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IOWA STATE
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ivu-v. i 6) I960

tn f

Hospital Benefits
Early 1959

Bulletin No. 1274
UNITED STATES DEPARTMENT OF LABOR
James P. Mitchell, Secretary
Ew an

C la g u e ,

 BUREAU OF


Com m issioner

LABOR STATISTICS




HEALTH AND INSURANCE PLANS
UNDER COLLECTIVE BARGAINING

H ospital Benefits
E arly 1959

Bulletin No. 1274
March I960

UNITED STATES DEPARTMENT OF LABOR
James P. Mitchell, Secretary
B U R EA U O F LA BO R STATISTICS
Ew an C lagu e , Commissioner

For sale by the Superintendent of Documents, U.S. Government Printing Office, Washington 25, D.C.




Price 30 cents







Preface
T his study o f the h o s p ita l b e n e fit fe a tu r e s o f h ea lth
and in s u r a n c e p lan s u n d er c o ll e c t iv e b a r g a in in g , b a s e d on
an a n a ly s is o f 300 s e le c t e d p la n s, is the s e c o n d in a s e r ie s
o f b u lle tin s d e a lin g s e p a r a te ly w ith the v a r io u s co m p o n e n ts
o f h ea lth and in s u r a n c e p la n s . The f i r s t b u lle tin d e s c r ib e s
a c c id e n t and s ic k n e s s b e n e fits in e ff e c t in the fa ll o f 1958
(B L S B u ll. 1250, June 1959); su b se q u e n t b u lle tin s w ill d ea l
w ith s u r g ic a l and m e d ic a l b e n e fit s , and life in s u r a n c e and
a c c id e n ta l death and d is m e m b e r m e n t b e n e f it s . A s a w h o le ,
this s e r ie s w ill b r in g up to date the B u rea u o f L a b o r S ta­
t i s t i c s 1 e a r li e r A n a ly s is o f H ealth and In su ra n ce P la n s
U n d er C o lle c t iv e B a r g a in in g , L a te 1955 (B L S B u ll. 1221,
N o v e m b e r 1957).
E a ch o f the 300 p lan s a n a ly z e d c o v e r e d at le a s t
1 ,000 w o r k e r s . In to ta l, the s e le c t e d p lan s p r o v id e d b e n e fit
c o v e r a g e to a lm o s t 5 m illio n w o r k e r s , o r abou t tw o -fifth s
o f the e s tim a te d c o v e r a g e o f a il h ea lth and in s u r a n c e p lan s
u n d e r c o ll e c t iv e b a r g a in in g .
T his stu dy w as co n d u cte d and the r e p o r t w as p r e ­
p a r e d in the B u r e a u ^ D iv is io n o f W a g es and In d u stria l
R e la tio n s b y D o r o th y K ittn e r G r e e n e , w ith the a s s is t a n c e
o f H a r r y E . D a v is .

iii




Contents
Page
In trodu ction ------------------------------------------------S cope o f study ___________________________________________________________________________________
F inancing _________________________________________________________________________________________
E lig ib ility req u irem en ts ________________________________________________________________________
T ypes o f d is a b ilitie s c o v e r e d ___________________________________________________________________
N onm aternity ben efits fo r a ctiv e w ork e rs and th eir dependents ____________________________
T ypes o f b en efits ____________________________________________________________________________
D uration ______________________________________________________________________________________
D aily ro o m and b o a rd b en efits ______________________________________________________________
M axim um ro o m and b o a rd allow an ce ______________________________________________________
H ospital ex tra s e r v ic e s b en efits ___________________________________________________________
R edu ction in ben efits during a ctiv e em p loym en t _________________________________________ —
Continuance o f co v e r a g e during la y o ff _____________________________________________________
R etired w o rk e rs and th eir dependents _________________________________________________________
M aternity ben efits _______________________________________________________________________________
T ypes o f b en efits ____________________________________________________________________________
R oom and b o a rd b en efits ____________________________________________________________________
H ospital ex tra s e r v ic e s b en efits ___________________________________________________________
F lat amount fo r h osp ita l c a r e _______________________________________________________________
G en eral lu m p -su m allow an ce _______________________________________________________________
Chart:

P e rc e n t o f health and in su ra n ce plans p ro v id in g h osp ita l ben efits to a ctive
and r e tir e d w o rk e rs and th eir dependents __________________________________________

1
2
6
9
11
11
11
12
14
16
20
23
23
25
28
31
31
33
36
36
5

T a b les:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.

Health and in su ra n ce plans studied in m anufacturing and nonm anufacturing
in d u stries by num ber o f w o rk e rs c o v e r e d and type o f bargain in g unit,
e a rly 1959 ______________________________________________________________________________
Health and in su ra n ce plans studied by in du stry and groups e lig ib le fo r
h osp ita l b e n e fits, e a r ly 1959 __________________________________________________________
C la ssifica tio n o f plans p rov id in g h osp ita l b en efits by e lig ib le g rou p s,
e a rly 1959 ______________________________________________________________________________
R elationsh ip o f nonm aternity h osp ital ben efits p ro v id e d a ctiv e w o rk e rs and th eir
dependents, a ctiv e and r e tir e d w o r k e r s , and dependents o f a ctiv e and
r e tir e d w o r k e r s , e a r ly 1959 __________________________________________________________
M ethod o f financing h osp ita l ben efits by groups e lig ib le and type o f
bargaining unit, e a r ly 1959 ______________________
R elationsh ip o f m ethod o f financing h osp ita l ben efits fo r a ctiv e w o rk e rs and
th eir dependents, r e tir e d w o rk e rs and th eir dependents, and a ctiv e
and r e tir e d w o r k e r s , e a r ly 1959 _____________________________________________________
E lig ib ility req u irem en ts fo r h osp ita l b e n e fits , e a r ly 1959 __________________________
E ffe c t o f age at h iring on a v a ila b ility o r le v e l o f h osp ita l b en efits fo r
a ctiv e w o rk e rs and th eir dependents, e a r ly 1959 ___________________________________
P lans p rov id in g n onm aternity h osp ital ben efits fo r a ctiv e w o r k e r s and th eir
dependents by type o f plan and type o f bargain in g unit, e a r ly 1959 _______________
R elationsh ip o f c h a r a c te r is t ic s o f nonm atern ity h osp ita l b en efits fo r a ctiv e
w o rk e rs and th eir dependents, e a r ly 1959
__________________________________________
Plans p rov id in g nonm aternity h osp ita l b en efits fo r a ctiv e w o rk e rs and th eir
dependents by duration o f fu ll-b e n e fit p e r io d and type o f ro o m and
b oard b en efit, e a r ly 1959 _____________________________________________________________
P lans p rov id in g nonm aternity h osp ita l ben efits fo r a ctiv e w o rk e rs and th eir
dependents by duration o f fu ll-b e n e fit and extended c o v e r a g e p e r io d s ,
e a rly 1959
P lans p rov id in g n onm aternity h osp ita l ben efits fo r a ctiv e w o rk e rs and th eir
dependents by d aily b en efit during the extended c o v e r a g e p e r io d ,
e a rly 1959




v

2
3
4
6
7
8
10
10
12
13
14
15
17

Contents— Continued
P age
T a b le s .---- Continued
14.
15.
16.
17.
18.

19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.

P lans p ro v id in g nonm aternity h osp ita l ben efits fo r a ctiv e w o r k e r s and th eir
dependents by d a ily r o o m and b o a rd a llow a n ce and duration o f fu ll-b e n e fit
p e r io d , e a r ly 1959
___________________________________________________________________ 18
P lan s p ro v id in g nonm atern ity h osp ita l ben efits fo r a ctiv e w o rk e rs and th eir
dependents by m axim u m ro o m and b o a rd a llow a n ce, e a r ly 1959 __________________ 20
P lans p ro v id in g nonm aternity h osp ita l ben efits fo r a ctiv e w o r k e r s and th eir
dependents by m ethod o f sp e cify in g a llow a n ce fo r h osp ita l e x tra s, e a r ly 1959 ___ 21
P lans p ro v id in g nonm atern ity h osp ital b en efits fo r a ctiv e w o rk e rs and th eir
dependents by m axim u m am ount o f fu ll re im b u rse m e n t o f ch a rg es
fo r h osp ita l e x tra s , e a r ly 1959 ______________________________________________________ 22
P lan s p rov id in g nonm atern ity h osp ita l ben efits fo r a ctiv e w o r k e r s and th eir
dependents by m axim u m amount o f fu ll re im b u rse m e n t o f ch a rg e s fo r
h osp ita l extra s with an additional re im b u rse m e n t on a p e rce n ta g e b a s is ,
e a rly 1959
_____________________________________________________________________________ 24
M aintenance o f nonm atern ity h osp ital b en efits during a ctiv e em p loym en t
fo r w o rk e rs and th eir dependents, e a r ly 1959 ______________________________________ 24
P lans p ro v id in g h osp ita l ben efits fo r r e tir e d w o rk e rs and th eir dependents
by type o f plan and type o f bargaining unit, e a r ly 1959 _____________________________ 25
R elation sh ip o f c h a r a c te r is t ic s o f h osp ita l b en efits fo r a ctiv e and r e tir e d
w o rk e r s and b en efits fo r dependents o f a ctiv e w o rk e rs and dependents of
r e tir e d w o r k e r s , e a r ly 1959 __________________________________________________________ 26
P lans p rov id in g h osp ita l ben efits fo r r e tir e d w o rk e rs and th eir dependents
by duration o f fu ll-b e n e fit p e r io d and type o f ro o m and b o a rd b en efit,
e a rly 1959 ______________________________________________________________________________ 27
P lans p ro v id in g h osp ita l b en efits fo r r e tir e d w o rk e rs and th eir dependents
by d a ily r o o m and b o a rd a llow a n ce, e a r ly 1959 _____________________________________ 28
Length o f tim e h osp ita l ben efits w ere ava ila b le to r e tir e d w o r k e r s and th eir
dependents, e a r ly 1959 ________________________________________________________________ 29
R elationsh ip o f m a tern ity and nonm aternity b en efits p ro v id e d w om en w o rk e rs
__________________ __________________________________ 29
and dependent w iv e s, e a r ly 1959
A v a ila b ility o f ben efits fo r h o sp ita liz e d m a tern ity c a s e s to new ly in su red
w om en w o rk e rs and dependent w iv e s, e a r ly 1959 ___________________________________ 30
T ypes o f h osp ita l ben efits p ro v id e d in m a tern ity c a s e s fo r w om en w o rk e rs
and dependent w iv e s, e a r ly 1959 ____________________________________________________ 31
R elation sh ip o f c h a r a c te r is t ic s o f h osp ita l m a tern ity b en efits fo r w om en
w o rk e r s and dependent w ives to nonm aternity h osp ita l b e n e fits, e a r ly 1959 ______ 32
P lans p rov id in g h osp ita l b en efits fo r w om en w o rk e rs and dependent w ives
in m a tern ity ca s e s by duration of fu ll-b e n e fit p e r io d and type o f ro o m
and b o a rd b e n e fits, e a r ly 1959 ________________________________________________________ 33
P lans p rov id in g h osp ita l ben efits fo r w om en w o rk e rs and dependent w ives in
m atern ity c a s e s by d aily r o o m and b o a rd a llow a n ce and m a xim u m duration
o f fu ll-b e n e fit p e r io d , e a r ly 1959 _____________________________________________________ 34
P lans p ro v id in g h osp ita l b en efits fo r w om en w o rk e rs and dependent w ives in
m atern ity ca s e s by m axim u m r o o m and b oa rd a llow a n ce, e a r ly 1959 _____________ 35
P lans p ro v id in g h osp ita l b en efits fo r w om en w o rk e rs and dependent w ives in
m atern ity ca s e s by m ethod o f sp e cify in g a llow a n ce fo r h osp ita l e x tra s,
e a rly 1959
35
P lans p ro v id in g h osp ital ben efits fo r w om en w o rk e rs and dependent w ives in
m a tern ity c a s e s by m axim u m amount o f fu ll re im b u rse m e n t o f ch a rg es
fo r h osp ita l e x tr a s , e a r ly 1959 _______________________________________________________ 36
P lans p ro v id in g h osp ital ben efits fo r w om en w o rk e rs and dependent w ives in
m atern ity c a s e s by the flat am ount allow ed fo r r o o m , b o a rd , and h osp ita l
e x tra s , e a r ly 1959 ____________________________________________________________________ 37
P lans p ro v id in g a g en era l lu m p -su m m a tern ity a llow a n ce fo r w om en w o rk e rs
and dependent w ives by am ount, e a rly 1959 _________________________________________ 37




vi

Health and Insurance Plans Under Collective B argaining

Hospital Benefits, Early 1959
In trodu ction
B e ca u se h osp ita l b ills a risin g fr o m o ccu p a tion a l illn e s s e s and a ccid en ts
a re c o v e r e d by w o rk m e n ’ s co m p e n sa tion b e n e fits, h osp ita l ben efits p ro v id e d under
p riv a te health and in su ra n ce plans a re a lm o st in v a ria b ly lim ite d to d is a b ilitie s
fr o m n on occu p a tion a l c a u se s .
T h ese ben efits a re p ro v id e d in the fo r m o f ca sh ,
o r s e r v ic e s , o r a com b in a tion o f ca sh and s e r v ic e s . U nder plans p rov id in g fo r
ca sh b e n e fits, w o r k e rs a re re im b u rs e d fo r h osp ita l ch a rg es up to a given
am ount.
U nder plans p ro v id in g fo r s e r v ic e b e n e fits, s p e c ifie d ro o m and b oa rd
a cco m m o d a tio n s, s e r v ic e s , drugs and su p plies a re fu rn ish ed , the h o s p it a ls
ch a rg e s being paid by the plan.
H osp ital b en efits a re u su a lly m ade a v ailable eith er through c o m m e r c ia l
in su ra n ce c a r r ie r s o r through p rep a ym en t plans o f n on p rofit O rganizations such
as Blue C r o s s . 1 U nder so m e p r o g r a m s the ben efits a re s e lf-in s u r e d ; that is ,
they a re paid d ir e c t ly by an e m p lo y e r o r fr o m a fund to w hich con trib u tion s are
m a d e.
G en e ra lly , plans u n derw ritten by c o m m e r c ia l in su ra n ce c a r r ie r s p ro v id e
fo r fix e d ca sh a llo w a n ce s to be a pplied tow ard ex p en ses n o rm a lly in c u r r e d in the
h o sp ita l (ca sh p la n s).
B en efits m ade a v a ila b le through plans op era ted by Blue
C r o s s and oth er n on p rofit o rg a n iz a tion s a re u su a lly o f a s e r v ic e type, i. e. ,
sp e c ifie d b en efits a re a s s u r e d , rath er than ca sh a llo w a n ce s , tow ard the c o s t of
h osp ita l s e r v ic e s .
S e lf-in s u r e d p r o g r a m s u tiliz e both m eth od s.
H osp ital ben efits a re g e n e ra lly d e s c r ib e d in te rm s o f two m a jo r c o m ­
pon en ts: (1) R oom and b o a rd b e n e fits, and (2) " e x t r a ” o r a n c illa r y h osp ita l s e r v ­
ic e a llo w a n ce s .
The fo r m e r c o v e r a llow a n ces fo r ro o m , m e a ls , s p e c ia l diets
if n eeded , and g e n e ra l n u rsin g c a r e ; the la tter a p p lies to a llow a n ces fo r oth er
h osp ita l s e r v ic e s such as the u se o f op era tin g and c y s t o s c o p ic r o o m , su p plies
(e. g. , ban dages, sp lin ts, a n esth etic m a te r ia ls ), p r e s c r ib e d la b o ra to ry e x a m i­
n ation s, s p e c ifie d dru gs and m e d ic a tio n s, and v a riou s types of X -r a y exam ina tion s.
A m axim u m n u m ber o f days of h osp ita l ben efits is s p e c ifie d in a lm ost
a ll p la n s.
U nder m o st p la n s, the d aily b en efit a llow a n ces o r s e r v ic e s rem ain
the sam e throughout this en tire p e r io d .
H ow ev er, under som e pla n s, lo w e r o r
lim ite d b en efits a re p ro v id e d du ring the la tter p a rt o f the p e r io d , freq u en tly r e ­
fe r r e d to as the "ex ten d ed c o v e r a g e " p e r io d .
The tim e during which the h igh er
o f fu ll b en efits a re p r o v id e d is g e n e ra lly d esig n ated as the " fu ll-b e n e fit " p e r io d .
With few e x ce p tio n s, h osp ita l b en efits a re a v a ila b le to the a ctiv e w o rk e r
and, in m o s t in sta n ce s, to his dependents as w e l l .2 Continuance o f h osp ita l
c o v e r a g e a fte r re tir e m e n t is a lso p ro v id e d under m any p lan s.

1 Blue C r o s s plans throughout the United States a re sp o n so re d by n on p rofit
in c o rp o r a te d a ffilia te s o f the Blue C r o s s C o m m is s io n o f the A m e r ic a n H osp ital
A s s o c ia tio n .
2 "D ep en d en ts" in clu d e the w o r k e r ’ s sp ou se and his (o r her) ch ild re n under
a s p e c ifie d a g e, u su a lly 19 y e a r s .




2
This r e p o r t c o v e r s the k ey fe a tu re s o f h osp ita l b en efits as p ro v id e d in
s e le c t e d c o lle c t iv e ly b a rg a in ed health and in su ra n ce p r o g r a m s in e ffe c t in e a r ly
1959. E lig ib ility re q u ir e m e n ts, financing a rra n g e m e n ts, and the ty p es, am ounts,
and du ration o f b en efits f o r a ctiv e and r e tir e d w o rk e rs and th eir dependents w ere
a n a lyzed.
A s im ila r stu d y 3 b a sed on plans in e ffe c t in late 1955 p r o v id e s a
b a s is fo r in dica tin g the changes that have been m ade in h osp ita l plans o v e r the
p a st fe w y e a r s .
S cop e o f Study
The 300 health and in su ra n ce plans studied w e re s e le c te d to p r o v id e a
b r o a d ly r e p re se n ta tiv e v ie w o f the type o f p r o te c tio n p ro v id e d by m a jo r plans
u nder c o lle c t iv e b a rga in in g, i. e. , th ose c o v e rin g 1,000 o r m o r e w o r k e r s . F a c to r s
given p r im a r y co n sid e r a tio n in the s e le c tio n o f the sa m p le w ere in d u stry , g e o ­
g ra p h ic lo ca tio n , type o f b a rg a in in g unit, and s iz e o f plan as m e a su re d by a ctiv e
w ork er cov era ge.
The 300 s e le c te d p la n s, w hich ranged in c o v e ra g e fr o m
1, 000 to a half m illio n w o r k e r s , p ro v id e d health and in su ra n ce b en efits to a total
o f 4. 9 m illio n w o r k e rs (table 1), o r about 40 p e r c e n t o f the estim a ted num ber o f

T A BL E 1.

