HEALTH AND INSURANCE PLANS UNDER COLLECTIVE BARGAINING, LATE 1955

Transcription

1 Analysis of HEALTH AND INSURANCE PLANS UNDER COLLECTIVE BARGAINING, LATE 1955 Life Insurance Accidental Death and Dismemberment Accident and Sickness Hospitalization Surgical Medical Maternity Bulletin No UNITED STATES DEPARTMENT OF LABOR James P. Mitchell, Secretary BUREAU OF LABOR STATISTICS Ewan Clague, Commissioner

2 Analysis of HEALTH AND INSURANCE PLANS UNDER COLLECTIVE BARGAINING, LATE Life Insurance Accidental Death and Dismemberment Accident and Sickness Hospitalization Surgical Medical Maternity Bulletin No November 1957 UNITED STATES DEPARTMENT OF LABOR James P. Mitchell, Secretary BUREAU OF LABOR STATISTICS Ewan Clague, Commissioner For sale by the Superintendent of Documents, U. S. Government Printing Office, Washington 25, D. C. Price 50 cents

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4 Preface P ro te ctio n again st the econom ic h azard s of o ff-th e -jo b in ju r ie s, illn e s s, and death through voluntary group p r o g r a m s, financed in whole or in part by the e m p lo y e r, constitutes a re la tiv e ly new and highly valued part of the com pen sation re c e iv e d by w ork ers in the United S ta te s. T rad e union in te re st in health and in su ran ce p ro g ra m s has been a m a jo r fo rce in the growth of these voluntary in s u r ance p la n s. Although unions have long been concern ed with the health and se cu rity o f their m e m b e rs and have provided so m e protection through u n io n -sp o n so re d b en e ficia l p r o g r a m s, the past 12 y ears have w itn essed a phenom enal growth of prepaid p ro gra m s under co lle ctiv e bargaining a g r e e m e n ts. In 1945, an e stim a ted h alf m illio n w ork ers w ere co vered by these p r o g r a m s. By m id , this figu re exceed ed the 3 -m illio n m a rk. Two y e a rs la te r, about 7 m illio n w ork ers w ere re ceiv in g so m e type of health and in suran ce p rotection under c o lle ctiv e bargaining a g r e e m e n ts. In e a rly , o ver 11 m illio n w o rk e rs approxim ately 70 p ercen t of a ll w o rk ers under la b o r-m a n a g e m e n t co n tracts w ere provided with at le a s t 1 type of health and insuran ce b en efit. By the end of 195 6, it was e stim a ted that in e x c e s s of 12 m illio n w o rk ers w ere c o v e re d. During the e a rly sta g es of this develop m en t, unions concentrated m ain ly on negotiating new p la n s, bringing existin g plans within the scope of the a g reem e n t, cla rify in g the leg a l a sp e cts of bargaining on the su b ject, and dealing with the m any new and fo rm id a b le tech nical p ro b lem s inherent in the esta b lish m en t of p lans. A l though c o lle c tiv e ly b argain ed plans have continued to spread during recen t y e a r s, attention has been in cre a sin g ly cen tered on broadening the co vera g e of existin g plans to include dependents and re tire d w o rk e rs, adding new b e n e fits, and in c re a sin g the le v e l of b e n e fits. In resp on se to public and govern m ental needs for in form ation in this fie 'd of in d u strial re la tio n s, the U. S. D ep artm ent of Labor* s Bureau of L abor S ta tistic s h a s, since , p repared a num ber of studies dealing with health and in su ran ce plans under co lle c tiv e bargain in g. T h ese studies include: P e rio d ic r e p orts on the o v e ra ll growth of em p loyee benefit plans under c o lle ctiv e bargaining a g r e e m e n ts, including data on m ethods oi financing and types of b enefits provided; re p orts providing d etails on the types and am ounts of benefits provided fo r se le c te d in d u strie s; su m m a ry d igests of se le cte d p ro g ra m s; and changes in p ro gra m s of m a jo r co m p a n ie s. The B ureau a lso m aintains a file of se le cte d plans fo r public u s e, as provided by sectio n 211 of the L abor M anagem ent R elation s A c t, as am ended. In addition, data on the prevalen ce of health and in surance benefits have been obtained in the v ariou s wage su rvey s undertaken by the B u reau. A s p art of this continuing p ro g ra m, the B u reau, in , undertook a d e tailed sta tistical a n a ly sis of the p ro v isio n s of 300 se le cte d health and in surance p ro g ra m s under co lle c tiv e bargain in g, each coverin g 1,0 0 0 or m o re w o rk e rs. The re su lts of this study, as p resen ted in this b u lletin, r e fle c t the m o st co m p reh en sive and penetrating a n a ly sis m ade by the Bureau to date in this p articular fie ld. The co m p le x itie s o f health and insuran ce p ro gra m s and the g reat v a rie ty of p ro vision s p resen ted m any new and d ifficu lt technical p ro b le m s, including the n e c e ssity of d evising a procedure for coding and m achine tabulation of the sta tistic a l data. T his bulletin p resen ts detailed sta tistic s on plan p rovision s and re la tiv e ly b r ie f su m m a riza tio n s of the sta tis tic s ; it does not purport to re p re sen t a guide or te x t book on health and in suran ce p la n s. T his study was conducted in the B u reau 's D ivision of W a ges and Industrial R elation s under the su p erv isio n of Evan K eith R ow e, who p repared this rep ort with D orothy K ittner G re e n e. H a rry E. D avis and H a rry L. L evin also p a r tic i pated in the an a ly sis of plans and in the preparation of the re p o rt. T his study was under the gen eral d irectio n o f Joseph W. B lo ch, ch ief, Branch of In du strial R elation s A n a ly s is. iii

