The next generation in affordable health care. (An Advertising Supplement to the San Fernando Valley Business Journal).

With growing numbers of seniors remaining longer in the workforce (thanks in part to a struggling national economy), many continue to receive their health benefits via their employers or through a small business group arrangement as opposed to Medicare.

Meanwhile, as the cost of providing

"We are facing a true crisis of affordability," says Walter Zelman, president of the California Association of Health Plans. "Premiums for the second year in a row are rising at rates of 10 percent or more and more than 7 million Californians have no insurance at all."

A rule of thumb, Zelman adds, is for every 1 percent increase in premiums over inflation, at least 20,000 Californians will lose insurance.

As a result, it's no surprise that in today's evolving health care market, two key factors drive consumer health insurance selections: cost and choice. And nowhere is this reality more evident than in the small business market.

According to a recent article in the Contra Costa Times, owners of small businesses -- already struggling in a weak economy -- are finding it harder and harder to find health care coverage for their employees at a reasonable cost, In addition, health maintenance organizations (HMOs) -- often considered the more cost-effective option, particularly for small businesses, have lost some of their affordable edge, as compared to preferred provider organizations (PPOs) and indemnity products.

"For most of the 1990s, HMOs like PacifiCare, did a great job holding the line on medical costs," says Debra Althouse, vice president, Sales and Marketing, Small Group and Individual Markets for PacifiCare of California. "During that time, HMO health plan premiums rose less than 2 percent a year. In addition, research showed that managed care saved up to $600 billion in unnecessary medical costs in the past five years."

However, market demands over the past few years has prompted one of the most significant jumps in health care costs across the board, making it more challenging for HMOs to contain premium and medical costs without some sort of premium increase, Althouse continues. These factors include: