Every year, public relations firm Rogers & Associates considers switching to a new health insurer for its 70 employees. And each year, it has made the same, unusual decision: not to sign up with a health maintenance organization.

The Century City-based firm instead has chosen each year to stick with insurance coverage that provides its employees with greater health care flexibility but at a higher price than HMOs offer.

That arrangement, said Elliott Fils, the company's chief financial officer, allows Rogers & Associates' employees more freedom to choose their doctors and to go directly to medical specialists which, in turn, allows the firm to attract and retain high-quality employees.

"You can't just look at the bottom line," said Fils, whose firm does public relations work for American Honda Motor Co. Inc., L.A. Cellular Telephone Co., the city of Santa Monica and others. "You're dealing with your employees' health. It's very important. They have to feel comfortable going to the doctor of their choice."

For the last two years, Rogers & Associates has used Piscataway, N.J.-based Anthem Health & Life Insurance Co. as its insurer. Like most small companies buying coverage for its employees, Rogers & Associates did not deal directly with the insurer, but rather worked through a broker, Triad Insurance Group.

The broker helps the employer to compare different product offerings and financial stability. Each year Triad prepares a spreadsheet comparing HMO coverage with more-flexible coverage, and each year the more-flexible coverage wins out partially because it offers Rogers & Associates employees better coverage when they are outside Los Angeles.

"They have better benefits outside (the city), because a lot of their people travel," said Gordon Silverstein, president of Triad. "They needed the flexibility because of their people."

Through Anthem Health, Rogers & Associates' employees have two choices. They can use a point-of-service plan, also known as a POS, which operates much like an HMO, in which the employees' choice of doctors is limited. Unlike many HMOs, though, employees in a POS plan can visit doctors or specialists outside the plan and still be partially covered.

Rogers & Associates employees can also choose a plan that's a hybrid between indemnity insurance and a preferred-provider plan. Under that plan, which is more expensive than the POS plan, employees can visit any approved doctor, and pay a co-payment, or visit any doctor they wish, and pay an annual deductible. Once the deductible is paid off, the employee pays a predetermined percentage of the bill for treatment, just as under traditional indemnity plans.

When the firm each year reevaluates its health insurance, it looks at such factors as the types of prescription medication the plan covers and the cost of co-payments for various procedures, Fils said.

"It's just a different way of getting medical care dealing with a primary doctor for everything," Fils said. "I'd have to say the quality of care provided by our insurance company is very good."

For reprint and licensing requests for this article, CLICK HERE.