Health and insurance plans studied in manufacturing and nonmanufacturing industries
by number of w orkers covered and type of bargaining unit, early 1959 1
(W orkers in thousands)
A ll industries

Plans

M ultiem ployer

Single em ployer

Total

W orkers covered

W orkers

Plans

Plans

W orkers

W orkers

A ll plans studied ------------------------------------

300

4 ,9 3 3 .2

205

2 ,8 0 6 .7

95

’ , 126. 5

1 ,0 0 0 and under 5, 000 w orkers ---------5, 000 and under 10, 000 w orkers ------1 0 ,0 0 0 and under 1 5 ,0 0 0 w orkers -----1 5 ,0 0 0 and under 2 5 ,0 0 0 w orkers -----2 5 ,0 0 0 and under 5 0 ,0 0 0 w orkers -----5 0 ,0 0 0 and under 1 0 0 ,0 0 0 w o r k e r s ----1 0 0 ,0 0 0 w orkers and over---------------------

137
59
34
26
28
5
11

3 5 1 .7
419. 1
387. 0
472. 0
928. 8
306. 6
2 ,0 6 8 .0

102
39
20
17
17
4
6

2 6 2 .4
2 72. 0
224. 6
302. 9
532. 0
250. 8
962. 0

35
20
14
9
11
1
5

89. 3
147. 1
1 6 2 .4
169. 1
396. 8
55. 8
1 ,1 0 6 .0

Manufacturing
Single employer

Nonmanufacturing

M ultiem ployer

Single em ployer

Mpltie m ployer

Plans

W orkers

Plans

W orkers

Plans

W orkers

Plans

W orkers

A ll plans studied ------------------------------------

179

2 ,6 5 0 . 4

40

672. 5

26

156. 3

55

1 ,4 5 4 .0

1 ,0 0 0 and under 5, 000 workers ---------5, 000 and under 1 0 ,0 0 0 w o r k e r s --------1 0 ,0 0 0 and under 1 5 ,0 0 0 workers -----1 5 ,0 0 0 and under 2 5 ,0 0 0 w orkers -----2 5, 000 and under 50, 000 w o r k e r s -----5 0 ,0 0 0 and under 1 0 0 ,0 0 0 w orkers ----1 0 0 ,0 0 0 w orkers and over -------------------

86
34
17
16
16
4
6

218. 6
240. 7
188. 6
2 8 7 .9
5 0 1 .8
250. 8
962. 0

14
11
8
1
3
1
2

39. 5
77. 6
90. 8
18. 0
109. 8
55. 8
2 8 1 .0

16
5
3
1
1

43. 8
3 1 .3
36. 0
15. 0
3 0 .2

21
9
6
8
8

4 9 .8
69. 5
7 1 .6
151. 1
287. 0

-

-

-

~

“

3

-

825. 0

1 A ll coverage data reported in this study relate to the number of active w orkers (men and women)
covered by the plans which provide the specified benefit. No attempt was made to determine the number
of women w ork ers, dependents, retired w orkers, or dependents of retired workers covered by the plans.

3 A n a ly sis o f Health and In surance P lans U nder C o lle ctiv e B argain in g,
Late 1955 (BLS B u ll. 1221, N ovem b er 1957).
4 The cu rre n t sa m p le is c o m p r is e d o f 271 plans a ls o c o v e re d in the B u ­
r e a u ^ 1955 study and 29 re p la ce m e n ts that w e re re q u ire d f o r the fo llow in g re a so n s :
D e c r e a s e in plan c o v e r a g e to fe w e r than 1, 000 w o r k e r s ; com pan y m e r g e r o r
shutdown; o r la ck o f s u fficie n t cu rre n t data.




3

w o r k e r s under a ll health and in su ra n ce plans under c o lle c t iv e bargain in g a g r e e ­
m e n ts. A ll c o v e r a g e data r e p o r te d in this study re la te to the n u m ber of a ctiv e
w o r k e r s (m en and w om en ) c o v e r e d by the p la n s .5
V irtu a lly e v e r y m a jo r m an u factu rin g and nonm anufacturing in d u stry w as
r e p r e s e n te d in the sam p le studied (table 2 ).
A lm o s t 3 out o f 4 plans (219),
TABLE 2.

Health and insurance plans studied by industry and groups
eligible for hospital benefits, early 1959 1
(Workers in thousands)
A ll plans providing hospital benefits for—
Total

Dependents
of active
workers

Active
workers

Industry

Dependents
of retired
workers

Retired
workers

Plans Workers Plans Workers Plans Workers Plans Workers Plans Workers
A ll plans studied ___________________

3QG

4 ,9 3 3 .2

2 293 4, 8 34 .0 282

Manufacturing___________________

219

3, 3 22 .9

218 3 ,3 1 3 .9 207

Food and kindred products
______
Tobacco m anufactures_____________
Textile m ill products ____________ _
Apparel and other finished
products _________________________
Lumber and wood products,
except furniture __________________
Furniture and fixtures
Paper and allied products _______
Printing, publishing, and
allied industries
Chemicals and allied products ____
Petroleum refining and
related industries
______________
Rubber and miscellaneous
plastics products_________________
Leather and leather p rodu cts_____
Stone, clay, and glass p ro d u c ts__
Prim ary metal industries
_______
Fabricated metal products ________
Machinery, except e le c tr ic a l_____
Electrical machinery, equipment
and supplies ______________________
Transportation equipment
Instruments and related
products ___________________________
Miscellaneous manufacturing
industries _________________________

17
3
11

168. 1
24. 0
44. 7

17
3
10

168. 1
24. 0
35. 7

6

395. 1

6

3
5
13

44. 5
68. 1
49. 5

6
10

Nonmanufacturing_______________
Mining, crude petroleum, and
natural gas production ___________
Transportation
Communications ___________________
Utilities: Electric and gas _______
Retail and wholesale trade _ _
_
Hotels and restaurants ____________
S ervices_____________________________
Construction
___
Miscellaneous nonmanufacturing
industries
..................

4, 717 .5 115

2, 0 77 .4 111

2 ,0 6 5 .4

3, 208 .9

81

1 ,6 5 8 .6

78

1 ,6 4 8 .6

17
3
6

168. 1
24. 0
23. 2

6

34. 6

6

34. 6

-

-

-

-

-

-

-

-

395. 1

4

344. 3

3

288* 5

3

288. 5

3
5
13

4 4 .5
68. 1
49. 5

3
5
13

4 4 .5
68. 1
49. 5

1
7

1. 3
22. 3

1
7

1. 3
22. 3

21. 7
109.4

6
10

21. 7
109.4

5
10

1 9 .2
109.4

4
6

19. 0
79. 6

2
6

12. 0
79. 6

8

92. 7

8

92. 7

7

7 1.5

4

48. 3

4

48. 3

8
11
10
21
11
22

108. 3
68. 7
76. 8
4 9 9 .2
98. 1
147. 0

8
11
10
21
11
22

108. 3
68. 7
76. 8
4 9 9 .2
98. 1
147. 0

8
8
10
21
11
22

108. 3
50. 7
76. 8
4 9 9 .2
98. 1
147. 0

6
1
6
3
2
13

105. 8
7. 3
3 6 .4
17.5
6. 0
113. 2

6
1
6
3
2
12

16
23

330. 2
902. 0

16
23

330. 2
902. 0

16
23

330. 2
902. 0

4
9

256. 9
596 .5

4
9

256. 9
596. 5

8

3 3 .4

8

3 3 .4

8

3 3 .4

4

16. 5

4

1 6.5

7

7

4 1 .4

81

1 ,6 1 0 .3

4 1 .4

7

4 1 .4

2

8 .9

2

75 1, 520. 1

75

1, 508. 6

34

418. 8

33

3
9

193. 6
9 9 .4

3
8

105.
7.
36.
17.
6.
110.

8
3
4
5
0
2

8 .9
!

416. 8

4
22
2
11
12
5
9
15

194.9
870. 7
38. 3
35. 2
60. 4
67. 1
140. 1
196. 4

4
17
1
11
12
5
9
15

194.9
810. 7
8. 1
35. 2
60. 4
67. 1
140. 1
196. 4

4
21
1
11
12
5
6
14

194.9
868. 7
8. 1
35. 2
60. 4
67. 1
74. 4
192. 6

9
3
1
4
4

26. 6
27. 5
8 .9
4 1 .4
14. 2

9
3
1
4
4

26. 6
27. 5
8 .9
4 1 .4
14. 2

1

7. 2

1

7. 2

1

7. 2

1

7. 2

1

7. 2

-

-

-

193. 6
9 7 .4
-

1 See footnote 1, table 1.
2 2 plans did not provide hospital benefits (footnote
, p.
4).
5 plans did not provide hospital ben­
efits to active workers.
These were plans covering maritime workers, who are entitled to use
U. S. Public Health Service hospitals free of charge (footnote 7, p. 4 ).

6

5
F o r e x a m p le , when r e fe r e n c e is m ade to dependent c o v e r a g e , the extent
o f such c o v e r a g e is e x p r e s s e d in t e r m s o f the num ber o f a ctiv e w o r k e r s c o v e r e d
by plans w h ich extend or p ro v id e the s p e c ifie d b en efits fo r dep en den ts. No a t­
tem pt w as m ade to d eterm in e the n um ber o f w om en w o r k e r s , dependents, r e tir e d
w o r k e r s , or dependents o f r e t ir e d w o r k e rs c o v e r e d by the plans in this study.




4
T A B L E 3.

C la ssifica tio n of plans providing hospital benefits by eligible groups, e arly 1959 1
(W ork ers in thousands)
E ligible group

A ctive
w orkers

Dependents
of active
w orkers

Dependents
of retired
w orkers

Total with hospital benefits ------X

X

X

-

-

X

X

X

X

-

_
X

X

X

X

-

-

X

X

X

X

“

X

Plans

W ork ers

298

Retired
w orkers

4 ,8 9 4 .0

167
14
a2
108
2
23
2

2 ,6 2 4 .1
1 7 2 .0
20. 5
2 ,0 2 5 .9
7. 5
3 9. 5
4. 5

1 Based on a study of 300 health and insurance plans under collective bargaining c o v ­
ering approxim ately 5 m illion w o rk e rs.
A ll coverage data relate to the number of active
w ork ers (men and women) covered by the plans which provided the specified benefit.
No
attempt was made to determ ine the number of women w ork e rs, dependents, retired w o rk e rs,
or dependents of retired w orkers covered by the plans.
* These plans covered m a ritim e w orkers (footnote 2 , table 2).

c o v e rin g tw o -th ir d s of the w o r k e r s , w e re in m anufacturing in d u s trie s .
N early
a th ird of the plans (9 5), c o v e rin g m o r e than 40 p ercen t of the w o r k e r s , w e re
n egotiated by m u ltie m p lo y e r g ro u p s.
A ll but two plans p ro v id e d h o sp ita l b e n e fit s .6 Under som e o f the plans
op era ted by m u ltie m p lo y e r g rou p s o r m ultiplant com p a n ies co v e rin g w ide g e o ­
graph ic a r e a s , the types and am ounts of b en efits v a r ie d fro m a rea to a r e a .
F or
this study, w h ere such v a ria tio n s o c c u r r e d under a p a rticu la r m ultiplant or
m u ltie m p lo y e r plan, the b en efits c o v e rin g the la r g e s t num ber of w o r k e r s w e re
a n a ly zed , and w e re a ss ig n e d the w eight (i. e. , the c o v e r a g e ) o f all w o r k e rs
c o v e r e d by the plan.
O f the 298 plan s, c o v e rin g about 4 .9 m illio n w o r k e r s , w ith h osp ita l
b e n e fits, 293 plan s, re p re se n tin g a p p ro x im a te ly 4 .8 m illio n w o r k e r s , m ade th ese
b en efits a va ila b le to a ctiv e w o r k e r s ; 282 plan s, re p re se n tin g about 4 .7 m illio n
w o r k e r s , extended h osp ita l c o v e r a g e to the w o rk e rs * d e p e n d e n ts .7 All but 21 plans
p ro v id e d h osp ita l b en efits fo r both a c tiv e w o r k e rs and their dependents (table 3).
H ospital c o v e r a g e fo r r e t ir e d w o r k e r s and their dependents w as a v a ila b le under
115 and 111 plans, r e s p e c t iv e ly , c o v e rin g 2 m illio n w o rk e r s . 8
With about 95 p e rce n t of the 1955 plans providin g c o v e ra g e to the d e ­
pendents o f a ctiv e w o r k e r s , little ex p an sion in this a re a w as to be e x p e cte d . H ow ­
e v e r , c o v e r a g e o f r e t ir e d w o r k e r s and th eir dependents r o s e fr o m about 20 p e r ­
cent o f the plans in 1955 to a lm o st 40 p ercen t in 1959 (ch a rt).

6 M ost w o r k e r s c o v e r e d by the 2 plans obtained h osp ita l co v e ra g e fo r th em ­
se lv e s and th eir dependents under sep a ra te grou p in su ra n ce p r o g r a m s , not under
c o lle c t iv e b a rga in in g.
7 The 5 plans that did not p rov id e b en efits for the a ctiv e w o rk e r c o v e r e d
w o r k e r s in the m a ritim e in du stry w ho r e c e iv e d fr e e c a r e in U .S . P u b lic Health
S e r v ic e h o sp ita ls and ou t-pa tien t fa c ilit ie s under the United States M a ritim e L aw .
H o w e v e r, a ll o f th ese plans c o v e r e d th eir dependents and 3 o f them a ls o c o v e r e d
r e t ir e d w o r k e r s and their dep en den ts.
8 The te rm ’’r e t ir e d w o r k e r , ” as u sed in this r e p o r t , d oes not n e c e s s a r ily
c o v e r a ll p e n s io n e r s . W o rk e r s r e t ir e d b e fo r e the exten sion of ben efits to pen­
s io n e r s a re so m e tim e s not c o v e r e d . A ls o ex clu d ed fr o m plan c o v e ra g e a re r e ­
tire d w o r k e r s who did not m eet p r e s c r ib e d e lig ib ility r e q u ir e m e n ts .




5

PERCENT OF HEALTH AND INSURANCE PLANS
PR O V ID IN G HOSPITAL BENEFITS TO ACTIVE AND
RETIRED WORKERS AND THEIR DEPENDENTS
Late 1955 and Early 1959
Percent of Plans

ACTIVE W O R K ER S:

0

IO

20

30

40

50

60

70

80

90

10 0

------------------ 1
------------------1
------------------ 1
------------------ 1
------------------ 1
------------------1
------------------ 1
------------------ 1
------------------ 1
1 ---------------- 1

Late 1955

Early 1959

ACTIVE W O R K ER ’S
DEPEN DEN TS:
Late 1955

Early 1959

R E T IR E D W O R K E R S:
Late 1955

Early 1959

R E T IR E D W O R K E R ’S
DEPEN DEN TS:
Late 1955

Early 1959

UNITED STATES DEPARTMENT OF LABO R
BUREAU OF LABOR




s t a t is t ic s

Total number of plans under
c o l l e c t i v e b a r g a in in g s t u d ie d
late 1955 an d e a r ly 1959=300

6
In the m a jo r ity o f pla n s, the sam e le v e l o f b en efits w as p ro v id e d fo r a ll
g rou p s c o v e r e d (table 4 ).
O f the 277 plans w ith b en efits fo r both the w o r k e r and
h is dep en den ts, only 49 exten ded l e s s e r b en efits to dep en den ts.
H o w e v e r, about
2 out o f 5 o f the 112 plans w ith b e n e fits fo r both a ctiv e and r e t ir e d w o r k e r s p r o ­
v id e d le s s lib e r a l b e n e fits a fter r e tir e m e n t. In about the sam e p ro p o rtio n o f p lan s,
the dependents o f r e t ir e d w o r k e r s w e r e fu rn ish ed b e n e fits in fe r io r to th ose given
dependents o f a c tiv e w o r k e r s .
Financing
The e n tire c o s t of the h o sp ita l b en efits p rov id ed w o r k e r s w as b orn e by
the e m p lo y e r in m o r e than 6 out o f 10 plans (table 5).
The w o r k e r s sh a red the
c o s t o f th eir b e n e fits in the r e s t o f the plans ( 1 0 7 ).9

T A B L E 4 . R elation sh ip of n on m aternity h osp ital b e n e fits p ro vid ed
a c tiv e w o rk e rs and th eir dependents, activ e and re tire d w o r k e r s ,
and dependents of activ e and re tire d w o r k e r s , e a r ly 1959 1
(W o rk e rs in thousands)
B en efit le v e l

P la n s

W ork ers

A ctiv e w o rk e rs and their dependents
A il plan s provid in g ben efits fo r activ e
w o rk e rs and dependents
__ ________
B e n efits fo r dependents:
S am e a s ben efit fo r activ e w o r k e r s ___
D ifferen t fr o m a ctiv e w ork e rs* benefit
in onp or m o ro rospp-rts

___

277

4 , b57. 5

__

228

3 ,5 6 1 . 1

49

1 ,0 9 6 . 4

112

2 ,0 3 7 . 9

66

1 ,4 9 3 . 0

46

544. 9

111

2, 065. 4

68

1 ,5 3 6 . 5

43

528. 9

A ctiv e and re tire d w o rk e rs
A ll p lan s p rovid in g b en efits fo r active
w o rk e rs and re tire d w o rk e rs _________________
B e n efits fo r re tire d w o rk e rs:
Sam e a s b en efit fo r activ e w o r k e r s _________
D ifferen t fr o m activ e w o r k e r s ’ benefit
in one or m o r e r e s p e c t s ____________________
Dependents of a ctiv e and re tire d w o rk e rs
A ll p lan s p rovid in g ben efits fo r dependents
of activ e w o rk e rs and dependents of
re tire d w o r k e r s ___________________________________
B e n efits fo r dependents of re tire d w o rk e rs:
Sam e as ben efit fo r dependents of
active w o r k e r s ______ __________________________
D ifferen t fr o m b en efits for dependents
of activ e w o rk e rs in one or m o re
r e s p e c ts _______________________________________

1

See footnote 1, table 3.

9
If the w o r k e r co n trib u ted tow a rd the co s t o f a health and in su ra n ce p r o ­
gra m as a w h ole (with the e m p lo y e r paying the rem a in in g c o s t ), the h osp ita l ben efit
w as c la s s ifie d as jo in tly fin a n ced .




7
.T A B L E 5.

Method of financing hosp ital benefits by groups eligib le
and type of bargaining unit, e a r ly 1959^
(W o rk e rs in thousands)
Type of bargaining unit

Groups covered and method
of financing 2

T otal
Single em p lo yer

M ultiem ploye r

P lans

W ork ers

P lans

Wo rk ers

Plans

Work er s

293
3 186
107

4 , 8 3 4 .0
3 ,0 5 3 .9
1, 7 8 0 . 1

203
98
105

2 ,7 6 7 .5
1, 0 1 4 .4
1, 7 53 . 1

90
88
2

2, 0 6 6 .5
2 ,0 3 9 .5
2 7 .0

282
4 129
5 122
31

4 , 717 . 5
2 , 3 4 4 .9
2, 0 2 0 .2
3 5 2 .4

197
53
119
25

2, 7 31. 8
501. 5
1, 9 86 . 7
2 4 3 .6

85
76
3
6

1, 9 8 5 .7
1, 8 4 3 .4
3 3. 5
108. 8

115
56
6 28
1
30

2 ,0 7 7 .4
1, 1 4 2 .0
2 0 6 .2
18. 0
7 1 1 .2

86
32
26
28

1, 3 9 8 . 0
5 00 . 5
198. 1
6 9 9 .4

29
24
2
1
2

6 7 9 .4
6 41 . 5
8. 1
18. 0
11. 8

111
48
6 28
1
34

2, 0 6 5 .4
1, 070. 9
240. 7
18. 0
7 3 5 .8

84
28
26
30

1, 3 93 . 0
4 5 1 .2
2 3 2 .6
7 0 9 .2

27
20
2
1
4

6 7 2 .4
6 19 . 7
8. 1
18. 0
26. 6

A ctive w ork ers
A ll plans providing b e n e f i t s ________
E m p lo y e r o n ly _____________________
E m p lo y e r and w o r k e r ___________
Dependents of active w ork ers
A ll plans providing b e n e fits_________
E m p lo y e r o n ly _____________________
E m p lo ye r and w o r k e r ___________
W ork er o n ly _______________________
R etired w ork ers
A ll plans extending b e n e f i t s ________
E m p lo y e r o n ly _____________________
E m p lo ye r and retired w ork er ___
E m p lo y e r and active w o r k e r ___
R etired w ork er o n l y _____________

-

Dependents of re tired w o rk e rs
A ll plans extending b e n e f i t s ________
E m p lo y e r o n ly _____________________
E m p lo y e r and retired w ork er . . .
E m p lo y e r and active w o r k e r ___
R etired w orker o n l y _____________

1 See footnote 1, table 3.
2 If the w orker contributed toward the cost of the health and insurance program as
a whole (with the em p loyer paying the rem aining co st), the hospital benefits w ere c la ssifie d
a s join tly financed.
3 Included is 1 plan under which hospital benefits for w o rk e rs with le s s than 1 y e a r ’ s
se rv ice w ere financed sole ly by the w ork er.
4 Included is 1 plan under which hospital benefits for dependents of w ork ers with le s s
than 1 y e a r ’ s se rv ice w ere financed sole ly by the w ork er.
5 Included is 1 plan under which hospital benefits for dependents of w ork e rs with le s s
than 1 y e a r ’s se rv ice w ere financed solely by the w ork er ; and 1 plan under which hospital
ben efits for the firs t dependent was financed sole ly by the em p loyer and the benefits for all
other dependents w ere financed by the em p lo yer and the w ork e r.
6 Included is 1 plan under which the hospital benefits w ere financed by the em p loyer
and the lo ca l union.

