This time of year, people choose whether to contribute to their 401k plans and pick what kind of health plan in which to enroll. With all those choices, how do you know which plan to pick? One annual report known as The Health Competence Survey found that more than half of people are in shell shock over the cost of coverage next year. People are seeing such large increases in health care costs that they are going to reduce the amount they contribute to their 401k plans. That is unfortunate, but it’s a sign of the times. So, when looking at jobs these days, consider health care, bonuses and other benefits. Typically, an employee only thinks of salary. But health care is huge these days. One alternative is a high-deductible health plans. Clark thinks these are great for people who own their own businesses and for contract workers. HSA plans are another option that Clark supports. Many people don’t have money saved, so paying the big out of pocket costs is not realistic. But for others it could be a great idea. For more on HSAs, click here.

If you own your own business and are self-employed, you probably know about the problems getting health care for yourself and your workers. Well, Clark has a solution for you. In response to Costco Wholesale offering health coverage in several states, Sam’s Club is now launching its own program in nearly all 50 states. The coverage is much less than other locations, including Costco, and there are several plans available. The Sam’s Club offering is designed to get people to buy the most expensive membership level, the “Plus” membership, in exchange for a large discount on health coverage. The information on Sam’s Web site is confusing, and you may have to go through medical underwriting. But the savings is worth it. Sam’s expects the most popular plan to be the one that has a $10,000 deductible. Yes, that’s a lot. But most people in small business want only catastrophic coverage and very low premiums, so the plan is perfect. Most employers will cap your coverage if you have a complicated procedure or long-term illness, regardless of whether your medical bills are paid. You can also take the HSA or Health Savings Account route. You put your money into a tax-free savings account, which pays for your premiums each month. There are a variety of offerings, so it’s great for business owners. For more, go to samsclub.com and click on “Member Services” in the left rail. From there you want to click on “Employee/Healthcare Services.”

Clark is a big advocate of Health Savings Accounts or HSAs, a new form of health coverage for which more than one million people have signed up. The most interested are the self employed and small business owners, but more corporations are starting to offer HSAs to employees, as well. Basically, members pay a $1,000 deductible up front and, in return, their premiums go down over time. At the same time, members can put money into a tax- free HSA, which earns interest and can be used down the road to pay for healthcare. It changes things because the member becomes the customer, not the company supplying the insurance. The problem is that some companies charge a significant amount to open an account. The Web site hsafinder.com lists the 10 worst companies out there today, and the worst one charges a $235 fee annual fee. So, if you open an account with $1,000, you immediately have only $765. Other companies charge no fee at all and those are the companies you want to join. When setting up your HSA, be aware of what charges are involved. There shouldn’t be any!

Health care in the United States is outrageously expensive, as you well know. Problems started in the '60s when companies offered to provide health coverage in lieu of pay raises and other benefits. The problem was people began not caring how much it cost because they weren’t paying. The whole thing has been upside down and backwards ever since. Well, fast forward to today when there is help on the way. Health Savings Accounts (HSAs) will provide us with that alternative. These are tax-advantaged accounts that allow individuals to shop around and keep track of how much health care costs them. You can end up with a big pile of cash if you remain fairly healthy. Information is slowly trickling out about these accounts and now there is a site that lists opportunities by state. It is hsadecisions.org.

You may have heard of Health Savings Accounts or HSAs but you’re not really sure what they are. It’s the Bush administration’s main initiative in the health care area and Clark really likes the idea. Right now, the health insurer and your employer are the customer, and you’re in third position. No one cares about you and you have no say in what you pay. But with an HSA, you get a trade-off. You get much lower premiums for health coverage, but you have to pay the first minimum $1,000 for coverage. The money you don’t spend, goes into a tax-free savings account known as an HAS. It earns money tax-free and is used tax free to pay for medical expenses. Now, if you see the doctor frequently, an HSA is not a good idea. But for many, it’s a huge improvement because you will be more conscious about how much you’re spending. Kaiser Permanente, one of the largest health care companies, is getting in on the HSA game early. The company is concerned about losing customers to individual HSA plans. So, as an experiment, the company is going to allow customers to buy an HSA plan through Kaiser. About one in four Kaiser members will be eligible. The premiums will be much lower, but the doctor visits will cost much more. It won’t be the typical $10 or $15 co-payment. It’s not the traditional Kaiser business model, but Clark congratulates them for trying something new. The market place will decide if it’s a good idea or not and we’ll keep you posted.

Clark has been getting a lot of calls from listeners about Health Savings Accounts or HSAs since Congress passed the law recently. These accounts are going to become a household name in the next few years, but right now they are very confusing. HSAs look at health care very differently. The idea is to make health care more of a patient-oriented system. Right now, you fill out medical forms and you might pay a co-payment or a percentage of the bill. And you have to check if your doctor or specialist is in your “network.” With HSAs, people are now “customers.” The first certain number of dollars come out of your pocket. After that, all the bills are paid by your health care plan. The idea is that you’ll try to think of a less expensive way to get care if you’re paying for it. If we’re spending someone else’s money, we don’t really care about it. With HSAs, your deductible could be as high as $2,600 or as low as $1,000. But the great thing is it’s up to you, and it’s tax free. And if you buy a policy that has a $1,500 deductible, you’re free to put $1,500 into it and it’s never taxed. HSAs will be available from large employers, small employers and the self-employed. It’s still very early in the HSA game, but we’ll keep you posted. There are some people who don’t like HSAs, of course. They think all of the money is being funneled to the rich. But, it’s better than our current system. Of all the economic output in the United States, 15 cents on every dollar goes to health care. That’s about 50 percent higher than any developed country. So, we are basically sapping our nation’s economic growth with the enormous amount of money going to health care.