Point to any business in Southwest Florida-any size, any market sector-and you'll likely find owners and executives facing rising health insurance costs and looking for ways to keep concerned workers happy.

"Businesses and employees are feeling increased pressure from the costs of health coverage," says Craig Palosky, a communications officer with the nonprofit Kaiser Family Foundation. "It continues to rise far faster than the rate of inflation and the rate of workers earnings and wages."

The foundation, which explores national healthcare issues, reports that health insurance premiums have risen by nearly 60 percent since 2001. In 2004 alone, premiums jumped an average 11.2 percent, while the rate of inflation and worker's wages only increased a little more than 2 percent.

While most large companies offer health coverage, only 63 percent of small firms do, and that number is getting smaller, says Palosky.

This slide is leaving millions of Americans to fend for themselves. In 2003, the U.S. Census Bureau estimated that 45 million Americans were uninsured, the highest number since the statistics were first compiled in the late 1980s.

"People who get coverage through their workplace are more likely to get treatment when they are sick," says Palosky, who fears the uninsured and under-insured will skip needed medical attention because they can't afford it.

We asked five area companies how they're coping with this increasingly major problem.

BLAME IT ON CHARLEY

When Gaye Levine and her partner, Bridgit Stone, decided to open the Redfish Blufish restaurant on Captiva Island last year, they had no way to know storms were brewing. The couple planned on finding a health insurance plan for themselves and the small team of full-time employees they would hire.

"We looked at [insurance] from all angles because we thought it was important and would help us recruit good personnel," Levine says.

Then Hurricane Charley thundered across the island and threw their business plan into turmoil. The expected customers from South Seas Plantation Resort up the road disappeared when the property closed for extended repairs. Access to the island was blocked for weeks, and day-trippers from the mainland could no longer be expected to fill seats.

Levine and Stone faced a tough decision.

"We sat with our insurance man and discussed all the options available to us and our future employees," Levine recalled. "The painful truth was that it was not feasible to offer [insurance] to anyone."

That decision made finding staff difficult. The restaurant is already way out on expensive Captiva, a long drive from where most restaurant staff would live. Not having a good benefit plan chased many job candidates away. "The chefs that we talked to asked about insurance, and most could not take the job without having it," Levine says.

Redfish Blufish opened at the end of 2004 and the business has done well so far. Levine and Stone hope they can revisit the insurance issue for their five employees and themselves when it is financially feasible.

A CUT ABOVE

The popular Top It Off Salon & Spa in Fort Myers is a posh place. All wood, stone, glass and attitude, the facility has more than a dozen stations plus a separate nail room, massage room and tanning room.

It's a far cry from the 600-square-foot, no-bathroom facility that opened in 1994. "It's taken some time, but now we offer full day spa services in a comfortable atmosphere," says co-owner Will Hutt.

With the growth has come a cadre of talented employees-all looking for better benefits.

Hutt and his partner, Vinnie Sullivan, offer their 30 employees a Blue Cross/Blue Shield PPO. Co-pays are part of the plan and the company covers 50 percent of premiums, while the employee picks up the other half.

"It's a very good plan for a small business," Hutt says.

The company covers 100 percent of premiums for a few longtime employees, but this perk has become more expensive. The owners say it's something they'll consider closely before offering again.

While satisfied with their plan, Hutt says the rising costs have hurt. He estimates each employee's participation this year costs him an additional $40 per month compared to 2004. That's about $480 a year for each employee, or nearly $15,000 a year for the whole staff.

Still, reducing or dropping health insurance benefits is not an option for this close-knit team.

"We care about our employees and want to offer this benefit to them," Hutt says. "Without insurance, if anything serious happens, it could wipe out a family's savings."

BANKING ON HEALTH

Like companies big and small, Jerry Williams chalks up finding cost-effective, affordable and comprehensive benefit coverage for his 250 employees as his biggest health insurance challenge.

"It is not uncommon to see a well-defined, low-deductible, benefit-rich plan cost the employer $400 or more a month per employee," says Williams, the president and CEO of Orion Bancorp, the parent of Orion Bank, the second largest privately owned community bank in Florida.

Naples-based Orion offers employees a Blue Cross/Blue Shield PPO. Employees can then choose a variety of coverage combinations, depending on their circumstances. The company finds that its strong health insurance program is an excellent tool for recruiting and retaining staff, as is the share of the costs picked up by the company. Orion did not disclose how much it contributes. "The amount of premium cost share that the employer is willing to underwrite can attract potential candidates," Williams says. "This is a question that is often asked during the interview process."

Orion Bancorp has found another attractive benefit-a Section 125 plan, which allows the employee to deduct heath insurance premiums on a pre-tax basis. This reduces the salary amount from which federal income tax is calculated.

Such steps have paid off for Orion.

"Providing a solid health insurance program is certainly good for overall morale," Williams says. "It means employees do not have to worry excessively about where or how they will pay medical bills."

DEVELOPING FITNESS

Stock Development, based in Naples, has made its name developing residential communities, commercial projects and real estate services. Now managers are also trying to develop a healthier staff as a way to stave off rising health insurance costs.

"We get the higher premiums [notice] and it's like sticker shock," says Margaret T. Pace, Stock's director of human resources. She says the company's insurance renewal later this summer is expected to be 20 percent higher than last year. Stock pays 80 percent of its employees' premiums.

To control these costs, Stock Development is joining many other large companies by exploring a proactive approach. It hopes to help its nearly 500 employees stay healthy and avoid doctor's visits and prescription medicines in the first place. Stock Development is offering staff discounted memberships to area fitness centers. An Employee Assistance Program (or EAP) provides help with a variety of physical and emotional problems. Pace says a smoking cessation class is also in the pipeline.

"I want to at least have opportunities available to them to pursue those [health] goals-not to force them to do it-but to give them some extra help if they need it," Pace says.

In this same vein, when illnesses do set in, Stock is working with its team to seek help earlier, both to keep them feeling better and to avoid more catastrophic medical claims later on.

"If employees don't get the routine stuff taken care of, that can lead to larger medical problems than if they had taken care of themselves earlier on," Pace says.

ABOVE AND BEYOND

WCI's approximately 3,500 employees are a lucky bunch. The builder/developer goes further than most when it comes to benefits offerings.

Full-time employees are offered not just health insurance, but also dental and vision coverage, increasingly rare as costs climb.

Then there's the percentage of insurance premiums covered by the company. Nationwide, the standard has hovered around an 80-20 ratio. In other words, the company covers 80 percent of coverage costs, the employee picks up the other 20 percent.

Bonita Springs-based WCI picks up 93 percent of the cost, leaving just 7 percent for the employee. But just as other companies are going for an 80-20 plan to a 70-30 or even a 50-50, WCI is considering whether to recalculate its offerings. In 2002, health insurance premiums cost the company $10 million. Three years later, that figure has doubled to $20 million.

"The costs have started to accrue to a point that we're taking a look at how we can mitigate them," says Scott Thibeault, the company's executive director of compensation and benefits. "We'll continue to examine the cost-sharing percentage."

While no decisions have yet been reached on this front, the company is also pursuing other measures to control costs. They too are offering healthy lifestyle incentives as well as health savings accounts and other money-saving programs.

It's a system constantly undergoing tweaking, looking for what's best for everyone.

"We walk a fine line between making sure we satisfy the needs of our shareholders while also satisfying the needs of our employees," says Paul Appolonia, WCI's senior vice president of human resources. "We are constantly looking for ways to provide an excellent schedule of benefits while maintaining costs, because our shareholders expect us to make a profit each year."