B en efits fo r dependents o f a ctiv e w o r k e rs w e re paid fo r s o le ly by the
e m p lo y e r in le s s than h alf o f the plans (129). A sligh tly s m a lle r n u m ber o f plans
(122) p r o v id e d dependents with jo in tly fin an ced b e n e fits.
Under the rem ain in g
31 plan s, w h ere the w o r k e r paid the fu ll c o s t of his dependents* h osp ita l b e n e fits,
the w o r k e r 1s dependents had the advantage o f p a rticip a tin g in a group in su ra n ce
plan that o th e rw ise m igh t not have been a v a ila b le to them . ^
F i f t y - s ix of the 115 plans extending b en efits to r e tir e d w o r k e rs re q u ire d
the e m p lo y e r to pay the fu ll c o s t o f the b en efits fo r this group.
The r e tir e d

10
It is g e n e r a lly r e c o g n iz e d that group in su ra n ce co n tra cts have the f o l ­
low in g advantages o v e r in dividu al in su ra n ce p o l i c ie s :
L ow er p re m iu m s, the a b ­
se n ce o f m e d ic a l, age, and oth er r e s t r ic t io n s on co v e ra g e , and the r a r ity o f
co n tr a c t ca n c e lla tio n s.




8
w o rk e r w as r e s p o n s ib le fo r the en tire p re m iu m fo r h is b en efits in m o r e than
1 out of 4 plan s (30), and fo r a p o r tio n o f the p re m iu m under a ll e x cep t 1 o f the
rem a in in g 29 plan s. H ow ever, even w h ere the r e tir e d e m p lo y e e pays the en tire
p re m iu m he has the advantage o f paying a grou p ra te u su ally b a sed on the a v ­
e ra g e c o s t o f p ro v id in g b e n e fits to a ll g rou p s. “
T A B L E 6 . Relationship of method of financing hospital benefits for active w orkers
and their dependents, retired w orkers and their dependents, and active and
retired w ork ers, early 1959 1
(W orkers in thousands)
Groups covered and method of financing 2

Plans

W orkers

Active w orkers and their dependents 3
A ll plans providing hospital benefits for active worker and dependents----------

277

4 ,6 5 7 .5

Benefit for active worker financed by employer
_
____
Benefit for dependents financed: By employer
By em ployer and worker
_
By worker
_
__ __ ___
_ __
Benefit for active worker financed by employer and worker
Benefit for dependents financed: By employer and w o r k e r ____ _ .
By worker __ _ ____
__ ___
_ _ _

170
124
19
27
107
103
4

2 ,8 7 7 .4
2 ,2 8 4 .9
3 1 5 .9
2 7 6 .6
1 ,7 8 0 .1
1 ,7 0 4 .3
7 5 .8

All plans providing hospital benefits for retired worker and d ep e n d e n ts_____

111

2 ,0 6 5 .4

Benefit for retired worker financed by employer
_ ___ ___
Benefit for Hpppnflpntfi financed* By employer
_____
__ _
By retired worker and employer
By retired worker
...
-_
Benefit for retired worker financed by retired worker and e m p l o y e r _______
Benefit for dependents financed: By retired worker and employer ____
By retired worker
_
_
____
Benefit for retired worker financed by active worker and employer _
Benefit for dependents financed: By active worker and e m p lo y e r ________
Benefit for retired worker financed by retired worker _____ ____ _ ___
Benefit for dependents financed* By retired worker _
__
____ ___ __

52
48
1
3
28
27
1
1
1
30
30

Retired w orkers ancl their dependents 4

1 ,1 3 0 .0
1 ,0 7 0 .9
3 7 .0
2 2. 1
2 0 6 .2
2 0 3 .7
2 .5
1 8 .0
1 8 .0
7 1 1 .2
7 1 1 .2

Active w orkers and retired w orkers 5
A ll plans providing hospital benefits for active worker and retired w o rk e r__

112

Benefit for active worker financed by employer
Benefit for retired worker financed: By employer
By retired worker and e m p lo y e r ___
By retired w o r k e r ____________________
Benefit for active worker financed by employer and worker
_
_ ________
_
Benefit for retired worker financed: By em ployer _________________________
By retired worker and em p lo y e r___
By active worker and e m p lo y e r ____
By retired worker
_
___

58
39
4
15
54
14
24
1
15

2 ,0 3 7 .9
1 ,0 0 3 .2
9 1 0 .5
1 2 .2
8 0 .5
1 ,0 3 4 .7
1 9 2 .0
1 9 4 .0
18. 0
6 3 0 .7

1 See footnote 1, table 3.
2 If the active or retired worker contributed toward the health and insurance program
as a whole (with the em ployer paying the remaining cost), the hospital benefits were c la s s i­
fied as jointly financed.
3 293 and 282 plans provided hospital benefits for active w orkers and dependents,
resp ectively.
4 115 and 111 plans provided hospital benefits for retired w orkers and dependents,
re sp ectively.
5 293 and 115 plans provided hospital benefits for active w orkers and retired w ork ers,
re sp ec tiv ely .

1
1
footn ote,
m in ed by
pendents
w ork ers,
w ork ers,




In addition to the advantages of group in su ra n ce cited in the fo re g o in g
the r e t ir e d w o r k e r is u su ally given the advantage of a low rate d e t e r ­
the a v e r a g e c o s t o f p ro v id in g b e n e fits fo r a ctiv e w o r k e r s and th eir d e ­
as w e ll as fo r r e t ir e d w o r k e rs and th eir dependents.
Since the a ctiv e
bein g on the w h ole y ou n ger, have lo w e r u tiliza tion ra tes than r e tir e d
the co m b in ed ra te is p a r tic u la r ly advantageous to the la tter.

9
B en efits fo r dependents o f r e tir e d w o r k e r s w e re paid fo r by the c o m ­
pany in o v e r 2 out o f 5 (48 o f the 111) plans p rov id in g b e n e fits fo r this group,
and by the r e t ir e d w o r k e r on a g r o u p -r a te b a s is in a lm o s t 1 out o f 3 plans
(34).
The rem a in in g 29 plan s m ade jo in tly fin an ced b en efits a v a ila b le to r e ­
t ir e d w o r k e r s 1 depen den ts.
The fin a n cin g o f h o sp ita l b e n e fits p ro v id e d under m u ltie m p lo y e r plan s
d iffe r e d sh a rp ly fr o m the fin an cin g under s in g le -e m p lo y e r p r o g r a m s .
In m o s t
m u lti e m p lo y e r pla n s, the e m p lo y e r paid the fu ll c o s t of the b e n e fits p ro v id e d
a c tiv e and r e t ir e d w o r k e r s and th eir dependents. F o r r e tir e d w o r k e rs and th eir
dependents, fin a n cin g under s in g le -e m p lo y e r plans w as about equ ally p ro v id e d
fr o m th ree s o u r c e s : E m p lo y e r only, r e tir e d w o rk e r only, and by e m p lo y e r and
r e t ir e d w o r k e r jo in tly .
The m eth od o f fin an cin g d ep en d en ts1 b en efits w as u su ally the sa m e as
that used fo r w o r k e r s in both sin g le and m u ltie m p lo y e r plan s. F o r ex am p le, in
a lm o s t th ree out o f fou r plans that p ro v id e d e m p lo y e r -fin a n c e d h o sp ita l b en efits
fo r a ctiv e w o r k e r s , the dependents* b en efits w e re a ls o paid fo r s o le ly by the
e m p lo y e r (ta b le 6).
S im ila rly , the m ethod of fin an cin g b e n e fits fo r dependents
o f r e t ir e d w o r k e r s s e ld o m d iffe r e d fr o m the m ethod u sed in fin an cin g the b en efits
o f r e t ir e d w o r k e r s .
B en efits fo r r e t ir e d w o r k e rs w e re , on the oth er hand, often fin an ced
d iffe r e n tly fr o m th ose fo r a ctiv e w o r k e rs . Of the 112 plans with h osp ita l b e n e fits
fo r both a ctiv e and r e t ir e d w o r k e r s , a th ird o f the 58 with e m p lo y e r -fin a n c e d
b e n e fits fo r the a ctiv e w o r k e r s u sed a d iffe re n t m ethod o f financing b e n e fits fo r
the r e t ir e d w o r k e r s (ta b le 6). M o re than half of the 54 plans that p ro v id e d jo in tly
fin a n ced b e n e fits fo r a ctiv e w o r k e rs and extended b en efits to r e tir e d w o r k e r s ,
changed the m eth od when the w o r k e r r e tir e d . Under 1 out of 4 of th ese 54 plan s,
the e m p lo y e r a ssu m e d the fu ll c o s t of the r e tir e d w ork ers* b e n efits; under a lm o s t
3 out o f 10 o f the plans the w o r k e r, on ce he re tire d , had to b e a r the en tire c o s t
o f h is c o v e r a g e .
E lig ib ility R e q u ir e m e n ts12
E lig ib ility r e q u ire m e n ts fo r h osp ita l b en efits w e re s im ila r to th ose that
had to be m et fo r a c c id e n t and s ick n e ss b e n e fits. 13 O ver 3 out of 4 o f the
298 plans w ith h o sp ita l b e n e fits m ade th ese b en efits a v a ila b le a fter l e s s than
4 months* em p loy m en t (ta b le 7).
Only six plans re q u ire d 8 or m o r e months*
em ploym en t. M o re than 1 out o f 4 of the 298 plans d e fe r r e d c o v e ra g e until the
f i r s t of the m onth fo llo w in g c o m p le tio n of the e lig ib ility p e rio d , p re s u m a b ly fo r
a ccou n tin g co n v e n ie n ce . F o r the sam e re a so n , th ese plans u su ally d e fe r r e d the
term in a tio n o f c o v e r a g e until the end of the month in w hich em p loy m en t ce a se d .
R a r e ly w e r e w o r k e r s or th eir dependents d ep riv e d of h osp ita l b e n e fit
c o v e r a g e b e c a u s e o f age at h irin g (table 8). Only th ree plans r e s t r ic t e d c o v e ra g e
to p e r s o n s under a s p e c ifie d age.
In two plans, c o v e ra g e w as lim ite d to in ­
d ivid u a ls under age 65.
None of the plans b a r r e d the w o rk e r fr o m pa rticip a tin g
in the plan b e c a u s e o f the se x o f the individual.
H ow ever, a few plan s d is c u s s e d
la te r in this r e p o r t, r e s t r ic t e d h o sp ita l b e n e fits fo r both a ctiv e w o r k e rs and th eir
dependents a fte r the w o r k e r s re a ch e d an advanced age.
12 E lig ib ility r e q u ire m e n ts as d is c u s s e d in this se ctio n r e fe r only to the
p e r io d of em p loy m en t r e q u ir e d o f the w o rk e r b e fo r e he is e lig ib le to p a rticip a te
in the plan. Under so m e plan s, in addition to sp ecify in g an em p loy m en t r e q u ir e ­
m ent, a p e r io d o f union m e m b e r sh ip was a ls o re q u ire d .
This p e r io d r a r e ly e x ­
ce e d e d the e m p loy m en t re q u ire m e n t. The p e r io d a w o rk e r m u st be c o v e r e d b e fo r e
b ein g e lig ib le fo r m a tern ity b e n e fits is d is c u s s e d in the m a tern ity se ctio n of
this r e p o r t.
13 F o r a d e s c r ip tio n o f e lig ib ility re q u ire m e n ts fo r a ccid e n t and s ick n e ss
b e n e fits, se e Health and In su ra n ce Plans Under C o lle c tiv e B argain in g: A ccid e n t
and S ick n ess B e n e fits, F a ll 1958 (B L S B ull. 1250, June 1959).




10
T A B L E 7.

Eligibility requirements for hospital benefits, early 1959 1
(W orkers in thousands
Plans

Effective date of coverage
All plans studied

W orkers

300

4 ,9 3 3 .2

All plans providing hospital b e n e fits____________

2298

4 ,8 9 4 .0

After employment for---Under 1 m o n th _________________________________
1 and under 2 m o n t h s ________________________ _
2 and under 3 months
3 and under 4 m o n t h s _________________________
4 and under 5 months _________________________
6 and under 7 months
8 and under 9 months _________________________
12 and under 13 months ______________________
18 and under 19 months ______________________

50
37
19
60
3
37
1
2
1

8 1 6 .8
3 4 9 .6
1 2 3 .0
6 0 8 .0
7 8. 0
5 6 6 .4
6 .3
4 0 .8
1 .3

F irst day of month following completion of
employment for—
Under 1 m o n th _________________________________
1 and under 2 months
_ ....
2 and under 3 months
3 and under 4 months _________________ ________
4 and under 5 months _________________________
6 and under 7 months
12 and under 13 months
. .
..... _ _

19
24
10
12
1
6
2

5 1 5 .5
3 7 3 .2
1 ,0 3 1 .7
76.1
1 3 .3
9 3 .2
5 .9

Other

14

194.9

... ....

.

_ _

_ .

.

1 See footnote 1, table 1 .
2 Includes 5 plans, which provided benefits for dependents but
not for active w orkers.

TA B LE 8.

Effect of age at hiring on availability or level of hospital benefits for active
workers and their dependents, early 1959 1
(W orkers in thousands)
Workers

Provision
A ll plans providing b e n e fit s __________
Availability or level of benefits
not affected by age at h irin g________
Reduced benefits provided if
hired after age—
6 0 ____________________________________
6 5 ____________________________________
7 0 _________________________ ____ _______
Benefits not available if hired
after age—
65 __________________________________
7 0 ____________________________________

Plans

Dependents
Workers

Plans

Workers

293

4 ,8 3 4 .0

282

4 ,7 1 7 .5

279

4, 7 0 5 .6

269

4, 5 9 1 .6

24
1
6

5 3 .8
2 .5
61. 1

23
1
6

5 1 .3
2. 5
61. 1

9 .7
1.3

2
1

9 .7
1.3

2
1

1 See footnote 1, table 3.
2 Included is 1 plan that provided w orkers hired after age 60 and their dependents a reduced amount
of benefit during the first 36 months of coverage.




11
T ypes o f D is a b ilitie s C o v e re d
U nlike a c c id e n t and s ic k n e s s b e n e fits, w hich often c o v e r o ccu p a tion a l
d is a b ilitie s , a ll e x ce p t th ree plan s lim ite d the a v a ila b ility o f h osp ita l b e n e fits to
h o sp ita liza tio n re su ltin g fr o m d is a b ilitie s o f a n on occu p a tion a l nature. 14 But not
a ll such d is a b ilitie s w e r e c o v e r e d by the p lan s. 15 M o r e o v e r , a s m a ll nu m ber o f
pla n s, as show n b e lo w , s p e c ific a lly ex clu d ed m a tern ity c a s e s :

W o rk e rs

D ependents

P lan s

W o rk e rs
(in thou­
sands)

P la n s

W o rk e rs
(in thou­
sands)

293

4, 834. 0

282

4, 717. 5

______ 273
N on m atern ity and m a te rn ity —
20
N on m atern ity o n ly _____________ ______

4, 477. 9
356. 1

271
11

4, 5 57.9
159. 6

D is a b ilitie s c o v e r e d
A ll plan s p ro v id in g h o sp ita l
b e n e fits _____________________________

N onm aternity B en efits fo r A ctiv e W o rk e rs and T h eir Dependents
T y p es o f B e n e fit s . 16— Cash b e n e fits w e re paid by le s s than h alf o f the
plans with h o sp ita l b e n e fits fo r a ctiv e w o r k e r s and th eir dependents (table 9).
Slightly fe w e r plans p ro v id e d only s e r v ic e b e n e fits, but th ese plans c o v e r e d m o r e
w o r k e r s than th ose p ro v id in g only ca sh a llo w a n ce s. A com bin ation o f ca sh and
s e r v ic e b e n e fits w as p ro v id e d by m o r e than 10 p e r c e n t o f the plans, m o s t o f
w hich paid a ca sh allow a n ce fo r r o o m and b o a rd and p ro v id e d s p e c ifie d h osp ita l
e x tra s on a s e r v ic e b a s is .
S e r v ic e b en efits w e re sligh tly m o r e co m m o n than
ca sh under s in g le -e m p lo y e r plan s— e s p e c ia lly am ong the la r g e r plans— but in
m u lti e m p lo y e r plans ca sh b e n e fits w e r e m o r e com m on .

14 The 3 plans that p ro v id e d b en efits to w o r k e rs h o sp ita lize d b e ca u se o f
occu p a tio n a l d is a b ilitie s s p e c ifie d that the ben efits p ayable w ould be the d iffe r e n c e
betw een the w o rk m e n 1s com p e n sa tio n h osp ita l b e n e fit and the b e n e fits p ro v id e d
under the plan„
15 In addition to the g e n e ra l e x clu s io n o f b e n e fits fo r o ccu p a tion a l d is a b ili­
tie s, m o s t plans s p e c ific a lly ex clu d ed 1 o r m o r e n on occu p ation al d is a b ilitie s .
Am ong such e x clu s io n s w e r e treatm en t fo r a lc o h o lis m , n a r c o tic a d d iction , s e l f in flicte d in ju r ie s , and c o s m e tic su rg e ry . Som e plans, although co v e rin g ce rta in
types o f d is a b ilitie s , lim ite d the duration or the am ount o f b e n e fits a v a ila b le fo r
th eir treatm ent. E xam ples o f d is a b ilitie s su b je ct to such lim ita tion s w e re m ental
and n erv ou s d is o r d e r s , to n s ille c to m ie s , and p o lio m y e litis .
16 P lan s w e re c la s s ifie d a c c o r d in g to type of b e n e fits (ca sh o r s e r v ic e ) p r o ­
vid ed during the fu ll-b e n e fit p e rio d .
This c la s s ific a tio n is b a sed s o le ly on the
type o f b e n e fit p ro v id e d without r e g a r d to the party (the h osp ita l or the in su red )
to w hom paym ent is m ade or to the type o f in su re r (c o m m e r c ia l in su ra n ce c a r ­
r ie r or n on p rofit p rep aym en t o rg a n iz a tio n ).
" F u ll-b e n e fit p e r io d " r e fe r s to the p e r io d during w hich the m axim u m
d a ily r o o m and b o a rd b e n e fit is p rov id ed .




12
T A B L E 9.

Plans providing nonmaternity hospital benefits for active w orkers and their
dependents by type of plan and type of bargaining unit, early 1959
(W orkers in thousands)
Total

Single em ployer

M ultiem ployer

Type of plan and group covered 2
Plans

W ork ers

Plans
A ll plans studied

W orkers

Plans

W ork ers

300

4 ,9 3 3 .2

205

2 ,8 0 6 .7

95

2 ,1 2 6 .5

293
133
124
36

4 ,8 3 4 .0
1 ,8 4 0 .6
2 ,1 8 7 .7
8 0 5 .7

203
85
90
28

2 ,7 6 7 .5
9 3 4 .4
1 ,6 1 7 .0
2 1 6 .1

90
48
34
8

2 ,0 6 6 .5
9 0 6 .2
5 7 0 .7
5 8 9 .6

282
129
121
32

4 ,7 1 7 .5
1 ,8 2 1 .5
2 ,1 6 9 .0
7 2 7 .0

197
80
89
28

2 ,7 3 1 .8
9 0 0 .7
1 ,6 1 5 .0
2 1 6 .1

85
49
32
4

1 ,9 8 5 .7
9 2 0 .8
5 5 4 .0
5 1 0 .9

W orker s
A ll plans providing hospital b e n e fits ___
Cash
Service
_
__
Cash and se rv ice _____________________
Dependents
A ll plans providing hospital b e n e fits___
Cash
Service _________ ___ ____________ _____ _
Cash and serv ice

1 See footnote 1, table 1.
2 Plans w ere cla ssifie d according to type of benefits provided during the fu ll-b en efit
p eriod . F u ll-ben efit period on this and subsequent tables re fe r s to the period during which
the m axim um daily room and board benefit is provided (footnote 16, p. 11).

