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Author tackles health insurance dilemmas

Amanda Tust Of the Record staff

After seven ski bum winters in the area, Paul Zane Pilzer decided to make a permanent move to Park City in 1989. The same year that his favorite snow country destination became home, Pilzer found out his wife was pregnant. Next, came the news that he had lost his employer-sponsored health insurance.

Pilzer started to do the math and realized that if his baby was born pre-term, medical expenses might cost him over $60,000 a day for up to four months.

After extensive research on insurance companies, as part of what he calls his own "insurance nightmare," Pilzer found less expensive insurance premiums with equal or better coverage than his former plan.

"I was able to buy better coverage for exactly half the price," he said.

Following his rush to find health insurance for his family, Pilzer began to view his experience as a potential business opportunity.

In 1999 he opened a business now called Extend Benefits, a company that got its start specializing in medical savings accounts now health savings accounts for the self-employed. Extend Benefits began in Park City and relocated to Salt Lake City in 2003. In August, Pilzer said Extend Benefits joined with Revolution Health Group, a multi-billion dollar business with investors such as former AOL Time Warner CEO Steve Case.

As an entrepreneur and seven-time best selling author, it was just a matter of time before Pilzer put his knowledge of the healthcare industry into print. He released "The Wellness Revolution" in 2002, which included two chapters on health insurance. His latest book, "The New Health Insurance Solution," released in September, details health insurance options in the United States with a state-by-state guide. Main topics include the benefits of individual health insurance plans, Health Savings Account options and state-guaranteed health insurance coverage. Individual versus company health insurance

Pilzer told The Park Record that Utah fares well when it comes to individual insurance costs and coverage. Pilzer said he now pays $433 a month for himself, his wife and their four children through an individual plan with Regence Blue Cross Blue Shield of Utah. His co-pay is $20.

"No one believes that you can buy health insurance on your own for one-half or one-third the employer plan, if you are healthy," he said.

Pilzer added that benefits of an individual plan over an employer plan, besides lower costs, include steady yearly premiums as opposed to insurance costs that increase each year due to overall claims within the company. Also, people with an individual plan will not lose their insurance if they lose their jobs or become too ill to return to work.

But Pilzer said there are some cases when employer health insurance is a good option, especially when employees have contracts where they cannot be fired or will be guaranteed health insurance coverage regardless of their work status. Pilzer said this includes people in their early 60s who are secure in a job until they are eligible for Medicare at 65. State guaranteed coverage

There is government-offered Medicare if you are old and Medicaid if you are young, and starting this year there is mandatory guaranteed health insurance coverage for "medical uninsurables" in every state. "Medical uninsurables" includes people denied medical coverage or those who have expensive insurance plans based on a pre-existing health problem.

Pilzer said during his work on the topic and his book, he hired researchers from Brigham Young University to get information about families who use state-guaranteed coverage in Utah. He was surprised to find out that everyone they found lived in Summit County, considered one of the most affluent counties in the state. He said in a nationwide study of 250,000 state guaranteed policy users in the United States, there were no low-income families on the list. He said this proved that the word is not out, and people still do not know about state guaranteed coverage options.

"We have a coming crisis on employer health insurance that is already bankrupting a million people, of which 80 percent have health insurance," Pilzer said, based on a 2005 Harvard University study showing that half of the two million bankruptcy filings in the United States are medical expense related.

Pilzer said instead of individuals or employers footing the bill for a family member with an illness such as leukemia that can cost over $300,000 a year, the state will have to pay.

Premiums for state-guaranteed coverage cost at least twice the price of private health insurance coverage. Utah, at about $493 per month, is triple the cost of private coverage, but is a top plan where the patient can choose his or her doctors, he added.

Pilzer said the best states for state-guaranteed coverage, including costs and programs, are Texas, Maryland and California. He said the worst states are South Dakota, Tennessee and Florida. Health Savings Accounts

Pilzer also introduces readers in "The New Health Insurance Solution" to Health Savings Accounts (HSAs), an optional savings plan for people with high premium health insurance.

Individuals can deposit the amount of their deductible into the HSA tax free, but unlike other savings plans it can be withdrawn for medical expenses. Pilzer said the deductible must be between $1,000 and $2,600 for a single person and $2,000 to $10,000 for a family.

He said people are also now arranging employer-sponsored individual insurance plans and HSAs, where the employer pays for the employees to get their own plans.

This option is tax free and often cheaper than the company rates for health insurance.

Pilzer’s new book, "The New Health Insurance Solution," 334 pages, costs $25. It can be purchased at nationwide bookstores, such as Barnes and Noble in Salt Lake City, and is available and discounted on http://www.Amazon.com and www. Buy.com.


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