintenance organization, which increased premiums 11 percent this year, said the change in fee structure will result in more predictable employer-paid premiums by shifting some cost-sharing responsibility to employees when they use health care services.

"The primary focus of this new option is for employers who have been concerned about their rising health plans' costs," said Scott Nariyoshi, corporate communications director for Kaiser.

Since it's still early in employers' insurance renewal process, Kaiser said it doesn't know how many employers will accept the cost-share plan.

Members who may be affected are those whose employers choose the new cost-share option. Employers could instead pay a higher premium so that employees don't have to make a co-payments for outpatient services.

The increased fees do not affect Medicare, Medicaid/Quest, state, union, individual plan members or those employers who already subscribe to a pre-existing 50 percent cost-share plan that has been an option for nearly 10 years. Under that plan, a Kaiser member receiving outpatient services pays 50 percent of the bill for lab, X-ray and diagnostic services, allowing the employer to pay lower premiums to Kaiser.

X-ray, lab and diagnostic tests previously were provided at no charge to members who were not part of the existing cost-share plan. The new X-ray and diagnostic co-payments could range from $6 to $10 for certain types of chest X-rays to $150 for an abdomen and pelvis CT scan. Preventive screenings, such as pap tests and mammograms, are exempt from the increases.

Beyond the cost-share plan, other changes that took effect Jan. 1 include having all Kaiser members pay half the cost of contraceptive drugs and devices.

Also, members will see billing charges go up to $20 from $15 if they don't pay for services on the same day they are received.