Of the 277 plan s that p ro v id e d h osp ita l b en efits fo r both w o r k e r s and d e ­
pendents, a ll ex ce p t 4 p ro v id e d the sam e type o f b e n e fits to each group (table 10).
T h ese fou r plans p r o v id e d the w o r k e r s a com b in a tion o f ca sh and s e r v ic e b en efits
and th eir dependents a ll ca sh b e n e fits.
S e r v ic e b e n e fits w e r e m o r e p re v a le n t am ong the plan s c o v e r e d in this
study than in th ose studied in late 1955— m o r e than two out o f fiv e plan s in 1959
as a ga in st about one out o f th ree plans in 1955.
D u ration . — A lthough the m axim u m p e r io d during w hich fu ll r o o m and
b o a rd b e n e fits w e re p a ya b le v a r ie d fr o m under 21 to o v e r 121 days, m o r e
than h alf o f the plans m ade the c o v e ra g e a v a ila b le to w o r k e r s and dependents fo r
70 days o r lo n g e r (table 11).
The m o s t freq u en t duration, 120 d a y s, w as found
in plans c o v e rin g o v e r two out o f fiv e o f the w o r k e r s under plans p rov id in g h o s ­
p ita l b e n e fits fo r each grou p. 17
F u ll-b e n e fit p e r io d s w e re g e n e ra lly lon g e r in s e r v ic e than in ca sh p lan s.
A fu ll-b e n e fit p e r io d o f 120 days o r m o r e w as p ro v id e d in a lm o s t h alf the s e r v ic e
plan s as c o m p a r e d w ith le s s than a fifth o f the ca sh b en efit plan s.

17
The a v e ra g e h o sp ita l stay in n on govern m en tal g e n e ra l h o sp ita ls w as s o m e ­
what le s s than 8 days in 1957. Only about 4 p e r c e n t of a ll h o s p ita liz e d p e r s o n s
re m a in ed in the h o sp ita l lo n g e r than 30 d ays; fe w e r than 1 p e r c e n t w e re h o s p i­
ta lize d lo n g e r than 60 da ys. See U. S. N ational Health Survey.
H osp ita liza tion :
P atien ts D isch a rg e d fr o m Sh ort-S tay H osp itals, United States, July 1 9 5 7 -June 1958.
U. S. P u b lic Health S e r v ic e . P u b lica tion No. 584-B 7, and unpublished data fr o m
the sa m e su rv ey .




13
T A B L E 10.

Relationship of ch a ra cte ristics of nonmaternity hospital benefits for active
w orkers and their dependents, early 1959 1
(W orkers in thousands)
Benefits during—
F u ll-b en efit period 2

P rovision

Type of
plan (cash
or se rv ice )

Daily room
and board

Plans W orkers Plans
A ll plans providing benefits
for both w orkers and
dependents
_
No variation in provision ___
Variation in p ro v is io n ______

Extended coverage period 2
Duration

Work ers Plans

Daily room
and board

Duration

W orkers Plans W orkers Plans W orkers

277

4 ,6 5 7 .5

277

4 ,6 5 7 .5

249

4, 285 .6

43

4 07 .4

43

4 0 7 .4

273

4, 578.8
78.7

247
30

4, 446.3
211.2

233
!6

4, 134.5
151.1

43

4 07 .4

43

4 07 .4

4

M axim um cash
Hospital extra
room and board
service benefit 2
benefit
A ll plans providing benefits
for both w orkers and
dependents____________ ___________ _

B a sis of
payment
specified

______________

146

1, 943.6

277

4 ,6 5 7 .5

277

4, 657.5

No variation in p ro v isio n __________________________ _____________ _
Variation in p ro v isio n _____________________________________ ________

109
37

1, 649-7
2 93 .9

246
31

3, 707.3
950.2

277

4, 657.5

___________

1 See footnote 1, table 3.
277 plans provided hospital benefits to both w ork ers and their dependents.
2 F or an explanation of "fu ll-b e n e fit" and "extended c o v e ra g e " periods and "h o sp ital extra s e r v ic e "
benefit, see p. 1.

D ependents
in a ll but 16 o f the
In v irtu a lly a ll c a s e s
fie d fo r depen den ts.
a fu ll-b e n e fit p e r io d

r e c e iv e d b e n e fits fo r the sam e length o f tim e as w o r k e rs
249 plans in dicating the p e r io d fo r both g rou p s (table 10).
w h ere th ere w as a d iffe r e n c e , a sh o rte r p e r io d w as s p e c i ­
F o r ex a m p le, under eight plan s, the w o rk e r w as p rov id ed
o f 70 days, and the dependents, 31 days.

The du ration of b e n e fits has in c re a s e d som ew hat sin ce late 1955.
The
num ber of plans p ro v id in g w o r k e r s fu ll-b e n e fit p e r io d s o f le s s than 70 days d e ­
c r e a s e d by about 25 p e r c e n t. The num ber with a fu ll-b e n e fit p e r io d of 120 days
o r m o r e in c r e a s e d by about 50 p e rce n t.
Extended c o v e r a g e p e r io d s at re d u ced a llow a n ces w e re p ro v id e d in
46 plans with h osp ita l b e n e fits fo r w o r k e rs and in 45 plans with b e n e fits fo r
dependents (ta b le 12). M ost o f th ese plans w e re s e r v ic e plans that p ro v id e d 21 days
o f fu ll c o v e r a g e and 180 add ition al days of p a rtia l c o v e ra g e .
At the other e x ­
tr e m e w e r e sev en plans with a fu ll-b e n e fit p e r io d o f 120 days and an extended
c o v e r a g e p e r io d o f 245 d a ys.
The duration of the extended c o v e ra g e p e r io d in
a ll of the 43 plan s that p ro v id e d such p e r io d s fo r both w o r k e rs and dependents
w as the sam e fo r both g rou p s (table 10).
The du ration of h o sp ita l b e n e fits was defin ed on a ’ ’p e r d is a b ility ” b a s is
in m o r e than 9 out o f 10 o f the plan s.
B en efits under th ese plans w e re a v a ila b le
fo r each sep a ra te d isa b ility o r p e r io d of h o sp ita liza tion . 18 The am ount o r num ber

18
A se p a ra te d isa b ility o r a sep a ra te p e r io d of h o sp ita liza tion w as u su ally
d e s c r ib e d , in r e la tio n to a p r e v io u s u se of h osp ita l fa c ilit ie s , as being due to
a d iffe r e n t or u n rela ted ca u se, o r sep a ra ted by a retu rn to w ork or by a s p e c i ­
fie d p e r io d o f tim e.




14
T A B L E 11. Plans providing nonmaternity hospital benefits for active w ork ers and
their dependents by duration of fu ll-b en efit period and type of room and
board benefit, early 1959 1
(W ork ers in thousands)
Type of room and board benefit for—
W ork ers
Duration of fu ll-b en efit period
Total

Cash

Service

Plans

W ork ers

Plans

A ll plans providing hospital
benefits ___________________ _______

*293

4 , 8 3 4 .0

161

2, 1 17 .6

132

2 ,7 1 6 .4

Duration specified ____ ________ _
Under 21 d a y s _________ _______
2 1 days _________________________
22 and under 31 days
_
_
3 1 d a y s __
___ ________________
32 and under 70 d a y s ___________
7 0 days
_ _ _ _ __ _
71 and under 120 days ______ _
120 days _________________________
121 days and o v e r _______________
Duration not sp ecifie d 3

262
1
27
3
51
14
60
10
85
11
31

4 ,2 5 8 .4
1 .8
2 7 8 .6
1 8 .5
4 4 3 .6
455. 0
7 5 1 .6
1 5 2 .6
2 ,0 6 3 .3
9 3 .4
5 7 5 .6

134
1
1
3
44
13
37
4
22
9
27

1, 7 3 9 .0
1 .8
2. 5
18. 5
3 9 7 .3
4 48 . 5
5 1 1 .0
9 6 .3
1 7 5 .5
8 7. 6
3 7 8 .6

128
26

2 ,5 1 9 .4
276. 1
4 6 .3
6. 5
2 4 0 .6
5 6 .3
1 ,8 8 7 .8
5. 8
197. 0

W ork ers

Plans

-

7
1
23
6
63
2
4

W ork ers

Dependents
A ll plans providing hospital
benefits
_
. __
Duration s p e c ifie d __________________
U nde r 2 1 day s ___________________
2 1 days
22 and under 31 days
3 1 days ___________________________
32 and under 70 days ___________
70 days . _
_ _
7 1 and under 120 d a y s __________
120 days __ ______________________
121 days and over _______________
Duration not sp ecified 3_____________

4 2 82

4 , 717. 5

153

2 , 0 1 9 .8

129

2, 6 9 7 .7

248
27
3
51
12
49
10
86
10
34

4 ,1 4 5 .8

122
1
3
44
9
28
6
23
8
31

1, 643. 1
2. 5
5 8 .3
4 60 . 0
351. 9
397. 0
110.3
185. 5
77. 6
3 7 6 .7

126

2 ,5 0 2 .7

-

2 7 8 .6
5 8 .3
5 0 6 .3
3 7 2 .9
6 2 0 .9
152. 1
2, 0 7 3 .3
8 3 .4
571. 7

-

26
7
3
21
4
63
2
3

-

2 76 . 1
-

4 6 .3
2 1 .0
223 . 9
4 1 .8
1, 8 8 7 .8
5 .8
195. 0

1 See footnote 1, table 3.
2 2 plans provided a shorter duration for women w ork ers.
3 Included are 2 plans under which the fu ll-b en efit period varied according to y e a rs
of participation in plan.
4 2 plans provided a longer duration for m ale spouses.

o f tim e s b e n e fits w e r e p a ya b le fo r p re v io u s d is a b ilitie s o r p e r io d s o f h osp ita l
con fin em en t had no b e a rin g on b e n e fits a v a ila b le to a w o r k e r fo r future d is a b ili­
tie s re q u irin g h o sp ita l c a r e . On the other hand, under plan s m aking the b e n e fits
p a ya b le on a "p e r y e a r " b a s is , the b en efits a v a ila b le fo r the se co n d d is a b ility
du rin g any one y e a r w as the unused p o rtio n fo r the p re ce d in g d is a b ility during
that y e a r .
Only fo u r plan s u sed both b a s is ; they m ade the r o o m and b o a rd a l ­
low a n ce a v a ila b le on a " p e r y e a r " b a s is and the a llow a n ce fo r ex tra h osp ita l
s e r v ic e s on a " p e r d is a b ility " b a s is .
D aily R oom and B oa rd B e n e fits . — Under v irtu a lly a ll plans p rov id in g
s e r v ic e ro o m and b o a rd b e n e fits, w o r k e rs and dependents w e re e lig ib le fo r s e m i­
p riv a te a c c o m m o d a tio n s during the fu ll-b e n e fit p e r io d with no ex tra c o s t fo r this
s e r v ic e . 19 If the patient o c cu p ie d a p riv a te ro o m , a s p e c ifie d ca sh a llow a n ce

1
9
S em ip riv a te a c c o m m o d a tio n s w e re g e n e ra lly d e s c r ib e d as r o o m s having
2 b ed s o r 2 and not m o r e than 4 bed s o r, in a few c a s e s , 6 b ed s.




15
T A B L E 12. Plans providing nonmaternity hospital benefits for active w orkers and their
dependents by duration of full-benefit and extended coverage periods, early 1959 1
(W orkers in thousands)
Duration of extended coverage period
Total

60 and
unde r
90 days

Duration of full-benefit period
Plans

90 days

Plans

Workers

1 Plans

Workers

4 2 3 .2

3

1 7.5

3

2 8 .5

27
6
1
3
8

2 7 8 .6
42. 1
3. 5
2 6 .4
7 0 .8

_

_

2
1
~

14. 0
3. 5

2
1
-

1 4.5
14. 0

45

4 2 1 .9
2 7 8 .6
28. 1
1 8.0
2 6 .4
70. 8

Workers

W orkers
A ll plans with extended coverage
provisions ____________________________
2 1 d a y s __________________________________
22 and under 60 d a y s __________________
60 days
....... _
_
61 and under 120 days
120 days

246

-

-

-

-

~

-

-

3

18 . 0

3

2 8 .5

_
3

_
18. 0
~

2
1
-

1 4.5
14. 0
-

Dependents
A ll plans with extended coverage
provisions ____________________________
21 days __ _____ _____ __ _____ ______
22 and under 60 days _
60 days __________________________________
61 and under 120 days
120 days ________________________________

27
4
3
3
8

-

~

-

■

Duration of extended coverage period— Continued
IST and
under
245 days

180 days

245 days

Workers
A ll plans with extended coverage
provisions
_
2 1 days
22 and under 60 days
60 days
61 and under 12 0 days
120 days

31
25
3
-

3 0 5 .4

1

264. 1
14. 1

.

.

.

_

_

_

_

_

_

-

7 .2

7

6 2 .8

-

-

-

1
-

7. 2
-

_

_

7

6 2 .8

3 0 5 .4

1

7 .2

7

6 2 .8

264. 1
14. 1
19.2
8. 0

.

_

_

-

2
1

19.2
8. 0

31

Dependents
A ll plans with extended coverage
provisions
_ ................ ....
2 1 d a y s _________________
22 and under 60 days _
60 days _________________
61 and under 12 0 days _
120 days _____________

25
3
-

2
1

-

1

.
_

_

-

-

-

7 .2

7

-

6 2 .8

1 See footnote 1, table 3. 293 and 282 plans provided hospital benefits for w orkers and dependents,
respectively.
2 Included is 1 plan with a full-benefit period of 20 days and an extended coverage period of 11 days.




16
o r the am ount ch a rg ed by the h o sp ita l fo r the a cco m m o d a tio n s to w hich the patient
w as en titled w as a llo w e d tow ard the c o s t o f the p riv a te r o o m ; the patient w as
r e s p o n s ib le fo r the d iffe r e n c e .
An extended c o v e r a g e p e r io d w as p ro v id e d w o r k e rs and dependents under
3 out of 10 plans that m ade s e r v ic e r o o m and b o a rd b e n e fits a v a ila b le during the
fu ll-b e n e fit p e r io d .
D uring the extended c o v e ra g e p e rio d , o n e -h a lf the c o s t of
w o r k e r s 1 and d e p en d en ts1 h o sp ita l a cco m m o d a tio n s w as m et by th r e e -fo u r th s o f
the plans (ta b le 13). The rem a in in g plans p ro v id e d a fix e d daily ca sh a llow a n ce
(e . g. , $5 p e r day) to be a pp lied tow ard a ll h osp ita l ch a rg e s.
With few e x ce p tio n s, the plans with ca sh r o o m and b o a rd b e n e fits p r o ­
v id ed a fix e d d a ily a llo w a n ce (ta b le 14). Under th ese p r o g r a m s , re im b u rse m e n t
w as m ade tow ard the ch a rg e fo r h osp ita l a cco m m o d a tio n s up to the stipulated
d a ily m a x im u m s.
Any ch a rg e in e x c e s s o f the d a ily m axim u m w as paid by
the w o r k e r.
D aily ca sh r o o m and b o a rd a llo w a n ce s fo r w o r k e rs and dependents ranged
fr o m le s s than $8 to m o r e than $21.
The a v e ra g e a llow a n ce fo r w o r k e rs was
$13. 18, fo r dependents, $12. 79. 20 T h ese a v e ra g e s w e re about 20 p e r c e n t m o r e
than the $11. 12 a v e ra g e am ount p ro v id e d w o r k e rs and the $ 1 0 .3 1 p ro v id e d d e ­
pendents in the late 1955 study. 2
1
T h irty o f the 277 plan s sp e cify in g d a ily r o o m and b o a rd b e n e fits fo r both
w o r k e r s and th eir dependents (ta b le 10) p ro v id e d a lo w e r b en efit fo r dependents.
The am ount p ro v id e d u su ally ran ged fr o m $1 to $5 le s s than that p ro v id e d w o r k e r s .
A s in late 1955, plans with low d a ily r o o m and b o a rd a llow a n ces tended
to p ro v id e b e n e fits fo r r e la tiv e ly sh ort fu ll-b e n e fit p e r io d s . F o r ex am p le, daily
a llo w a n ce s o f le s s than $12 fo r w o r k e rs and dependents w e re p ro v id e d under a
su bstan tially la r g e r p r o p o r tio n o f plans with fu ll-b e n e fit p e r io d s of le s s than
70 days than under th ose with p e r io d s of 70 days or m o r e .
Unlike the s e r v ic e plan s, only a few of the ca sh plans p ro v id e d fo r e x ­
tended c o v e r a g e . M ost freq u en tly, the plans with this p r o v is io n p ro v id e d during
the extended c o v e r a g e p e r io d a d a ily allow a n ce equal to h alf the am ount a v a ila b le
during the fu ll-b e n e fit p e r io d .
M axim um R oom and B oa rd A llo w a n ce . ----The m ax im u m r o o m and b o a rd
a llo w a n ce , the p ro d u ct of the d a ily ca sh a llow a n ce and the m axim u m num ber of
days o f h osp ita l stay p r o v id e d under the plan, m ay often be taken as a rough
sin g le m e a su re o f the le v e l o f b en efits o ffe r e d by a plan. 2 2 O bviou sly, this
a llo w a n ce can b e ca lcu la te d only fo r ca sh plans, sin ce in s e r v ic e plan s, the
d a ily b e n e fit is s p e c ifie d in te r m s of the p a rticu la r h osp ita l a cco m m o d a tio n p r o ­
vid ed, e. g. , a s e m ip riv a te r o o m , without any lim ita tion on its co s t.
T h e r e fo r e ,

2 T h ese a v e r a g e s w e r e d e r iv e d by w eighting the am ount o f b e n e fit p ro v id e d
0
to w o r k e r or dependent b y ea ch plan by the total num ber o f w o r k e rs c o v e r e d by
that plan.
2 The B u reau o f L a b or S ta tis tic s 1 index of p riv a te, s e m ip riv a te , and w ard
1
a c c o m m o d a tio n s r o s e fr o m 166. 9 in D e ce m b e r 1955 to 205. 3 in M a rch 1959, an
in c r e a s e of 23 p e rce n t. See BLS C on su m er P r ic e Index, P r ic e Indexes fo r S e­
le cte d Item s and G rou ps.
S ep tem ber and N ovem b er 1959 r e le a s e s .
22 A lthough a c o m p a r is o n o f m axim u m r o o m and b o a rd a llo w a n ce s is u s e ­
fu l in d e s c r ib in g the ran ge o f b e n efits p ro v id e d under h osp ita l plans, it is not
the id e a l m e a su r e o f d iffe r e n c e s la r g e ly b e ca u s e m o s t h osp ita l stays a re o f sh ort
du ration (footn ote 17, p. 12).




