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Sears to overhaul health insurance benefits

In this Feb. 22 2012 phoshoppers enter Sears department store locatiDedham Mass.  Sears Holdings said Thursday Feb. 23 2012

In this Feb. 22, 2012 photo, shoppers enter a Sears department store location in Dedham, Mass. Sears Holdings said Thursday, Feb. 23, 2012, it will separate its smaller hometown stores, outlets and some hardware stores in a deal expected to raise $400 million to $500 million as it seeks to regain profitability and market share. (AP Photo/Steven Senne)

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Updated: October 29, 2012 6:50AM



Sears Holdings Corp. and Aon P.L.C. are radically shifting the way their employees choose their health care coverage — letting employees decide their level of coverage and how much of their employer’s contribution to spend.

Employees will go to an online Web portal to make their selections, starting Jan. 1.

More companies are expected to adopt the model as health care reform gets under way and as they face higher health care coverage expenses as long as they run their own medical insurance programs. Companies save money by letting an outside administrator choose their employees’ health insurers and run the program. As plan sponsors, employers’ premium contributions are still tax-deductible. Employees get a greater choice of coverage.

“The more insurance providers compete, the better,” said Chris Brathwaite, spokesman for Hoffman Estates-based Sears. “I will have an opportunity to shop for a health care provider who meets my medical and my pocketbook needs.”

Aon Hewitt, Aon’s Lincolnshire-based benefits consultancy, will administer a health care “exchange,” or marketplace, where Sears and Aon employees will choose among five different health care plans. Nine insurers are participating, including Cigna Corp., UnitedHealthcare and Health Care Service Corp., which runs many Blue Cross/Blue Shield plans.

Darden Restaurants, the Orlando, Fla.-based owner of Red Lobster, Olive Garden and LongHorn Steakhouse restaurants, will also participate in the exchange. The company operates about 50 restaurants in the Chicago area.

Employees will receive a fixed premium contribution as they do now — as pre-tax dollars out of their checks — and pay more or less than that amount depending on the level and type of policy they choose.

The credits will most likely differ based on an employee’s family status, with higher credits given to employees who want to buy family coverage, as is the case now.

Sears and Darden spokespeople said they will provide the same subsidy they do now, and will review yearly cost-of-living expenses as part of the equation.

Initially, the premiums will be based on each employer’s claims experience.

All of the insurance plans provide for catastrophic protection and cannot reject people for medical histories or pre-existing conditions, said Ken Sperling, national health exchange strategy leader for Aon Hewitt.

The new system will include 90,000 full-time Sears employees and 45,000 full-time Darden Restaurant employees. Aon didn’t provide a number, but said it expects the health care exchange to enroll more than 100,000 employees in total.

Brandon Cruz, founder and president of Chicago-based GoHealth, said companies that previously paid 16 percent yearly increases in healthcare provider costs, on average, can now just keep paying the fixed subsidy to employees.

“If the cost of the coverage goes up, the employee can switch to another provider” that’s more affordable, he said.

The shift also takes away a largely unspoken dilemma that company leaders face prior to health care reform’s 2014 requirements — knowing that laying off an employee or otherwise kicking an employee off coverage will leave certain employees — those with pre-existing conditions, for example — with no coverage.

“After 2014, people can get health care coverage on their own,” Cruz said.

GoHealth, which runs a healthcare exchange for individuals and sells a software platform for companies to set up their own exchanges, is benefitting from insurance companies’ need to operate more efficiently in the new health care environment.

GoHealth has hired 130 sales, service and technology employees in the past three weeks and is searching for a new Loop site to hold 600 employees. It now employs 325.



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