During this spring’s open enrollment period, the Indemnity Plan had a net gain of 630 new members. Not surprising, the majority of those new enrollees transferred from one of the eight managed care plans offered by the GIC.

In total, 1,008 participants joined the GIC Indemnity plan, while 362 enrollees left the plan for another GIC sponsored plan. An additional 16 people dropped all but their GIC life insurance, most likely to opt into a private plan.

The largest exodus came from the Harvard Pilgrim plan, which lost 216 members to the Indemnity Plan and another 397 to other GIC plans. Tufts followed, losing 194 members to the Indemnity Plan and 391 to the others. In all, five plans – CIGNA, Fallon, Harvard Pilgrim, Neighborhood, and Tufts – each suffered a net loss in membership.

“The movement that we witnessed during open enrollment is the likely result of the problems the HMOs have faced over the past several years. People have reevaluated their choice in health plans as a result of some of the developments in the market,” explains Association Legislative Liaison Shawn Duhamel. “HMOs may work well for some people, but for retirees the Indemnity Plan is the way to go. Even with the active employees, we are seeing more interest in Indemnity coverage.”

Over the years, the determining factor in health care selection has often been the monthly premium. At times, indemnity plans have been nearly twice the price of the least expensive HMO. While HMO prices have risen sharply in recent years, HMOs are still less costly than indemnity plans.

Since 1991, the monthly premium for a retiree paying 10% under the state’s GIC Indemnity Plan has gone from $38.36 to $56.38 for an individual plan. The respective prices rose from $18.00 to $27.23 for HPHC and from $17.11 to $26.00 for Tufts.

Unlike the mid-90s, recent price increases for the GIC Indemnity Plan have been in line with or just slightly higher than real inflation. Increases for most of the state offered HMOs have been far higher than inflation during the same period.

However, in Boston as well as many other municipalities the price of the indemnity plans continue to skyrocket. For instance, the price of the coveted Blue Cross Blue Shield Master Medical plan is becoming prohibitive in many communities. This year in Boston, the cost of the Blue Cross run indemnity plan went from $133.76 a month to 159.40, causing financial hardship for many members.

The late 90s proved especially difficult for many HMOs, as many struggled through tough economic times. This was the result of overaggressive business plans that, among other things, expanded the companies market shares too rapidly. At the same time, many HMOs found it difficult providing the services they had been contracted to provide, given the low premiums they were charging.

As the prices for all of the health insurance plans continue to rise, members have been forced to take stock in their health care decisions. In the ever-changing world of health care, it can no longer be taken for granted that any one plan, from the least expensive to the Cadillac of insurance, will provide optimum coverage.

Members can no longer shop for their health coverage by price alone. Although, generally speaking when it comes to health care you get what you pay for. With few exceptions, the less expensive the plan, the less coverage and freedom of choice you will have.

However, managed care has encroached into every modern day health plan. It is now a part of every plan offered throughout Massachusetts without exception. What differs between plans is the degree to which managed care is implemented.

To many members, such as Department of Mental Health retiree Madeline Hall of Dorchester, the most important issue when choosing a health plan is quality. While price is and must be a consideration, benefits are the highest factor in which plan retirees select.

“I would never even consider switching to another plan, no matter what the cost. Yes, the coverage is expensive, but your health care is not something you can cut corners with,” says Hall, who belongs to the GIC Indemnity Plan. “I would not be willing to give up the freedoms and benefits offered by the Indemnity Plan. If it comes to it, I’ll find other ways to cut my costs, but not with my insurance.”

“It is a sad state of affairs when some retirees are being forced into inferior health plans due to the cost. Our members know the value of the indemnity coverage and realize how important it is for them to have the best possible insurance,” said Association Insurance Coordinator Cheryl Stillman.