17
T A B L E 1 3. P lans providing non m aternity hosp ital ben efits fo r active
w o rk e rs and th eir dependents by daily benefit during
the extended co vera ge p erio d , e a r ly 1959 1
(W o rk e rs in thousands)
D a ily b en efit during extended co vera ge p eriod

Plans

W o rk e rs

W o rk e rs
A ll plans with extended co vera ge p e r io d ----------50 p erce n t of co st of se m ip riv a te room
accom m od ation s ---------------------------------------------------50 p ercen t of co st of w ard accom m od ation s —
M o re than o n e -h a lf of daily room and board
allow ance p rovided during fu ll-b e n e fit
period ---------------------------------------------------------------------O n e -h a lf of allow an ce provided during
fu ll-b e n e fit p eriod -----------------------------------------------Specified allow ance provided fo r ro o m ,
b o ard , and extra h osp ital s e r v ic e s ----------------

2 46

4 2 3 .2

28
1

295. 8
1 4 .0

1

1. 8

3

13. 5

12
1

9 0 .9
7 .2

3 45

4 2 1 .9

30
1

3 1 0 .3
1 4 .0

3

13. 5

10
1

7 6 .9
7 .2

Dependents
A ll plans with extended covera ge p e r io d ----------50 p erce n t of co st of se m ip riv a te room
accom m od ation s ---------------------------------------------------50 p erce n t of co st of w ard accom m od ation s —
M o re than o n e -h a lf of daily room and board
allow ance p rovided during fu ll-b e n e fit
period ---------------------------------------------------------------------O n e -h a lf of allow ance provided during
fu ll-b e n e fit period -----------------------------------------------S pecified allow ance provided fo r ro o m ,
b o a rd , and extra h osp ital s e r v ic e s ---------------Othe r --------------------------------------------------------------------------

1 See footnote 1, table 3.
293 and 282 plans provided hospital
ben efits fo r w o rk e rs and dependents, re s p e c tiv e ly .
2 39 and 7 p lans provided s e r v ic e and cash b e n e fits , re sp e c tiv e ly ,
during the fu ll-b e n e fit p eriod .
3 41 and 4 plans provided s e rv ic e and cash b e n e fits , re sp e c tiv e ly ,
during the fu ll-b e n e fit p eriod .

a w o rk e r h o sp ita liz e d fo r an extended p e r io d of tim e w ould be c o n ce rn e d p r i ­
m a r ily with the m axim u m du ration of the h osp ita l stay p ro v id e d by a s e r v ic e
plan and by both the d a ily r o o m and b o a rd allow a n ce and the du ration of b e n e fits
p ro v id e d by a ca sh plan.
On the other hand, if the stay is a sh ort one, a w o rk e r
under a ca sh plan w ould b e c h ie fly co n ce rn e d with the am ount of the d a ily r o o m
and b o a rd a llo w a n ce , i. e. , how n e a rly it a p p rox im a tes the h o s p ita l's ch a rg e
fo r the a c c o m m o d a tio n used.
The m a xim u m a llo w a n ce a v a ila b le p e r h osp ita l stay ranged fr o m $150 to
o v e r $2, 000 (ta b le 15).
Under tw o -fifth s o f the plan s, w o r k e rs cou ld r e c e iv e
a m axim u m r o o m and b o a rd a llo w a n ce o f $ 1 ,0 0 0 or m o r e , w hile dependents
cou ld r e c e iv e this am ount in sligh tly m o r e than one out of th ree plan s. 23

2
3
W here the m a xim u m r o o m and b o a rd a llow a n ce w as not s p e c ifie d , it w as
com pu ted by m u ltip lyin g the m a xim u m d a ily a llow a n ce by the m axim u m num ber of
days of h o sp ita l stay p ro v id e d . Included in this com pu tation w e re the a llow a n ces
p r o v id e d during the fu ll-b e n e fit p e r io d and the extended c o v e r a g e p e r io d .
Ex­
clu ded fr o m the table w e r e a ll plans p rov id in g s e r v ic e b en efits and th ose plans
with ca sh o r a com b in a tion ca sh and s e r v ic e b e n e fit under w hich the m axim u m
am ount w as not com pu ta b le.




18
T A B L E 14. Plans providing nonmaternity hospital benefits for active workers and their dependents
by daily room and board allowance and duration of full-benefit period, early 1959 1
(Workers in thousands)
Maximum number of days in full-benefit period
Total

Maximum daily room and
board allowance

32 and
70
undejr 70
W orkers Plans W orkers Plans
W orkers Plans W orkers

Under 31
Plans W orkers

Plans

31

W orkers
A ll plans providing cash
room and board
benefits ----------------------------Daily allowance
specified -------------------------Under $8 ----------------------$8 and under $9 ---------$9 and under $ 1 0 -----—
$10 and under $ 1 1 ------$11 and under $ 1 2 -------$12 and under $ 1 3 ------$13 and under $ 1 4 ------$14 and under $ 1 5 ------$15 and under $ 1 6 ------$16 and under $ 1 7 ------$17 and under $ 1 8 ------$18 and under $ 1 9 ------$19 and under $ 2 0 -------$20 and under $ 2 1 ------$21 and over ----------------Daily allowance not
s p e c ifie d --------------------------Average maximum
daily allow ance4 —-----------

* 161

2, 117. 6

5

2 2 .8

44

3 9 7 .3

13

448. 5

37

511. 0

149
3
9
8
17
6
34
8
11
28
8
2
9
1
4
1

1 ,7 5 7 .4
2 3. 5
no. 6
62. 5
164. 7
152. 5
315. 1
42. 7
2 1 5 .3
340. 7
1 7 4 .0
48. 0
62. 1
1 .2
1 6 .5
2 8 .0

5

2 2 .8

448. 5

36

4 8 1 .0

3
-

2 3 7 .3
2 3 .5
4 3 .3
1 9 .0
3 2 .2
2 2 .4
23. 7
1 .0
1 2 .2
33. 6
2 5 .0
1 .4
-

13

1 5 .8
-

42
3
5
2
6
3
9
1
4
7
1
1
-

-

-

2

160. 0

-

3 6 0 .2

3 12

-

-

1

4 .5

-

-

-

2. 5

1
-

-

-

1
2
1
2
1
1
1
2
2
-

-

14. 5
42. 8
106. 0
46. 4
3. 0
175. 0
3. 5
53. 8
3 .5
-

-

-

3
8
3
2
2
1
1

35. 0
10. 9
16. 5
1 .0
8 9 .9
18. 7
1 9 5 .4
10. 8
48. 0
16. 8
10. 0
2 8 .0

1

30. 0

1
2
2
1
10
-

$ 1 3 .1 8

120

71 and
under 120
A ll plans providing cash
room and board
b e n e fits------ *------------------Daily allowance
s p e c ifie d ------ —
Under $8
$8 and under $9 -------$9 and under $ 1 0 ---------------------------------------$10 and under $11 --------------------------------------$11 and under $ 1 2 --------------------------------------$12 and under $ 1 3 --------------------------------------$13 and under $ 1 4 --------------------------------------$14 and under $ 1 5 --------------------------------------$15 and under $ 1 6 --------------------------------------$16 and under $ 1 7 --------------------------------------$17 and under $ 1 8 --------------------------------------$18 and under $ 1 9 --------------------------------------$19 and under $ 2 0 --------------------------------------$20 and under $21 --------------------------------------$21 and over
Daily allowance not
s p e c ifie d ---------- -----

See footnotes at end of table.




-

O th er:

121 and over

9 6 .3

22

175. 5

87. 6

27

378. 6

96.3

22

175. 5

78. 6

19

217. 4

3
11.0

44. 3

2

2 7. 6
2 6 .9
3 .0
8 2 .9

15. 8

5

32. 3
13. 6
17. 9
23. 1
3 0 .2

2

3 .9
2. 0
84. 4

2

79. 0
17.3

10. 0

2. 5
6. 0

1

1
1
1

1.8

8.2

1 9 .9

1.2

3. 0

9. 0

161.2

19
T A BL E 14. Plans providing nonrrsaternity hospital benefits for active w orkers and their dependents
by daily room and board allowance and duration’of full-benefit period, early 1959 1— Continued
(W orkers in thousands)
Maximum number of days in full-benefit period
M aximum daily room and
board allowance

32 and
under 70

31

Under 31
Plans W orkers Plans W orkers Plans

H

orkers Plans

70

Workers Plans Workers

Dependents
A ll plans providing cash
room and board
6 153
Daily allowance
s p e c ifie d __________________
Under $ 8 ________________
$ 8 and under $ 9 _______
$ 9 and under $ 10 _____
$ 10 and under $ 11
$ 11 and under $ 1 2 _____
$ 12 and under $ 1 3 _____
$ 13 and under $ 1 4 _____
$ 14 and under $ 1 5 _____
$ 15 and under $ 1 6 _____
$ 16 and under $ 1 1
$ 17 and under $ 1 8 _____
$ 18 and under $ 19
$ 19 and under $ 2 0
$ 2 0 and under $ 2 1 _____
Daily allowance not
s p e c ifie d __________________
Average maximum
daily allow ance4 _________

2, 0 1 9 .8

4

6 0 .8

44

4 60. 0

9

3 5 1 .9

28

3 9 7 .0

143
8
9
6
21
6
29
9
18
21
4
2
5
1
4

1 ,6 8 4 .6
36. 0
133.4
4 3 .5
164. 9
156.6
255. 5
77. 3
304. 7
308. 8
98. 7
4 8 .0
5 9 .5
1.2
16. 5

4
1
1
1
I

60. 8
4. 5
2 .5
52. 8
1. 0

42
5
5
2
7
3
6
1
7
4
1
1
-

3 0 0 .0
15.5
66. 1
1 9 .0
3 5 .2
2 1 .1
15.8
2 5 .0
48. 9
2 5 .6
2 6 .4
1 .4
-

9
1
1
2
1
2
1
1

351. 9
14.5
106. 0
4 6 .4
3. 0
1 7 6 .0
3 .5
2. 5

27
1
2
3
7
1
3
4
2
2
1
1

367. 0
3 5 .0
10. 9
22. 5
27. 7
6. 0
11. 1
1 7 1 .5
14.3
4 8 .0
10. 0
10. 0

-

-

2

160. 0

-

1

30. 0

3 10

3 3 5 .2

$ 1 2.7 9
7 1 and
under 120

A ll plans providing cash
room and board
benefits _____________________
Daily allowance
specified ____________________
Under $ 8 _________________
$ 8 and unde r $ 9
$ 9 and under $ 10
$ 10 a nd und e r $ 11
$ 11 and under $ 12
$ 12 and under $ 13
$ 13 and under $ 1 4 _______
$ 14 and under $ 15
$ 15 and under $ 1 6 _______
$ 16 and under $ 17
$ 17 and under $ 18 _______
$ 18 and under $ 1 9 _______
$ 19 and under $ 2 0 _______
$ 2 0 and under $21
Daily allowance not
specified
............ .

-

120

121 and over

Other 5

6

110.3

23

185. 5

8

7 7 .6

31

376. 7

6
-

110.3
14. 0
79. 0
17. 3
-

23
1
1
3
4
1
9
2
1
1

185.5
1 1 .0
6 .4
27. 6
3 0 .5
3 .0
82. 9
19. 9
1.2
3. 0

7
4
1
1
1
-

6 8 .6
44. 3
15. 8
2. 5
6. 0
-

25
1
3
2
4
1
6
2
3
1
1
1
-

240. 5
1. 5
3 2 .3
13. 6
37. 9
23. 1
40. 7
12. 8
1 0.4
2. 0
58. 0
8 .2
-

1

9. 0

6

136.2

2
3
1
-

1 See footnote 1, table 3. 293 and 282 plans provided hospital benefits for w orkers and dependents,
respectively.
2 2 plans provided a shorter duration for women w orkers.
3 Included are 2 plans that provided a lower daily allowance during the first year of coverage than
during succeeding y e a rs.
4 Benefit provided by each plan weighted by number of active workers covered.
5 Included are plans with no specified duration and plans under which the full-benefit period varied
according to years of participation in the plan.
6 2 plans provided a longer duration for the male spouse.




20
Under 37 o f the 146 plans s p e cify in g a m axim u m r o o m and b o a rd a l ­
lo w a n ce fo r both w o r k e r s and dependents (table 10), le s s e r am ounts w e re p r o ­
v id e d depen den ts.
The m a xim u m a llo w a n ce a v e ra g e d $1, 000 fo r w o r k e rs and $912 fo r
depen den ts— an in c r e a s e o f m o r e than $200 o v e r the late 1955 a v e r a g e s ($781
and $673, r e s p e c t iv e ly ).
H osp ital E xtra S e r v ic e s B e n e fits . — H osp ital ch a rg e s in cu rre d by w o r k e r s
and th eir dependents fo r s e r v ic e s other than fo r r o o m and b o a rd w e r e d efra y ed ,
at le a s t in pa rt, by a ll o f the p la n s.
M ost o f the plans eith er paid a ll ch a rg e s
up to a fix e d m a x im u m o r the fu ll c o s t of s p e c ifie d s e r v ic e s fu rn ish ed at any
tim e during the b e n e fit p e r io d (table 16).
Som e o f the plans p ro v id e d fu ll p a y ­
m en t up to a c e r ta in le v e l but m ad e a llow a n ce fo r fu rth er re im b u rs e m e n t on a
p e r c e n ta g e b a s is if the stipu lated le v e l w as e x ce e d e d .
F o r ex am p le, one plan
T A B L E 15. Plans providing nonmaternity hospital benefits for active w ork ers
and their dependents by m axim um room and board allow ance, e a r ly 1959 1
(W ork ers in thousands)
M axim um room and board allow ance
per hospital stay

W orker s

Dependents

Plans

W ork ers

AIT plans with m axim um ro om and
board allow ance 2 __________________________

3 141

1 ,6 0 0 .3

$150 and under $200 _______________ ______
$200 and under $2 50
$250 and under $300 _______________________
$300 and under $350 _______________________
$350 and under $400 _ ________ __________
$400 and under $450 _ ________________ __
$ 450 and under $500 _______________________
$500 and under $550 __
____
$550 and under $600
$600 and under $650
$650 and under $700 _______________________
$700 and under $ 750 _______________________
$750 and under $800 _ ____________________
$800 and under ,$8 50 _______________________
$850 and under $900
_
______
$900 and under $950
$950 and under $ 1 ,0 0 0 _________ ________
$ 1 ,0 0 0 and under $ 1 ,2 0 0 _ _
____ _
$ 1 ,2 0 0 and under $ 1 ,4 0 0 __________________
$ 1 ,4 0 0 and under $ 1 ,6 0 0
$ 1 ,6 0 0 and under $ 1 ,8 0 0 __________________
$ 1 ,8 0 0 and under $ 2 ,0 0 0 __________________
$ 2 ,0 0 0 and over

2
8
3
8
11
7
10
1
2
3
2
4
2
16
1
1
5
12
8
11
3
14
7

A verage m axim um room and
board allow ance 5 _ _______________________

Plans

4 136

1

1 ,5 7 5 .7

2
11
3
10
9
13
6

1 3 .5
6 4 .6
2 0 .6
5 2 .3
3 0 .0
1 8 .5
75. 1
1 .8
3 6 .4
6 5 .0
1 0 8 .9
3 4 .4
5 .5
3 0 7 .9
6 .0
1 .8
7 2 .5
2 4 6 .7
1 0 6 .6
105. 3
3 7 .4
1 4 2 .9
4 6 .6

$ 1 ,0 0 0

W or ker s

3 .0
9 1 .4
2 0 .6
56. 3
5 6 .9
1 4 7 .0
5 4 .0
3 6 .4
6 6 .0
1 0 8 .9
4 3 .4
5. 5
226. 1
9 .5
7 .8
1 3 .6
226. 3
1 0 5 .2
115. 3
3 .0
1 4 2 .9
3 6 .6

-

2
4
2
6
2
11
2
2
4
7
7
12
1
14
6

.

$912

1
____________ 1
_________________

1 See footnote 1, table 3.
293 and 282 plans provided hospital benefits for w ork ers
and dependents, re sp e c tiv e ly .
2 W h ere the m axim um room and board allow ance was not sp ecified , it was computed
by m ultiplying the m axim um daily allowance by the m axim um number of days of hospital
stay provided.
Excluded from this table are all se rv ic e -ty p e plans and a few cash plans
with a daily room and board allowance that specified a m axim um allow ance to be applied
to all hospital c h a rg es, and a few cash or cash and s e rv ic e -ty p e plans under which the
m axim um room and board allowance was not com putable.
3 2 plans provided a le s s e r amount for women w o rk e rs.
Excluded are 2 plans that
provided a low er m axim um allow ance during the first year of coverage than during succeeding
year s .
4 2 plans provided a greater amount for m ale sp ou ses.
E xcluded are 2 plans that
provided a low er m axim um allow ance during the first year of coverage than during succeeding
years.
5 Benefit provided by each plan weighted by number of active w ork ers covered .




21
T A B L E 16. Plans providing nonmaternity hospital benefits for active w ork ers and their
dependents by method of specifying allowance for hospital e xtras, early 1959 1

Method of specifying allowance
for hospital extras

A ll plans providing benefits for extra hospital s e r v i c e s __
Allow ances provided for expenses incurred . „. .. .... .
Up to a fixed amount
_ __
,.
, , r
With additional reim bursem ent on percentage
ba sis
___ _
.................
Without additional reim bursem ent on percentage
b a sis
_
_
___
Up to difference between room and board charges
and a fixed amount
....
___ ______
Other
.
...
.
Benefits provided on a serv ice b a sis
.
For entire benefit period ___________________________________
For part of benefit period and reim bursem ent of
percentage of cost of se rv ice s for rem ainder of
period
. T ...
_
For part of benefit period and reim bursem ent of
difference between room and board charges and
a fixed amount for rem ainder of benefit p e r io d ________
Other
_

1 See footnote 1, table 3.
dependents, re sp ec tiv ely .

W ork ers

Dependents

Plans

W ork ers

Plans

W ork ers

293

4 ,8 3 4 .0

282

4 ,7 1 7 .5

141
126

2 ,3 6 9 .3
2 ,1 1 5 .5

137
126

2 ,3 5 0 .2
2 ,1 8 6 .6

33

8 1 5 .6

33

3 1 9 .1

93

1 ,2 9 9 .9

93

1 ,8 6 7 .5

8
7
152
112

97. 1
1 5 6 .7
2 ,4 6 4 .7
2 ,0 7 3 .7

5
6
145
103

28. 1
1 3 5 .5
2 ,3 6 7 .3
1 ,9 6 1 .8

30

3 1 3 .3

32

3 2 7 .8

9
1

7 5 .2
2 .5

9
1

7 5 .2
2 .5

293 and 282 plans provided hospital benefits for w orkers and

r e im b u r s e d a ll ex tra ch a r g e s up to $240 plus 75 p e r c e n t of ch a rg e s in e x c e s s
o f that am ount up to $500.
S im ila rly , som e o f the s e r v ic e plans paid the fu ll
c o s t o f s p e c ifie d s e r v ic e s during the fu ll-b e n e fit p e r io d and p ro v id e d p a rtia l r e ­
im b u rse m e n t (u su a lly 50 p e rce n t) during the extended c o v e ra g e p e rio d .
A la r g e r p r o p o r tio n of the plans paid the fu ll c o s t of s p e c ifie d h osp ita l
s e r v ic e s (s e r v i c e b e n e fits) in 1959 than in 1955.
C on v ersely , re im b u rs e m e n t of
ex p e n se s in c u r r e d fo r any extra h osp ita l s e r v ic e s up to a s p e c ifie d am ount (ca s h
b e n e fits) w as p ro v id e d by fe w e r plans.
P lan s p ro v id in g s e r v ic e b en efits rath er than ca sh a llo w a n ce s ty p ica lly
lis te d th ose b e n e fits fo r w hich the c o s t w as c o v e r e d (in fu ll o r in part), and
th ose b e n e fits w hich w e r e exclu d ed.
W hile s p e c ifie d s e r v ic e s v a r ie d c o n s id ­
e ra b ly am ong plan s, v irtu a lly a ll plans fu lly c o v e r e d the u se o f operatin g or
c y s t o s c o p ic ro o m , su p plies (su ch as bandages, splints, m a te ria l fo r ca s ts , and
a n esth etic m a te r ia ls ), and m o s t la b o ra to ry s e r v ic e s .
R e im b u rsem en t fo r the
fu ll c o s t of dru gs lis te d in the la te st edition s of the United States P h a rm a co p e ia ,
The N ational F o rm u la ry , and New and N on o fficia l R e m e d ie s was a ls o com m on .
L e s s fre q u e n tly in clu ded w e r e d ia g n ostic and th erap eu tic X -r a y s , and b lo o d fo r
tra n sfu sio n s.
O f the 141 plan s c o v e r in g w o r k e rs and 137 plans c o v e rin g dependents
that p ro v id e d ca sh a llo w a n ce s fo r h osp ita l ex tra s, 126 of them p ro v id e d fu ll r e ­
im b u rse m e n t up to a fix e d m a xim u m (table 16).
The m a x im u m s s p e c ifie d in
th ese plans ranged fr o m le s s than $50 to m o r e than $600, and the a v e ra g e
am ount p ro v id e d by plans using this m ethod w as $300 fo r w o r k e rs and $226
fo r dependents (ta b le 17).
In addition to the b a s ic a llow a n ce, 33 plans paid a
p e rce n ta g e o f the ch a rg e s a fte r the fu lly r e im b u r s a b le am ount had been e x ­
hausted.
The b a s ic am ount p ro v id e d under these plans a v e ra g e d $451 fo r the
w o rk e r and $292 fo r dependents.
This r e p re s e n te d an a v era g e in c r e a s e sin ce