5 Note on C hanges Since L ate 1955 H ealth and in suran ce plans are fluid p r o g r a m s, in the sen se that the types and le v e ls of benefits are su b ject to re la tiv e ly frequen t ch an ge. A ll plans included in this study w ere in e ffe ct in late A s b e st the B ureau can d eterm in e fr o m an exam ination of settlem en ts rep orted in its m onthly re p o rt on C u rren t W age D e v e lo p m en ts, probably about 80 p ercen t of the plans studied had not b een changed in any r e sp e c t by m i d , and a m a jo rity had not been changed by the end of The B ureau has no m eans of readily determ in ing the extent to which changes negotiated in 1956 and , so m e of which w ere m in o r in c h a ra c te r, would alter the cen tral tendencies re fle c te d in the tabulations p re se n te d in this b u lletin. The m a jo r purpose of this study, it m u st be e m p h a sized, was to provide a ben ch m ark again st which future changes in c o lle c tiv e ly bargain ed plans can be m e a su r e d. It is ex p e cte d, m o r e o v e r, that the a vailab ility of data of this type fo r the fir s t tim e w ill in its e lf fu lfill an urgent public and govern m en tal n eed. The B ureau is now bringing up to date its 1954 D ig e st of One Hundred S elected H ealth and Insurance P lan s Under C o lle ctiv e B argain ing (BBS B u ll. N o ). The new D ig e st, which w ill be available in the Spring o f , w ill provide the d etails of cu rren t p la n s. M eanw h ile, som e indication of the freq u en cy and nature of the changes being m ade in m a jo r plans m ay be obtained fr o m the B u re a u 1s m onthly rep ort on C u rren t W age D e v e lo p m en ts. IV

6 Contents M a jo r featu res of health and insurance plans 1 Scope and m ethod of s t u d y 1 Types of benefits studied 1 V ariation s am ong plans 3 Financing concepts 4 P re v a le n ce of b e n e f i t s 5 A ctiv e w o r k e r s 5 Dependents of a ctiv e w o rk ers 5 R etired w o rk e rs 8 Dependents of retire d w ork ers 8 E lig ib ility req u irem en ts 11 E ffe ct of age on ben efits fo r w ork ers 12 V a riation in amount of benefits based on se x 12 Financ i n g 12 P age L ife in suran ce 21 B en efits for active w o rk ers 21 B a sis fo r d eterm in in g am ount of insurance 21 Am ount of in suran ce 22 V ariation s in am ount b ased on s e x 23 R eduction of benefit during active e m p lo y m e n t 24 B en efits for retire d w o rk ers 24 B en efits for dependents of active w o rk ers 26 P erm an en t and total d isa b ility p ro vision s 26 A ccid en ta l death and d ism e m b e rm e n t benefits 29 A ccid en t and sick n e ss benefits 33 N onoccupational benefits 3 3 W aiting p eriod 33 B a sis for d eterm in in g a m o u n t 34 A m ount of benefits 37 V ariation s in am ount based on s e x 37 D uration of benefits 39 Reduction of benefits during active em p loym en t 39 O ccupational benefits 40 H osp ital benefits 41 T ypes of plans 41 D uration of benefits 41 R oom and board allow ances 45 S e rv ice plans 45 C a sh p l a n s 45 M axim um allow ance 45 H osp ital extra allow an ces 47 Reduction of b enefits during active em ploym en t 49 B en efits fo r re tire d w ork ers and d ep en d en ts 49 v

