among plan options. Now in the second year of enrollment, the company has found that the effort was justified and will need to be continued, particularly for retirees. Much attention was given to communicating with employees—through mailings and several sets of meetings. The company publishes a consumer guide and maintains two toll-free telephone help lines, one for active employees and one for retirees. (In a 9-month period, these lines received 38,000 calls, with perhaps one half to three fourths being from retirees and with an average call length of 10 to 20 minutes.) The consumer guide emphasizes shared responsibility among the consumer, the health plan/provider, and the company. To obtain feedback on how the plan is working, the company created several consumer advocacy groups and has funded surveys and consumer focus groups to determine employee needs and concerns.

Educating retirees is especially challenging and requires substantial resources. Retirees are often very hesitant to give up what they see as traditional Medicare coverage. They need assistance in understanding choices and benefits and seem to be easily confused by the range of choices—especially the more complicated structure of the POS option. The company recruited retiree volunteers to provide peer support and found this approach to be quite effective.

Company administrators conclude that in a situation in which employees have a choice of a number of plans, it is important that part of the employee education be done not by the health plans but by an objective party. Such an approach gives employees greater confidence that plan comparisons are unbiased. Providing such assurance is particularly important because of the extensive negative media coverage of managed care plans, as well as general resistance to change.

Although company-specific data on the performance of participating health plans is not yet available, the company sponsored publication of a Los Angeles edition of Health Pages and made available plan-specific consumer satisfaction data based on the experience of other enrollees in participating plans.

Anticipated Improvements

In assessing the program to this point, company administra-



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