22
T A BL E 17. Plans providing nonmaternity hospital benefits for active workers
and their dependents by maximum amount of full reim bursem ent of charges
for hospital extras, early 1959 1
(W orkers in thousands)
W orkers

Basic amount

Plans with additional
reim bursem ent on
percentage basis

Total

W orkers

Plans

A ll plans providing full
reim bursem ent up to a
fixed a m ou n t-----------------------

2 124

1 ,9 5 5 .5

Under $50 ----------------------------$ 50 and under $ 75 -------------$75 and under $ 1 0 0 ------------$100 and under $ 1 2 5 ----------$125 and under $ 1 5 0 ----------$150 and under $ 1 7 5 ---------- $175 and under $200 ----------$200 and under $ 2 2 5 ----------$225 and under $250 ------- —
$250 and under $300 ----------$300 and under $400 — ----$400 and under $500 ----------$500 and under $600 ----------$600 and o v e r -----------------------

i
7
5
22
6
7
5
14
12
8
24
4
7
2

1 2 .0
318. 5
22. 0
2 8 1 .9
18. 5
6 5 .8
2 6 .6
1 5 6 .2
1 1 6 .5
4 8 .3
2 5 1 .8
56. 6
5 5 8 .0
2 2. 8

Average basic am ount3 -------

W orkers

Plans

33

8 1 5 .6

-

-

8 .8
2 4 .8
1 0 .9
3 5 .0
22. 7
3 6 .6
145. 7
31. 1
5 0 0 .0
-

2
2
-

2
5
5
4
10
2
1
-

$4 51
$3 00
______________ 1 ______________ _______________1
1
_
1
___________
Dependents

A ll plans providing full
reim bursem ent up to a
fixed a m ou n t-----------------------

2 124

2 ,0 2 6 .6

33

319. 1

Under $50 -----------------------------$50 and under $ 7 5 --------------$75 and under $100 ------------$100 and under $ 1 2 5 ----------$125 and under $ 1 5 0 ----------$150 and under $ 1 7 5 ----------$175 and under $200 ----------$200 and under $225 ----------$225 and under $250 ----------$250 and under $300 —-------$300 and under $400 ----------$400 and under $500 ----------$500 and under $600 ----------$ 600 and over -----------------------

1
6
6
19
4
5
7
16
12
14
21
2
8
3

1 .0
303. 5
55. 8
225. 1
16. 3
62. 5
35. 6
6 8 4 .2
114. 0
125. 0
272. 1
31. 1
59. 6
40. 8

2
2
4
5
5
6
7
2
-

8. 8
2 4. 8
1 9 .9
3 5 .0
2 0 .2
39. 7
1 3 9 .6
3 1 .1

Average basic am ount3 -------

$2 26

-

$2 92

Plans without additional
reim bursem ent on
percentage basis
Plans

W orkers

291

1 ,1 3 9 .9

1
7
3
20
6
7
3
9
7
4
14
2
6
2

12. 0
318. 5
1 3 .2
257. 1
18. 5
6 5 .8
15. 7
1 21 .2
93. 8
1 1 .7
106. 1
2 5 .5
5 8 .0
2 2. 8

$194
_______________1
______________

a91

1 ,7 0 7 .5

1
6
4
17
4
5
3
11
7
48
14

1 .0
303. 5
4 7 .0
2 0 0 .3
16. 3
62. 5
15. 7
6 4 9 .2
93. 8
85. 3
132. 5

-

-

8
3

5 9 .6
40. 8
$2‘ 14

1 See footnote l, table 3.
293 and 282 plans provided hospital benefits for workers and dependents,
respectively.
2 Excluded are 2 plans that provided a maximum allowance of $100 for extra services during the first
year of coverage and up to $200 thereafter.
3 Benefit provided by each plan weighted by number of active workers covered.
4 Included is 1 plan that provided up to $100 during the first 31 days of hospitalization and $200
thereafter.




23
1955 o f $13 o r 4 .5 p e r c e n t fo r a ctiv e w o r k e rs and an in c r e a s e o f $39 o r
21 p e r c e n t fo r th eir depen den ts.
N ea rly the en tire d iffe r e n c e b etw een the a v ­
e ra g e r e im b u r s e m e n ts fo r w o r k e r s and fo r th eir dependents stem m ed fr o m the
m o r e lib e r a l a llo w a n ce by a sin g le la rg e plan in the sam p le. 24
L ow er b a s ic
a llo w a n ce s w e r e p ro v id e d , on the a v e ra g e , b y the 91 plans that did not p ro v id e
any add ition al re im b u rse m e n t.
The w o r k e r 's a llow a n ce a v e ra g e d $194 and the
d e p e n d e n ts , $214.
A ll but 4 of the 33 plan s p rov id in g additional r e im b u rs e m e n t on a p e r ­
cen tage b a s is s p e c ifie d the m axim u m am ount of the e x c e s s ch a rg e s fo r w hich
they w ould p r o v id e p a r tia l re im b u rse m e n t (table 18).
W hile th ese m axim u m
am ounts ran ged fr o m $500 to $ 5 ,0 0 0 , m o s t of them w e re betw een $ 1 ,0 0 0 and
$2, 500. With one ex cep tion , th ese plans paid 75 p e r c e n t o f the add ition al c h a rg e s .
The total am ount pa ya b le (b a s ic am ount plus additional re im b u rse m e n t) fo r ex tra
s e r v ic e s ran ged fr o m $615 to $3, 950. M o re than two out o f fiv e plans lim ite d
the am ount to betw een $1, 000 and $2, 500.
O f the 277 plan s p ro v id in g a h osp ita l ex tra s e r v ic e ben efit fo r both w o r k e rs
and dependents, 246 plan s s p e c ifie d id en tica l b en efits fo r both g rou p s (table 10).
W here th ese b e n e fits d iffe r e d , the dep en den ts' a llow a n ce w as a lm o s t alw ays le s s
lib e r a l than that p ro v id e d the w o r k e r.
R ed u ction in B en efits D uring A ctiv e E m ploym ent. — H osp ital b e n e fits fo r
w o r k e r s and th eir dependents w e r e r a r e ly m o d ifie d on the b a s is o f age during
the w o r k e r 's a c tiv e em ploym en t. L e s s than 10 plans red u ced b e n e fits when the
in su red attained an a dvan ced age (table 19). Under six o f th ese, the du ration of
the b e n e fit fo r the w o r k e r and h is dependents w as red u ced fr o m o v e r 120 days to
20 days p e r y e a r when the p e r s o n rea ch ed ag e 70, and under one plan, fr o m
365 days to 31 days p e r d isa b ility when the in su red re a ch e d age 65.
B en efits
w e re changed fr o m a " p e r d is a b ility " to a "p e r y e a r " b a s is under the other plan s.
C ontinuance o f C o v e ra g e D uring L a y o ff.— A s in d icated p re v io u s ly , h o s ­
p ita l b e n e fits a r e g e n e ra lly a v a ila b le to w o r k e r s a fter a sh ort p e r io d o f e m p lo y ­
m ent. When a ctiv e e m p loy m en t c e a s e s b e ca u s e o f la y o ff or oth er re a s o n s , h o s ­
p ita l c o v e r a g e te rm in a te s im m e d ia tely , or by the f i r s t o f the m onth fo llo w in g
the date o f sep a ra tion , u n less s p e c ific a g re e m e n t has been re a ch e d on continuance
o f group c o v e r a g e beyon d su ch date. 25 H ow ever, c o v e ra g e o f h o sp ita liz e d w o r k e rs
con tin u es to the end o f th eir d isa b ility . A lm o st h alf of the 298 plans with h osp ita l
b e n e fits s p e c ific a lly p ro v id e d fo r continuance of h osp ita l c o v e r a g e fo r p e r io d s
ranging fr o m 1 m onth to m o r e than 2 y e a r s follow in g the date o f la y o ff.
Only
o n e -th ird o f such plans p e rm itte d continuance fo r a p e r io d o f o v e r 6 m onths.
With few e x ce p tio n s, under plans that p ro v id e d continuance o f c o v e ra g e
fo r le s s than 6 m onths a fte r the date of la y off, the h osp ita l b e n e fit fo r the la id o ff w o rk e r w as fin a n ced in the sam e way that it w as fin an ced w h ile the w o rk e r
w as a c tiv e ly at w ork (by the e m p lo y e r only or jo in tly by the e m p lo y e r and the

24 T h is plan p ro v id e d a $500 b a s ic a llow a n ce fo r w o r k e rs and add ition al
r e im b u r s e m e n t fo r c h a r g e s o v e r $500; dependents r e c e iv e d a b a s ic a llow a n ce of
$200 w ithout add ition al r e im b u rse m e n t.
E x clu sion o f this plan re d u ced the a v ­
e ra g e b a s ic a llo w a n ce fo r w o r k e r s under a ll cash plans fr o m $300 to $215 and
under th ose p ro v id in g add ition al r e im b u rse m e n t fr o m $451 to $313.
This n a r ­
row ed the d iffe r e n c e betw een the a v e r a g e s fo r w o r k e rs and th eir dependents to
$11 fo r a ll ca sh plans and to $21 fo r th ose p rov id in g add ition al re im b u rse m e n t.
25 Under m any plans, a w o rk e r w h ose group c o v e ra g e c e a s e s m ay c o n ­
v e r t his c o v e r a g e to an individual p o lic y .




24
T A B L E 18. Plans providing nonmaternity hospital benefits fo j active w orkers and their dependents
by maximum amount of full reim bursem ent of charges forTipspital extras with an additional
reim bursem ent on a percentage b a sis, early 19f>9'1
_______________________________(W orkers in thousands)

__________________
W orkers

Dependents

Amount
Plans
All plans providing for full reim bursem ent of hospital extras
up to a fixed maximum with additional reim bursem ent on
a percentage b a s i s ________________________________________________
Basic amount
J 7 * ----------------$90 ________________________
$100
____ ___ _
$120 ___________________________
$180 ________
............. ..
$ 1 80
_
$190 _______________
. ....
$195 ___________________________
$200
_____
______
$200 _ _
___
_________ ...
$200 ___________________________
$225
____
______ ____
$240
$240
$240
$240
$250
$250
$260
$280
$300
$300
$300
$300
$315
$320
$360
$400
$465
$500

_________ _______ ____ ______
. _________ .
___________________________
_____________________
________
_____ _____ _
___________________________
. .
___ .... .
____
______
___
_________
____ .
___________________________
_____ _ _
____
____________ ________
________
_______
...... .

Plus 75 percent of next—
$ 1 .2 0 0
“
$ 1 T000 _____________ ____ ______
$ 3 ,9 0 0 ____________________________
$ 1 , 173 _____ _____
____ ___ _
$ 1 ,6 2 0
$ 3 r 750
$ 4 ,0 0 0 ____________________________
$ 1 .8 0 5
__
__ _
$ 1 .8 0 0
$ 2 ,4 0 0 ____________________________
$ 5 ,0 0 0
_______
______
$ 1 ,7 7 5
$ 4 . 000 _______________________
..
E xcess 3
$500
$ 2 ,0 0 0 .....................................
$ 4 ,0 0 0 ____________________________
$ 2 ,0 0 0 __ __
......................
$ 4 ,0 0 0 ...... _____________________
E x ce ss3
......
..... .
$ 1 T000
$ 1 .0 0 0
$ 2 ,0 0 0 ____________________________
$ 2 ,4 0 0
___
_
______
$ 4 ,0 0 0 ____________________________
$ 3 ,7 5 0
$ 1 .0 0 0 ____ _
_____
$ 1 ,0 0 0 ____________________________
E x ce ss3
__
_
.
$ 2 .0 4 7
E x c e ss3 ___________________________

W orkers

Plans

W orkers

s32

7 5 7 .6

232

26 1 . 1

1
1
1
1
1

7 .2
1 .6
1 5 .8
9 .0
8 .0

1
_
1
3
1
1
1
1
1

2 .9
7 .5
1 7 .5
1 0 .0
6 .0
3 .5
1 .5
6 .8

1
1
1
1
1
1
1
2
2
1
1
1
1
1
1

4 .9
15. 0
3 .4
1 6 .4
1 .8
9 .0
1 0 .6
4 4 .6
1 7 .4
3 .0
1 .3
1 .8
3 0 .0
1. 1
500. 0

1
1
1
1
1
1
1
1
1
3
1
_
1
1
1
1
1
1
1
1
3
1
1
2
2

7 .2
1 .6
1 5 .8
9 .0
8 .0
3 .0
2 .9
6 .0
7 .5
1 7 .5
10. 0
_
3 .5
1 .5
6 .8
3 .5
4 .9
1 5 .0
3 .4
1 6 .4
4 .9
9 .0
1 0 .6
4 4 .6
1 7 .4

_

_

_

_

1
1

30. 0
1. 1

1 See footnote 1, table 3.
293 and 282 plans provided hospital benefits for w orkers and dependents,
resp ectively.
2 Excluded is 1 plan that provided $300 basic amount plus 80 percent of additional charges up to a
maximum that is applicable to all hospital, surgical, and medical expenses.
3 No upper lim it on the additional amount was specified.

T A BL E 19.

Maintenance of nonmaternity hospital benefits during active employment for
w orkers and their dependents, early 1959 1
(W orkers in thousands)
W orkers

Dependents

Provision
Plans

W orkers

Plans

W orkers

All plans providing hospital benefits _________________________________

293

4 ,8 3 4 .0

282

4 ,7 1 7 .5

Maintained at constant level
Reduced at age---60
65 ...
_
____
70 _________________
___
Discontinued at age—
70 ____
___ ..... ..........................

283

4 ,7 6 4 .8

273

4 ,6 5 0 .8

2
1
6

4 .3
2 .5
6 1 .1

1
1
6

1 .8
2 .5
6 1.1

1

1 .3

1

1 .3

See footnote 1, table 3.




25
w o r k e r).
On the oth er hand, under plans continuing c o v e ra g e fo r 6 m onths or
lo n g e r the m eth od o f fin an cin g u su ally changed im m ed ia tely upon la y o ff, or at
the f ir s t of the fo llo w in g m onth, fr o m e m p lo y e r only or jo in tly to w o rk e r only.
R e tire d W o rk e rs and T h eir D ependents
R e tire d w o r k e r s and th eir dependents w e re p ro v id e d b e n e fits under a l ­
m o s t two out o f fiv e o f the plan s with b en efits fo r the a ctiv e w o r k e rs and th eir
dependents, r e s p e c t iv e ly (ta b le 2)— a sharp in c r e a s e o v e r 1955 when only one
out o f fou r plans extended b e n e fits to r e tir e d w o r k e rs and one out o f fiv e e x ­
tended them to r e t ir e d w o r k e r s 1 dependents.
In addition, th ree plan s in the
m a r itim e in du stry that did not p r o v id e b en efits fo r w o r k e rs w hile a ctiv e e m p lo y e e s
granted them c o v e r a g e o n ce they r e tir e d . 27 P r o v is io n s fo r the e x ten sion o f b e n e ­
fits to r e t ir e d w o r k e r s and th eir dependents w e re m o r e com m on in s in g le -e m p lo y e r
plans than in m u lti e m p lo y e r plan s (table 20).
A bout th r e e -fift h s o f the 112 plans with b en efits fo r both a ctiv e and r e ­
tire d w o r k e r s (66 plan s) p ro v id e d the r e tir e d w o r k e rs with the sam e b en efits,
in a ll r e s p e c t s , as th ose a v a ila b le to the w o r k e rs im m e d ia te ly b e fo r e r e tir e m e n t
(table 4). 28 A bout the sam e p r o p o r tio n o f the 111 plan s (68 plans) with b en efits
fo r dependents o f r e t ir e d w o r k e r s m aintained the sam e b en efits p ro v id e d d ep en d ­
ents o f a c tiv e w o r k e r s .

T A B L E 20.

P lan s providing hosp ital ben efits for re tire d w o rk e rs and their dependents
by type of plan and type of bargaining unit, e a rly 1959 1
(W o rk e r s in thousands)
em
Single < ployer

Total

M u ltiem p lo y e r

Type of plan 2 and group co vered
P lans
A ll plans with h ospital b en efits

W o rk e rs

Plans

W o rk e rs

P lans

W o rk e rs

298

4 ,8 9 4 .0

203

2 ,7 6 7 .5

95

2 ,1 2 6 . 5

115
48
59
8

2 ,0 7 7 .4
8 5 4 .8
1 ,1 9 4 .8
2 7 .8

86
33
45
8

1 ,3 9 8 .0
4 4 6 .9
9 2 3 .3
27. 8

29
15
14
-

6 7 9 .4
4 0 7 .9
2 7 1 .5
-

111
45
58
8

2 ,0 6 5 .4
8 4 4 .8
1 ,1 9 2 .8
2 7 .8

84
32
44
8

1 ,3 9 3 .0
4 4 3 .9
9 2 1 .3
2 7 .8

27
13
14
-

6 7 2 .4
4 0 0 .9
2 7 1 .5
-

R etired w o rk e rs
A ll plans extending hosp ital ben efits ___
Cash
S ervice
___ _
Cash and se rv ic e
Dependents of re tire d w ork ers
A ll plans extending h ospital b en efits ___
Cash
.. ...
S erv ic e
Cash and s e r v ic e ... _
, ,

1 See footnote 1, table 3 .
293 and 282
w o rk e rs and th eir dependents, r e s p e c tiv e ly .
2 See footnote 2 , table 9 .

plans

p rovided

hospital ben efits for active

26 See footn ote 8 , p. 4 .
27 W o rk e rs in the m a r itim e industry r e c e iv e fr e e m e d ic a l and s u r g ica l
c a r e in U. S. P u b lic Health S e r v ice h osp ita ls and outpatient fa c ilit ie s under the
United States M a ritim e law.
28 F o r this a n a ly sis, b e n e fits a v a ila b le to the w o rk e r re tir in g at n o rm a l
r e tir e m e n t age (u su a lly age 65) w e re co m p a re d with th ose a v a ila b le to them im ­
m e d ia te ly p r io r to r e tir e m e n t (u su ally age 64).




26
T A B L E 21. Relationship of ch aracteristics of hospital benefits for active and retired w orkers and
benefits for dependents of active w orkers and dependents of retired w ork ers, early 1959 1
(W orkers in thousands)
Benefit during
F ull-benefit period
P rovision

Type of plan
(cash or
service)

Daily room
and board

Extended coverage period
Duration

Daily room
and board

Duration

Plans W orkers Plans W orkers Plans W orkers Plans W orkers Plans W orkers
Active and retired w orkers 2
All plans providing benefits
for active worker and
retired worker

112

2 ,0 3 7 .9

112

2 ,0 3 7 .9

95

1 ,8 2 8 .0

24

1 6 6 .6

24

1 6 6 .6

No variation in provision ______
Variation in provision _________

108
4

2 ,0 1 6 .6
2 1 .3

98
14

1 ,9 3 5 .1
102. 8

87
8

1 ,7 1 8 .3
1 0 9 .7

23
1

1 2 9 .6
3 7 .0

23
1

1 2 9 .6
3 7 .0

All plans providing benefits
for dependents of active
w orkers and dependents
of retired w orkers

111

2 ,0 6 5 .4

111

2 ,0 6 5 .4

92

1 ,8 4 9 .0

24

1 6 6 .6

24

1 6 6 .6

No variation in provision .
Variation in provision _ ......

