HMO costs on the rise in Maine Survey: State premiums higher than U.S. average

PORTLAND – The state’s average premium for HMO coverage was 23 percent higher than the national average last year, according to a survey by the Maine Health Care Information Center.

The average 2002 premium of $5,519, including employer and employee contributions, was also 13 percent higher than the average premium around the Northeast.

The average cost for point-of-service coverage was $5,601, or 15 percent higher than the national average. For preferred provider coverage, the average premium was $5,065, or 12 percent higher than the national average.

Point-of-service coverage allows the policyholder to seek care from a provider outside the network of providers assigned by the insurance company, but at an increased share of the cost.

Preferred provider coverage gives the policyholder even more flexibility for seeing an out-of-network care provider with less cost to the individual than point-of-service coverage.

The survey of employers was commissioned by the Maine Health Management Coalition, which consists of businesses, hospitals, doctors and health plans.

It found that businesses are absorbing more of the rising costs than employees, but everyone is paying more, said James Harnar, president of the Maine Health Care Information Center.

The survey also found that 92 percent of the state’s part-time employees were offered health benefits. Nationally, the comparable figure was only 56 percent.

Thirty employers offering 72 different health plans were surveyed during the late winter and early spring of 2002. All the employers surveyed are members of the coalition and most are larger employers, such as Hannaford Bros., the University of Maine System, Bath Iron Works and the state of Maine.