7 Contents - Continued P a g e Surgical benefits 53 T y p e s of plans 53 C a s h plans 53 A m o u n t of benefits 54 Reduction of benefits during active e m p l o y m e n t 56 Benefits for retired w o r k e r s and dependents 58 M ed ical benefits 59 C a sh plans 59 L oca tio n of treatm en ts 60 W aiting p eriod 60 B a sis of paym ents 62 A m ou nt of allow ance 62 M axim u m a llo w a n c e 63 In -h o sp ita l consultation a llo w a n c e 65 S e rv ice p l a n s 65 Reduction of benefits during active em p loym en t 65 B en efits fo r retire d w o rk ers and dependents 65 M atern ity benefits 69 A ccid e n t and sic k n e ss benefits 70 Q ualifyin g p e r io d 70 A m ount of benefits 70 D uration of benefits 72 H o sp ita l benefits 72 T ypes of plans 73 Q u alifying p e r io d. 74 R o o m and board allow an ces 74 H osp ital extra allow an ces 77 L u m p -s u m allow ance for h ospital ca re 79 S u rg ica l benefits 79 Q ualifyin g p e r i o d 79 Am ount of benefits 80 M ed ical b enefits 81 G en eral lu m p -s u m allow ance 81 Other m e d ica l ca re benefits 83 M a jo r m e d ica l benefits 83 P rev a le n ce 83 Type and amount o f deductible 84 B en efit am ounts 84 B en efit p e r i o d 84 P o lio m y e litis benefits 84 O u t-patien t diagn ostic X -r a y and la b o rato ry benefits 86 Supplem ental accident benefits 87 vi

8 Contents - Continued M ajor F ea tu res of H ealth and Insurance P lans P age T a b le s: H ealth and in suran ce plans - A - l. D istrib u tion of plans studied by w o rk ers c o v e re d, industry d iv isio n, and type of bargaining unit 2 A - 2. D istrib u tion of plans studied by in d ustry group 2 A - 3. B en efits provided active w o rk ers by m ethod of financing, late A - 4. P re v a le n ce of benefits by group c o v e re d, industry d iv isio n, and type of bargaining unit, late A - 5. B en efits provided dependents of a ctive w o rk e rs by m ethod of financing, la te r A - 6. R elation sh ip of benefits p rovided active w o rk e rs and th eir dependents, late A - 7. B enefits provided re tire d w o rk ers by m ethod of financing, late A - 8. B enefit le v e ls fo r w o rk ers retirin g at age 65 co m p ared with th ose provided im m e d ia te ly b efo re r e tire m e n t, late A - 9. Length of tim e benefits a va ilab le to re tire d w o r k e r s, late A B en efits provided dependents of re tire d w o rk ers by m ethod of financing, la te r A R elation sh ip of benefits provided re tire d w o rk ers and th eir dependents, late A E lig ib ility req u irem en ts by type of b en efit, late A M aintenance of benefits fo r a ctive w o rk e rs, A E ffe ct of age at h irin g on a v a ila b ility or le v e l of benefits fo r active w o r k e r s, late A V ariation in amount of benefits b ased on se x, late A R elation sh ip of m ethod o f financing plans as a whole for active w ork ers and plan fo r their dependents, late A M ethod o f financing individual benefits fo r active w o rk ers and th eir dependents, late A R elationship of m ethod of financing plan as a whole fo r re tire d w ork ers and plan fo r their dependents, late A M ethod of financing individual benefits fo r re tire d w o rk ers and their dependents, late L ife Insurance L ife in suran ce - B - l. B a sis of d eterm in ing am ount by type of bargaining unit, late B - 2. D istribution of plans providing flat am ount by amount p rovid ed, late B - 3. D istribution o f graduated plans by amount provided w o rk ers earning $ 3,0 0 0 and $ 4,0 0 0 y e a rly, late vii