107
4

2 ,0 4 4 .1
2 1 .3

97
14

1 ,9 6 2 .6
102. 8

84
8

1 ,7 3 9 .3
1 0 9 .7

23
1

1 2 9 .6
3 7 .0

23
1

1 2 9 .6
3 7 .0

Dependents of active and
retired w orkers 3

M aximum cash
Hospital extra
room and
service benefit
board benefit

Basis of
payment
specified

Active and retired w orkers 2
All plans providing benefits for active worker and
retired worker

46

8 0 4 .4

112

2 ,0 3 7 .9

112

2 ,0 3 7 .9

No variation in p r o v is io n ________
Variation in provision
__

29
17

5 7 4 .6
2 2 9 .8

91
21

1 ,7 5 0 .3
2 8 7 .6

84
28

1 ,7 4 0 .2
2 9 7 .7

All plans providing benefits for dependents of active w orkers
and dependents of retired w orkers

45

8 3 1 .9

111

2 ,0 6 5 .4

111

2 ,0 6 5 .4

No variation in provision___ _____
Variation in provision
_______

29
16

7 1 9 .1
1 1 2 .8

91
20

1 ,7 8 1 .8
2 8 3 .6

85
26

1 ,7 7 5 .7
2 8 9 .7

Dependents of active and retired w orkers 3

1
2
3
retired

See footnote 1, table 3.
112 plans provided hospital benefits to both active w orkers and retired w ork ers.
111 plans provided hospital benefits to both dependents of active w orkers
w ork ers.

and dependents

of

B en efits w e re re d u ce d in the rem ain in g tw o -fifth s o f the plans by one of
two m eth ods.
M o re often this w as done by r e s tr ic tin g the am ount o f b en efits
p ro v id e d during the en tire r e tir e m e n t p e rio d .
F o r exam ple, som e plans lim ite d
the total am ount o f h o sp ita l b e n e fits p ro v id e d ; oth ers lim ite d th eir total paym ents
fo r a ll h osp ita l, s u r g ica l, and m e d ic a l b en efits com b in ed .
A few plans applied
th ese r e s t r ic t io n s to the b e n e fits a v a ila b le to a r e tir e d w o r k e r 1s en tire fa m ily
rath er than to each in dividu al p e rs o n .
The secon d and le s s co m m o n m ethod w as
by d ir e c t ly red u cin g the b en efits fo r each d isa b ility .
This m ethod in clu d ed r e ­
ducing the du ration as w e ll as the r o o m and b oa rd and extra s e r v ic e s b en efits.
S e r v ic e b e n e fits w e re p r o v id e d during the fu ll-b e n e fit p e r io d by o v e r
half of the plans with b e n e fits fo r r e tir e d w o r k e rs and th eir dependents, w hile
a ll ca sh b e n e fits w e r e p r o v id e d under a lm o st a ll of the rem ain in g plans (table 20).




27
TA B L E 22. Plans providing hospital benefits for retired w orkers and their dependents
by duration of full-benefit period and type of room and board benefit, early 1959 1
(W orkers in thousands)
Type of room and board benefits provided
Retired workers

Duration of fu llbenefit period 2

Cash

Total
Plans

A ll plans extending hospital
benefits ------------------------------ —
Duration specified ____________
21 days ____________________
22 and under 31 d a y s ---------31 days ------- ----------------------32 and under 70 d a y s ______
70 days ---------------------------------71 and under 120 days ------120 days ------------------------------121 days and o v e r __________
Duration not specified ________

W orkers

115

2, 077. 4

53

393

1, 638.
98.
4.
104.
300.
211.
25.
863.
31.
438.

35

16
1
11
7
14
2
3 37
5
22

8
2
5
2
5
8
2
2
2
6

Plans

-

1
9
6
9
1
6
3
18

Service
Plans

W orkers

869. 4

61

1, 204. 0

653. 3

57
16
2
1
5
1
30
2
4

981. 5
98. 2
5. 4
3. 0
37. 9
18. 0
813. 2
5. 8
222. 5

W orkers

-

4.
98.
297.
173.
7.
46.
25.
216.

5
8
5
9
2
0
4
1

Dependents of retired workers
A ll plans extending hospital
benefits -------------------------------

.

111

2, 065. 4

50

859. 4

60

1, 202. 0

Duration specified ------------------21 days ______________________
22 and under 31 d a y s ---------31 days _____________________
32 and under 70 d a y s ---------70 days ______________________
71 and under 120 d a y s _____
120 days ------------------------------121 days and o v e r __________
Duration not sp ecified --------------

389
16
2
8
6
14
2
3 36
5
22

I, 624.
98.
5.
93.
299.
211.
25.
860.
31.
440.

31

639. 3

57
16

981. 5
98. 2

8
2
5
2
5
8
2
2
2
6

-

2
6
5
9
1
5
3
19

-

5.
87.
296.
173.
7.
43.
25.
220.

5
8
5
9
2
0
4
1

-

2
1
5
1
30
2
3

-

5. 4
3. 0
3 7 .9
18. 0
813. 2
5. 8
220. 5

1 See footnote 1, table 3.
2 See p. 26 for a discussion of provisions affecting the frequency and duration of bene­
fit payments to retired workers and their dependents.
3 Included is 1 plan, covering 4, 000 w orkers, that provided service benefits for the
first 120 days of hospital confinement during the retirem ent period; thereafter, cash benefits
were payable.

V irtu a lly a ll o f the plan s that m ade h osp ita l b e n e fits a v a ila b le fo r both
a ctiv e and r e t ir e d w o r k e r s p ro v id e d the sam e type o f b en efits (ca s h o r s e r v ic e )
fo r both g ro u p s (ta b le 21). S im ila rly , the type of b en efits a v a ila b le to dependents
of a ctiv e and r e t ir e d w o r k e r s w e r e u su ally the sam e.
In the few plans w h ere
the type o f b e n e fits v a rie d , a ctiv e w o r k e rs and th eir dependents u su a lly r e c e iv e d
s e r v ic e b e n e fits, w hile r e t ir e d w o r k e rs and th eir dependents got ca sh or a c o m ­
bination o f ca sh and s e r v ic e b e n e fits.
The fu ll-b e n e fit p e r io d fo r r e tir e d w o r k e rs and th eir dependents ranged
fr o m 21 days to m o r e than 121 days in length (table 22).
About one out of th ree
plans p r o v id e d each grou p with 120 fu ll-b e n e fit days. E xtended c o v e r a g e p e r io d s ,
during w hich p a r tia l b e n e fits w e re payable, w e r e p ro v id e d in 24 plan s.
Chief
am ong th ese w e r e 16 plans with 21 fu ll-b e n e fit days that p ro v id e d an extended
c o v e r a g e p e r io d o f 180 days.
The fu ll-b e n e fit p e r io d and the extended c o v e ra g e p e r io d w e re u su ally
the sam e fo r a ctiv e and r e t ir e d w o r k e rs , and fo r th eir dependents (table 21).




28
H osp ital b e n e fits fo r r e t ir e d w o r k e rs and th eir dependents w e r e g e n e ra lly
a v a ila b le on a " p e r d is a b ility " b a s is .
About o n e -s ix th of the plan s, h ow ev er,
s p e c ifie d a set o f b e n e fits fo r r e t ir e d w o r k e rs and th eir dependents that w as p a y ­
ab le on ly on ce during the w o r k e r 1s r e tir e m e n t p e r io d .
When th ese b e n e fits w e re
exhausted, c o v e r a g e c e a se d .
B e fo r e re tire m e n t, w o r k e rs and dependents under
th ese plan s w e r e c o v e r e d on a "p e r d is a b ility " b a s is .
P la n s p ro v id in g ca sh r o o m and b oa rd b e n e fits— som ew hat le s s than h alf
th ose with h o sp ita l b e n e fits fo r r e t ir e d w o r k e rs and th eir dependents— paid r e i m ­
b u rse m e n ts ranging fr o m under $8 to $21 a day (table 23).
A s fo r a ctiv e w o r k ­
e r s , about th ree out o f fiv e plan s paid r e tir e d w o r k e r s $12 o r m o r e d aily ; sligh tly
fe w e r plans gave r e t ir e d w o r k e r s 1 dependents this am ount.

T A B L E 23.

Plans providing hospital benefits for retired w orkers and their dependents
by daily room and board allowance, early 1959 1
(W o rk ers in thousands)
Retired w orkers

M axim um daily room and board allowance
Plans
A ll plans extending cash benefit

W ork ers

Dependents of
retired w orkers
Plans

W ork ers

-----------------------

53

869. 4

50

859. 4

Daily allowance specified ----------------------------------Under $8 ----------------------------------------------------------$8 and under $ 9 ----------------------------------------------$9 and under $ 10 -------------------------------------------$10 and under $11 ------------------------------------------$11 and under $ 1 2 ------------------------------------------$ 12 and under $ 1 3 ------------------------------------------$13 and under $ 1 4 ------------------------------------------$ 14 and under $ 1 5 ------------------------------------------$15 and under $ 1 6 -------------------------------- -------$16 and under $ 1 7 ____________________________
$18 and under $ 1 9 ------------------------------------------$20 and under $21 ------------------------------------------Daily allowance not specified __________________

48
1
1
4
11
1
10
6
4
5
1
1
3
5

729.
7.
35.
35.
87.
106.
74.
34.
182.
140.
7.
6.
13.
139.

45
2
1
3
11
2
10
4
4
3
2

719.
11.
35.
30.
88.
112.
72.
24.
182.
135.
14.

7
2
0
0
5
0
2
2
0
8
5
8
5
7

-

3
5

7
7
0
5
0
4
5
8
0
0
3

-

13. 5
139. 7

1 See footnote 1, table 3.
115 and 111 plans extended hospital benefits to retired
w orkers and dependents, resp ectiv ely.
See p. 26 for a d iscu ssion of p rovisions affecting
the lev el and amount of benefit payments to retired w orkers and dependents.

Only 7 o f the m o r e than 100 plans co v e rin g r e tir e d w o r k e rs and th eir
dependents d iscon tin u ed c o v e r a g e a fter a s p e c ifie d tim e follow in g r e tir e m e n t
(ta b le 24).
Under s ix o f th ese plans, h osp ita l b e n e fits rem a in ed in e ffe c t fo r
1 y e a r o r le s s a fte r r e tire m e n t.
M atern ity B en efits
N ea rly a ll plan s c o v e r e d h osp ita l ex p en ses resu ltin g fr o m p reg n an cy , 29
but in fou r out of fiv e plans, add ition al lim ita tion s w e re p la ce d on m a tern ity
b e n e fits, such as red u cin g the n um ber o f days fo r w hich b en efits w ould b e paid
(ta b le 25). 30 T w o -fifth s o f the plans m ade a v a ila b le to w om en w o r k e rs eith er a

29 See tabulation on p. 11 •
30 Under som e plan s, b e n e fit lim ita tion s w e re p la ce d on a ll types o f m a tern ity
c a s e s (n o rm a l d e liv e r y , C a e sa re a n section , e c to p ic p regn an cy, m is c a r r ia g e , -e t c .);
under other plan s, they w e r e p la ce d on n o rm a l d e liv e r y c a s e s only.
The d i s ­
cu s s io n in this se c tio n c o v e r s b e n efits p ro v id e d in n o rm a l d e liv e r y c a s e s only.




29
T A B L E 2 4 . Length of time hospital benefits w ere available to
re tired w ork ers and their dependents, early 1959 1
(W o rk ers in thousands)
Benefits available

Plans

W orkers

115

2 ,0 7 7 .4

2 108
7

1 ,7 6 1 .8
3 1 5 .6

A ll plans extending hospital benefits _________________

111

2 ,0 6 5 .4

For duration of retirem en t ____________________________
For specified period ____________________________________

2 104
7

1 ,7 4 9 .8
3 1 5 .6

R etired w orkers
A ll plans extending hospital benefits _________________
For

d u ration

of retirem en t

For specified period ____________________________________

Dependents of retired w ork ers

1
2
year of
serv ice

TABLE 25.

See footnote 1, table 3.
Included is 1 plan that provided benefits only during the first
retirem en t for w ork ers who retired with le s s than 5 y e a r s '
and their dependents.

Relationship of m aternity and nonmaternity benefits provided women w orkers
and dependent w iv e s, early 19 59 1
(W ork ers in thousands)
W om en w orkers

Dependent w ives

P rovision
Plans

W ork ers 2

Plans

W orker s

4 ,4 7 7 .9

271

4 ,5 5 7 .9

52

1 ,1 7 5 .5

219

3 ,3 8 2 .4

A ll plans providing both m aternity and
nonmaternity benefits

2 73

Benefits for m aternity c a s e s :
Same as nonmaternity benefits
Different from nonmaternity benefits in
one or m ore resp ects

52

1 ,0 1 1 .5

221

3 ,4 6 6 .4

1 See footnote 1, table 3. 293 and 282 plans provided hospital benefits for nonmaternity
ca ses for w ork ers and dependents.
2 Number of w ork ers covered by plan may not indicate the frequency of use of m aternity
provisions since the proportion of women covered varied substantially among plans.

fla t am ount (e. g. , $125) fo r a ll h osp ita l ch a rg e s (r o o m , b oa rd , and ex tra s e r v ­
ic e c h a r g e s), o r a g e n e ra l lu m p -su m m a tern ity a llow a n ce that cou ld be u sed
tow ard a ll types o f m e d ic a l e x p e n ses in cu rre d , in o r out o f the h osp ita l.
M ore
than h alf of the plans m ade th ese types of b en efits a v a ila b le to dependent w iv e s .




30
C o v e ra g e under ea ch o f th e se
fo llo w in g tabulation:

two types

is shown in the la s t two ite m s o f the

W om en w o r k e rs 1 D ependent w iv e s
T ype o f b e n e fit p r o v id e d fo r
h o sp ita liz e d m a te rn ity c a s e s

P lan s

A ll plan s p ro v id in g a m a t e r ­
nity b e n e fit fo r h o s p ita l­
iz e d c a s e s _____ _____________

P lan s

W o rk e rs
(in thou­
sands)

273

S p e cifie d b e n e fit o r a llo w a n ce
p r o v id e d fo r ea ch type o f
h o sp ita l s e r v ic e __________________
F la t am ount p r o v id e d fo r a ll
h o sp ita l c h a r g e s __________________
G en era l lu m p -su m am ount fo r
e x p e n se s in c u r r e d in o r out
o f h o s p it a l _________________________
1 See footn ote 2,

W o rk e rs
(in thou­
sands)

4, 477. 9

271

4, 557. 9

161

2, 727. 1

124

2, 103. 4

82

878. 1

116

1, 648. 3

30

872. 7

31

806. 2

table 25.

M atern ity b e n e fits fo r w om en w o r k e r s and dependent w iv es w e re a v a ila ­
b le im m e d ia te ly on b e c o m in g in su red under about a fifth o f the plans (ta b le 26).
The rem a in in g plans had w aiting p e r io d s d esig n ed to r e q u ir e that p reg n a n cy c o m ­
m e n ce d w h ile they w e r e in su red . About 100 plans sim p ly stated that req u irem en t,
w h ile a som ew h at g r e a te r n u m ber, in n o rm a l d e liv e r y c a s e s , re q u ire d that w om en
be in su re d fo r a s p e c ifie d p e r io d , g e n e ra lly 9 m onths.

T A B L E 2 6 . A vaila bility of benefits for h osp italized m aternity c a se s to newly
in su red w om en w ork ers and dependent w iv e s, e a rly 1959 1
j^Worke^^jLi^thou^
W om en w ork e rs

Dependent w ives

A vaila bility of benefits
P lans
A ll plans providing ben efits for
h osp italized m atern ity ca s e s
B en efits becom e available
i m m e d ia t e l y ________________________________
If pregnancy co m m en ces while
in su red
A fter being in su red for:
L e s s than 8 months
8 months
9 months
.... ...
10 months
...
___ .. .....
12 months
.... ..... . .
____ ...
Other




See footnote 1, table 3.
See footnote 2 , table 2 5 .

W o rk e rs 2

P lans

W o rk e rs

273

4 ,4 7 7 .9

271

4 ,5 5 7 .9

58

8 1 8 .8

53

9 2 9 .4

100

1 ,9 7 8 .2

103

1 ,9 8 5 .6

3
12
84
13
1
2

3 6 .3
1 1 7 .9
1 ,3 4 0 .8
1 3 7 .6
1 2 .0
3 6 .3

3
12
85
12
1
2

3 6 .3
1 1 7 .9
1 ,3 1 2 .3
1 28 . 1
1 2 .0
3 6 .3

31
T y p es o f B e n e fits.— M ost plans p ro v id e d the sam e type o f b e n e fit (ca sh
or s e r v ic e ) in m a tern ity c a s e s as in n on m atern ity c a s e s .
About 3 out o f 5 o f
the plans p ro v id in g a s p e c ific h osp ita l m a tern ity b e n e fit (150 p la n s )31— paid ca sh
b en efits during the fu ll-b e n e fit p e r io d (table 27).
S e rv ice b en efits w e re p ro v id e d
w om en w o r k e r s and dependent w iv es under about 1 out o f 3 plans (80).
Under
th ese plans, s p e c ifie d b en e fits w e re guaranteed rath er than a llo w a n ce s p ro v id e d
tow ard the c o s t o f the s e r v ic e s .

T A B L E 2 7. Types of hospital benefits provided in m aternity ca ses for women w orkers and
dependent w iv e s , early 1959 1
(W ork ers in thousands)
W omen w orkers

Dependent w ives

Plans

W ork ers 2

Plans

W ork ers

3 243

3 ,6 0 5 .2

3 240

3 ,7 5 1 .7

150
80
13

1 ,3 9 3 .6
1 ,6 0 1 .4
6 1 0 .2

150
80
10

1 ,8 9 8 .3
1 ,7 6 5 .4
88. 0

Type of benefit

A ll plans providing hospital benefits
for m aternity ca ses _____________________
Cash
Service
Cash and se rv ice

_

_
_

___

1 See footnote 1, table 3.
2 See footnote 2, table 2 5.
3 Excluded are 30 and 31 plans that provided a general lu m p -su m m aternity allowance
for women w orkers and dependent w ives, re sp ectiv ely.

