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IOWA STATE TE ' ' ' '-FGE 53 / sdL 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 W orkers Plans 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 Retired 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 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 . 11 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 N on m atern ity and m a te rn ity —______ 273 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 A ll plans studied Plans W ork ers Plans 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 19 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. 21 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 , 20 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 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. 21 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 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 23 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 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 _________ 6 153 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 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 1 W or ker s 4 136 1 ,5 7 5 .7 2 11 3 10 9 13 6 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 ______________ 11_______________ _______________11___________ 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 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 ___________________________ Plans 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) Total Single <em ployer M u ltiem p lo y e r Type of plan 2 and group co vered A ll plans with h ospital b en efits P lans 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 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 ________ Plans 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 _____ _____________ 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) P lan s W o rk e rs (in thou sands) 273 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 31 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 3 No variation ........... _ _ V a ria tio n ----------------------------------------------- 2 ,7 2 7 .1 273 4 ,4 7 7 .9 206 67 3 ,8 5 4 .7 6 2 3 .2 152 9 2 ,6 3 9 .1 8 8 . 0 271 4 ,5 5 7 .9 4 124 2 ,1 0 3 .4 208 63 3 ,5 6 6 .9 9 9 1 .0 4 1 6 1 4 147 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 11 4 1 6 1 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 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 ____________ Cash Plans 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 CW ^ (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 17.6 7 9 4 .0 - 3 .6 4 6 .5 - 7 4 14 4 - 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 1 - - 1 7 .5 _ _ - _ _ _ _ - - 1 3 .5 2 _ - _ _ - 1 4 5 .0 1 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 _ 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 _ _ 17.6 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 W orkers 3 484. 9 50. 109. 42. 125. 15. 77. 1 5 7 2 - 64. 0 25 228. 3. 41. 57. 45. 6 . 27. 2 8 7 Workers 5 3 4 6 - Plans 1 4 - - 6 47. 9 5 1 3 5 0 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 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 Plans 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 2 Plans W orker s 1 1 6 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. ☆ U. S. GOVERNMENT PRINTING OFFICE : I960 O - 546805
@FedFRASER