G en era lly , under plans p rov id in g h osp ita l b en efits fo r both w om en w o r k ­
e r s and dependent w iv es, the sam e type of b e n e fit (ca sh or s e r v ic e ) w as p ro v id e d
each group.
R oom and B oa rd B e n e fits . — F u ll d aily r o o m and b o a rd b e n e fits w e re
p ro v id e d fo r p e r io d s ranging fr o m 6 days to m o r e than 121 days (table 29).
W here a du ration w as sp e c ifie d , m o s t freq u en tly w om en w o r k e rs w e re c o v e r e d
fo r 14 days (47 pla n s), and dependent w iv e s fo r 10 days (36 plan s).
F u llb e n e fit p e r io d s of 70 days or m o r e w e re u su ally p ro v id e d in plans with s e r v ic e
ro o m and b o a rd b e n e fits.
U sually the fu ll-b e n e fit p e r io d w as the sam e fo r
w om en w o r k e r s and dependent w iv e s.
In addition to the plans sp ecify in g the num ber of days of b e n e fits, th ere
w e r e m any plans w hich did not d ir e c tly lim it the duration of b e n e fits.
T h ese
la tter plans in d ir e ctly gave m uch the sam e fin a n cia l a s s is ta n c e by paying a fla t
am ount fo r h o sp ita l c a r e (i. e. , fo r ro o m , board , and h osp ita l extra ch a r g e s —
se e b elow ).
A sh o r te r fu ll-b e n e fit p e r io d w as s p e c ifie d fo r m a tern ity than fo r n on ­
m a tern ity c a s e s in 98 plans c o v e rin g w om en w o rk e rs and in 62 c o v e rin g d ep en d ­
ent w iv e s (ta b le 28).
The ca sh da ily r o o m and b o a rd a llow a n ce p ro v id e d during the fu ll-b e n e fit
p e r io d fo r w om en w o r k e r s and dependent w iv e s ranged fr o m le s s than $7 to m o r e

3
1
E x clu d es the plans that p ro v id e d
w om en w o r k e r s and dependent w iv e s.




a g e n e ra l lu m p -su m

a llow a n ce

fo r

32
TABLE 28.

Relationship of characteristics of hospital maternity benefits for women workers and
dependent wives to nonmaternity hospital benefits, early 1959 1
(Workers in thousands)
Benefits during---Full-benefit period
Type of plan
(cash or
service)

Provision

Plans

Daily' room
and board
Plans

W ork ers 2

W ork ers 2

Duration
Plans

W ork ers 2

Women workers
All plans providing maternity and
nonmaternity benefits

2 ,7 2 7 .1

4 ,4 7 7 .9
3 ,8 5 4 .7
6 2 3 .2

152
9

271

4 ,5 5 7 .9

4 124

2 ,1 0 3 .4

3 ,5 6 6 .9
9 9 1 .0

147

2 ,6 3 9 .1
8 8 . 0

208
63

No variation ...........
_ _
V a ria tio n -----------------------------------------------

273
206
67

3

4 1 6 1

4

2 ,6 2 5 .2
1 ,0 0 4 .2
,621.0

49
98

1

Dependent wives
All plans providing maternity and
nonmaternity benefits
No variation
Variation

3

1 2 0

4

2 ,0 1 9 . 1

4 1 1 1

2 ,0 8 1 .8

49

2 1 . 6

1

,

1 6 8 . 2

850 .9

6 2

Benefits during— Continued
Maximum cash
room and board
benefit

Extended coverage period
Daily room
and board
Plans W ork ers 2

Hospital extra
service benefit

Duration
Plans Workers 2

Plans W ork ers 2

Plans Workers 2

Women workers
All plans providing maternity and
nonmaternity benefits
No variation
V a r ia tio n

_ _
_

44

2 2 .9

44

2 2 .9

4
-

2 2 .9
-

4
-

2 2 .9
-

44

2 3 .4

44

2 3 .4

4
-

2 3 .4
-

4
-

2 3 .4
-

4 6 8

548. 3

57

6 8 .3
4 8 0 .0

35

2 9 6 . 8

4 1 6 1

11

2 ,7 2 7 .1

41

2 ,2 7 8 .4
448. 7

124

2 ,1 0 3 .4

94
30

1 ,8 3 8 .3
265. 1

1 2 0

Dependent wives
All plans providing maternity and
nonmaternity benefits ______________
No variation
Variation

4

1 0

25

6 7 .3
2 2 9 .5

4

1
See footnote 1, table 3.
293 and 282 plans provided workers and dependents, respectively,
hospital benefits for nonmaternity ca ses.
2
See footnote 2, table 25.
3
Included are plans providing a flat amount for room, board, and extra services and a general
lum p-sum allowance.
4
Excluded are plans providing a flat amount for room, board, and extra services and a general
lum p-sum allowance.

than $16 (table 30).
This allowance averaged $12. 15 for women workers, and
$12.80 for dependent wives— an increase over the corresponding late 1955 averages
of about $1 for workers and $2. 30 for dependents.
As in nonmaternity cases,
a higher daily allowance was found in plans that also specified a longer fu llbenefit period.

The cash daily allowance provided for hospital room and board for m a ­
ternity confinements was usually the same as the amount specified for nonma­
ternity cases.




33
T A B L E 2 9.

Plans providing hospital benefits for women w orkers and dependent w ives
in m aternity ca ses by duration of fu ll-b en efit period and type of
ro om and board benefits, early 1959 1

^ W o rk ei^
Type of room and board benefit fo r—
W om en w orkers
Duration of fu ll-b en efit period
Total

Cash

Plans
A ll plans providing hospital ben efits for m aternity ca ses _________
Duration specified _________________
Under 8 days
____________________________
8 days
1 0 days ___________________________
11 and under 14 d a y s ___________
14 days
__________________________
15 and under 7 0 days
7 0 days
7 1 and under 120 d a y s __________
1 2 0 d a y s __________________________
1 2 1
days and over
_
Duration not sp ecified 4 ____________

W orkers

243

3 ,6 0 5 .2

149

2 ,6 5 4 .6
92. 8
14. 1
1, 1 4 2 .6
45. 0
355. 9
4 1 .5
121. 3
57. 1
782. 5
1 . 8
9 5 0 .6

3

1 2

3
37
1

47
6
8
6

28
1

94

2

Plans

156
6 2
1

3
7
1

43
4
2
1

Service

W orkers

1 ,4 7 0 .7
520. 1
3 .5
14. 1
94. 0
4 5. 0
307. 8
2 9 .5
19. 0
7 .2

-

-

-

-

94

9 5 0 .6

2

Plans

Wo r k e r s 2

87

2, 1 34 .5

87

2, 1 3 4 .5
8 9 .3

11

-

30
-

4
2
6

5
28
1

-

1, 0 4 8 .6
-

48. 1
1 2 . 0
102 .3
4 9 .9
7 8 2 .5
1 . 8

-

_

84

1, 7 7 6 .3

82

1, 589. 0
8 9 .3

Dependent w ives
A ll plans providing hospital bene­
fits for m aternity ca ses _________
Duration specified _________________
Under 8 days ____________________
8 days
____________________________
1 0 days ____________________________________________
11 and under 14 days ___________
14 days ___________________________
15 and under 70 days __________
7 0 days ____________________________________________
7 1 and under 120 d a y s _________________
1 2 0 d a y s _________________________ __________
1 2 1
days and over ________________________
Duration not sp ecified 4 ____________

3240
109
12

3
36

3 ,7 5 1 .7

156

1, 831. 8
92. 8
14. 1
6 3 6 .3

27

1 1
6

7
6

27
1

131

-

1 07 .7
42. 0
114. 0
5 6 . 6
766. 5
1

. 8

1 ,9 1 9 .9

1

3
8

-

1, 9 7 5 .4
2 42. 8
3. 5
14. 1
9 3 .9
-

2

75. 6
15. 5
19. 0

3

2 1 . 2

8
2

-

129

-

1 ,7 3 2 .6

1 1

-

28
-

3
4
5
3
27
1
2

-

5 4 2 .4
-

3 2. 1
2 6. 5
95. 0
3 5 .4
766. 5
1 . 8

187.3

See footnote 1, table 3.
See footnote 2, table 25.
3
Excluded are 30 and 3 1 plans that provided a general lu m p -su m m aternity allowance
for women w orkers and dependent w ives, resp ectively.
4
Included are plans that provided a flat amount for room , board, and hospital extra
ch arges.
1

2

The maximum amount payable for room and board during a maternity
confinement ranged from le ss than $100 to more than $250 (table 31).
Hospital Extra Services Benefits. — Allowances for hospital charges, other
than for room and board, were specifically provided women workers and dependent
wives under 161 and 124 plans, respectively (table 32). 32 Usually the plans
paid up to a fixed amount, or the full cost of specified services.
The full cost
of specified extra services was provided by more than half of the plans (86)

room,

32
board,




Not included in these groups are plans that provided a flat amount for
and extra services.




TABLE 30. Plans providing hospital benefits for women workers and dependent wives in maternity cases
by daily room and board allowance and maximum duration of full-benefit period, early 1959 1

C
W
^

(Workers in thousands)
Maximum number of days, in full-benefit period
Under

Daily room and board allowance

1 0

days

1 0

days

1 2

days

Over 14 days

14 days

Other

Plans W orkers 2 Plans W orkers 2 Plans 1Workers 2 Plans W orkers 2 Plans W orkers 2 Plans W orkers 2 Plans W orkers 2
Women workers
All plans providing cash room
and board allowance for
maternity cases
_ ------Under $7 _
_______
___ _
$7 and under $ 8
.
$ 8
and under $ 9 _T,
_
_
$ 9 and under $10 ,
, ...
$ 1 0 and under $ 1 1 ______ __________
$ 1 1
and under $ 1 2
_
_
_ _
$ 1 2 and under $13
----------------$13 and under $14 _ _
$14 and under $15
$15 and under $16
_
$16 and under $17
$17 and over
Not specified
_ __ ... _ .
Average maximum daily
allowance 4 .........
__ .

3

74
2

592.6

2

14
3
4
1 2
2

5
5

7

9 4 .0

-

82.9
2 0 . 0

6 0 .5
3 .3
9 7 .6
5 .8
13.2
9 8 .5
79.2
4 1 .4
4 3 .7

-

_
3

-

_
14.1

-

3 .6

1

-

-

1

7 .5

_
_
-

_
_
_

_
-

-

1

3 .5

2

_
-

_
_
-

1

4 5 .0

1

17.6

4 6 .5

-

7
4
14

4

4 5 .0
-

-

-

4

1

9 .8
5 2 .8

1
-

1.0
-

8

9 3 .9

-

-

19.3
_
-

1

-

_
_
_
_
_
_
_
_
-

1

43

_
_
_
_
-

-

3 0 7 .8

-

2

8

7 5.6

8
2
11
1
2
8
1

1

5 5 .7

1 2

7 2 .5

1 .5
4 7 .3
3 .9
3 4 .2
3 .3
5 9 .6
3 .0
7 .0
7 6.2
2 6 .4
1 6.4
2 9 .0

2

7

-

1

-

1 4.5

2

-

3 2 .0

1

1 . 6

2

4 .7

-

-

1

7 .2

1

1
-

1.0
-

1

1 . 8

2

6 . 2

1

9 .0

_

-

3

2 4 .0
-

-

-

-

-

1 1.5
_
-

3

14.7

13

8 4.3

$ 1 2 .1 5

Dependent wives
All plans providing cash room
and board allowance for
maternity cases
... .....
Under $ 7
. _____ __________________
$ 7 and under $ 8 ... _
$ 8
and under $9
$ 9 and under $10 ___
_
$ 1 0 and under $ 1 1
_
___
$ 1 1
and under $ 1 2 ... .
$12 and under $13 _____ _ _
_
$13 and under $14 ____ ____
$14 and under $15 __ —_ r
____
$15 a n d under $16
... .
... .
$ 1 6
and over
Not specified
_ _ _
_
_
Average maximum daily
allowance 4
... ......

340

327.1

2
2
1

8
1

8
3

15.5
9 .5

_

17.6

.

1 . 6

4 0.1
1 . 0

8

8 3.9
1 8.8
55.1
7 5.9

2

1 1 . 0

3

1 4.7

2

4

.

_

_
3

_
-

_
1
_
_

7

_
_
_

_
14.1
_
_
_
-

3 .5
_
_

1
1

_
1

_
2

_
1

1
1
-

1.0

2 .5
-

7 .5
_
2 3.1
_
5 2 .8
6 . 0

1.0
_

5 5 .7
.

-

_
_

_

_

1

7 .0

_

_
_
_
_
_

1

_
_
_
_
_

_

_
_
_

_
_
_

1

_
2
1

3
_
_

_
1 .5
_
3 4 .2
6 . 0

_
2 6 .9

_

_

2
1
1

_
_
1
1
_

1 4 .5
_

_
1 4 .0
1 . 0

7 .2
_
_
9 .0
1 0 . 0

_

_
_
1

_
_
1 . 6

3

3 .0
_
1 9.4

2

1 2 . 8

1

_

1
2

2 .3
3 0.5

_

_

3

14.7

$ 12 .8 0
________ 1
_____________

See footnote 1, table 3.
See footnote 2, table 25.
Excluded are 82 and 116 plans that provided a flat amount for room and board and hospital extra charges for workers and depend­
ents, respectively.
4
Benefit provided by each plan weighted by number of active workers covered.
1

2

3

35
TA B L E 31.

Plans providing hospital benefits for women w orkers and dependent wives in maternity
ca ses by maximum room and board allowance, early 1959 1
(W orkers in thousands)
Dependent wives

Women workers

Maximum room and
board allowance 2

Plans

A ll plans providing maximum room and
board allowance for maternity c a s e s ________
Under $100 _______________________________________
$100 and under $ 1 2 5 ------------------------------------------$125 and under $ 1 5 0 ____________________________
$150 and under $ 1 7 5 ____________________________
$175 and under $200 ____________________________
$200 and under $225 ____________________________
$225 and under $250 ____________________________
$250 and o v e r ____________________________________

61
3
9
1 2

16
5
9

3

484. 9
50.
109.
42.
125.
15.
77.

1

228.
3.
41.
57.
45.
6 .
27.

2

8

5
7
2

-

Workers

5
3
4

6

1

4

-

7

Plans

25

W orkers

-

64. 0

47.

5
1
3
5
0

9

-

6

9

6

See footnote 1, table 3.
Where the maximum room and board allowance was not specified, it was computed by multiplying
the maximum daily allowance by the number of days of hospital stay provided.
Excluded are all service
plans, all cash plans providing a flat amount for room, board, and hospital extra charges, a few cash or
cash and service type plans under which no maximum room and board allowance was specified, and 1 plan
that provided a lower maximum allowance during the first year of coverage than during succeeding years.
3
See footnote 2, table 25.
1

2

T A BL E 32.

Plans providing hospital benefits for women workers and dependent wives in maternity
cases by method of specifying allowance for hospital extras, early 1959 1
(W orkers in thousands)
Women workers

Dependent wives

Method
Plans
A ll plans providing extra hospital benefit
for maternity cases 3 _________________________
Allowance provided for expense in c u rre d ____
Up to a fixed a m o u n t___ ___________________
With additional reimbursement on a
percentage basis _______________________
Without additional reimbursement on
a percentage basis ____________________
Up to a difference between room and
board charges and a fixed amount ___
Other___________________ _____________________
Benefit provided on a service basis __________
For entire benefit period ___________________
For part of benefit period and reim b u rse­
ment of percentage of cost for r e ­
mainder of benefit period ________________

1
2
3

W orkers

161
75
62
6

56
1 0

3
8 6
8 6

See footnote 1, table 3.
See footnote 2, table 25.
Excluded are plans that provided a flat amount for




Plans

W orkers

2, 727. 1

124

2, 103. 4

1, 0 4 8 .6
9 4 8 .9

38
2 1

260. 9
141. 7

2

4

15.

6

422. 3

17

126.

1

.6
13. 1
1 ,6 7 8 .5
1, 678. 5

14
3

106. 1
13. 1
1, 842. 5
1 , 828. 0

526.

6

8 6

8 6

84

14. 5

2

room,

board,

and hospital

extra

charges.

36
covering women workers and by two-thirds of the plans (84) covering dependent
wives.
Extras up to a fixed amount were paid under 62 plans covering workers
and 21 plans covering dependents.
The basic amounts available under the plans
ranged from under $50 to over $275 (table 33).
In addition to the basic amount,
a few plans paid a percentage of the charges after the fully reimbursable amount
was exhausted.

T A B L E 3 3. Plans providing hospital benefits for women w orkers and dependent w ives in m aternity cases
by m axim um amount of full reim bursem ent of charges for hospital extras, early 1959 1
(W orkers in thousands)
Dependent w ives

W omen w orkers

Amount

Total

Plans
A ll plans providing full r e im ­
bursem ent up to a maximum
fixed amount
_

Plans without
additional r e im ­
bursem ent on
percentage basis

_

Under $50 ______________________________
$50 and under $ 7 5 _____________________
$75 and under $100
$100 and under $125 ____________ __ __
$125 and under $150
$150 and under $175
$175 and under $200 ________________ _
$ 2 0 0
and under $225 __________________
$225 and under $250
$250 and under $275
$275 and over _________________________

3 ,4

5 9

2

4
8

14
4
6
2

5
3
2

9

W orkers

9 1 3 .7
5 6 .0
1 1 .5
8 7 .6
6 9 .3
1 2 .5
5 9 .2
14. 1
1 8 .7
1 1 . 0

1 8 .2
5 5 5 .6

2

Plans W o rk e rs 2 i Plans

4

53
2

4
7
14
4
6
2

5

1

2
6

3 8 7 .1
5 6 .0
1 1 .5
8 6 . 0

6 9 .3
1 2 .5
5 9 .2
1 4 .1
1 8 .7
6 . 0

1 8 .2
3 5 .6

Plans without
additional r e im ­
bursem ent on
percentage ba sis

Total

5 2 1

1
1
4
4
-

1
2

3
2

_
3

W orkers

1 4 1 .7

1.0
3 .0
4 2 .9
1 6 .2
-

1 8 .0
1 7 .5
1 3 .5
5 .0
2 4 .6

Plans W orkers

17

1
1
3
4
-

1
2

3
2

1 2 6

.

1

1.0
3 .0
4 1 .3
1 6 .2
1 8 .0
1 7 .5
1 3 .5
1 5 .6

See footnote 1, table 3.
See footnote 2, table 25.
Included are 6 plans, covering 5 2 6 ,6 0 0 w ork ers, that provided additional reim bursem ent on a
percentage b a sis.
4
Excluded is 1 plan that provided a lower m axim um allowance for extra serv ice during the first
year of coverage than during succeeding y e a r s, 1 plan that provided an amount equal to 1 0 tim es the
hosp ital’ s daily charges for sem iprivate room accom m odations, and 1 plan that provided an allowance
up to a fixed m aximum plus an additional allowance for charges in excess of the extra serv ice allowance
and the other allowances provided under the plan.
5
Included are 4 plans, covering 1 5 ,6 0 0 w ork ers, that provided additional reim bursem ent on a
percentage b a s is .
1

2

3

Flat Amount for Hospital Care. — A flat amount, to be applied toward
the combined cost of all hospital charges (i. e. , room, board, and extra serv­
ices), was provided under about 3 out of 10 plans (82) covering women workers
and more than 2 out of 5 plans (116) covering dependent wives (table 34).
While
the amount available under these plans for each group ranged widely (from $50
to over $175), 7 out of 10 of the plans paid from $75 to $125.
General Lump-Sum Allowance.— A general lump-sum allowance, instead
of separate allowances for hospital charges and for the obstetrician or other
physician, was provided for women workers by 30 plans and for dependent wives
by 31 plans (table 35); This allowance, unlike the flat amount described in the
preceding section, could be used for any charges incurred in or out of the hos­
pital in connection with the pregnancy. The amount payable varied from $50 to
$275.
However, slightly more than half of the plans provided women workers
and dependent wives with a general lump-sum allowance of either $100 or $150.




37
T A B L E 34.

Plans providing hospital benefits for women w orkers and dependent wives in maternity cases
by the flat amount allowed for room , board, and hospital e x tr a s, early 1959 1
(W orkers in thousands)
Dependent wives

Women w orkers
A m ount
Plans

W orker s

Plans

W orker s

1 1 6

2

1 ,6 4 8 .3

A ll plans providing a flat amount for room ,
board, and hospital extras for maternity
82
$50 and under $75 ______________________ ______
$75 and under $100 _ _ _
__
__
$100 and under $12 5 ____________________________
$12 5 and under $150 _
__
__
$150 and under $175 __ ________ ________ ___
$ 175 and over ____________________________________

1
2
3
4

2

28
29
4 12

9
2

8 78 . 1
1 4 .8
225. 1
2 9 1 .8
2 4 1 .0
9 8. 5
6 .9

6 9 .9
7 6 6 .0
5 5 9 .4
1 17 .9
6 4 .7
7 0 .4

8

33
48
15

3

8

4

See footnote 1, table 3.
See footnote 2 , table 2 5.
Included are 2 plans that provided a lower amount during the first year of coverage.
Included is 1 plan that provided a lower amount during the first year of coverage.

TA B L E 35.

Plans providing a general lum p-sum maternity allowance for women w orkers
and dependent wives by amount, early 1959 1
(W orkers in thousands)
V/omen workers

Dependent wives

Amount
Plans
A ll plans providing a general lum p-sum
allowance for maternity cases

30

$ 5 0 .......... ............................... .................................... .........
$ 7 5 ______ __ ________ __ _____ ___________ ______

3
3

$ 1 0 0

8

_____________________________________________
$175
$ 1 50
$175 ..................................................................................
$ 2 0 0
_
_______
__
_ $7.7 5
$250 _______________________________________________
$2 75
.... ............................................................................
$ 1 2 0

1
2

1
1
8
1
2
1
1
1

Worker s

2

Plans

8 7 2 .7

31

2 9 9 .0
18.9
105.2
2 .9
4 9 .0
3 72 .8

4
2
10
1

W orkers

806.

-

8

6 . 8

1

3 .7
4 .0
6 .4
4 .0

3

2

303. 5
3 .4
114. 5
2 .9
3 5 7 .0
6 . 8

1

.1
4. 0

1

4 .0

1 0

See footnote 1, table 3.
See footnote 2 , table 25.




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