9 Contents - Continued P age T a b le s: - Continued L ife in su ran ce - Continued B - 4. D istrib u tion of plans providing a flat amount by am ount and num ber of w o rk ers co v e re d by p la n s, late B - 5. D istrib u tion of plans graduating am ount accordin g to earnings alone by amount provid ed w ork ers earning $ 4, 000 y e a r ly and num ber of w ork ers covere d by the p la n s, late B - 6. D istrib u tion of plans by am ounts p rovided w ork ers at ages 65 and 70 who re tire d at age 65 and earned $ 4,0 0 0 y e a rly p rio r to re tire m e n t, late B - 7. E ffe ct of length of s e r v ic e on amount provided retire d w o rk e rs, late B - 8. D isp o sition of life in suran ce b enefits under perm anent and total d isa b ility p ro v isio n s, late B - 9. E lig ib ility req u irem en ts to re ceiv e perm anent and total d isa b ility b e n e fits, late A ccid en ta l Death and D ism e m b e rm e n t B en efits A ccid en ta l death and d ism e m b erm en t - C - l. B a sis of d eterm in ing amount of ben efit, late C - 2. R elation sh ip of accid ental death benefit to amount of life in su ran ce p rovided w ork ers earning $ 3,0 0 0 and $ 4,0 0 0 y e a r ly, late C - 3. D istrib u tion of plans providing flat amount by am ount p rovid ed, late C - 4. D istrib u tion of plans graduated a ccord in g to earnings alone by am ount provided w o rk e rs earning $ 3,0 0 0 and $ 4,0 0 0 y e a r ly, late A ccid en t and S ick n ess B enefits A ccid en t and sick n e ss - D - l. Types of d isa b ility co v e re d by in dustry d iv isio n, late D - 2. W aiting period for w eek ly nonoccupational b e n e fits, late 1955 ~ 34 D - 3. B a sis for d eterm in ing nonoccupational benefit am ount by type of bargaining unit, late D -4o D istrib u tion of plans providing a graduated n on occupational benefit by amount provided w ork ers earning $ 4, 000 y e a r ly, late D - 5. D istrib u tion of plans providing a flat amount by amount of w eekly nonoccupational b enefit, late D - 6. D istribution of plans by amount of w eekly nonoccupational benefit provided w ork ers earning $ 4, 000 y e a rly and duration of benefit p eriod, late viii

10 Contents - Continued Page T a b le s: - Continued A ccid en t and sick n ess - Continued D - 7. Change in b asis of w eek ly nonoccupational benefit paym ent due to a ge, late D - 8. R elationship betw een amount of w eek ly n on occupational and occupational benefits provided w ork ers earning $ 4, 000 y e a r ly, late H osp ital B en efits H osp italization - E - l. T ypes of plans fo r w o rk ers and dependents by type of bargaining unit, late E - 2. D istribution of plans by duration of fu ll-b e n e fit p eriod fo r w ork ers and dependents and type of ro o m and board b enefit, late E - 3. R elationship of p rovision s for w o rk ers and dependents, late E - 4. D istribution of plans by duration of fu ll-b e n e fit and extended co v e ra g e periods for w ork ers and dependents, late E - 5. D istribution of plans by daily ro o m and board allow ance for w o rk ers and dependents and duration of fu ll-b e n e fit p erio d, late E - 6. D istrib u tion of plans by m a x im u m ro o m and board allow ance for w o rk ers and dependents, late E - 7. M ethod of sp ecifyin g allow ance fo r h osp ital extras for w ork ers and dependents, late E - 8. D istrib u tion of plans providing full re im b u rse m e n t of ch arges fo r h ospital extras up to a fixed m axim u m by amount provided w o rk ers and dependents, late E -9. D istribution of plans providing full re im b u rsem e n t of ch arg es for h ospital extras up to a fixed amount with additional re im b u rsem e n ts on a percentage b a sis by am ount for w o rk ers and dependents, late E D istribution of plans by duration of fu ll-b e n e fit period fo r re tire d w o rk ers and their dependents and type of ro o m and board b enefit, late E - l l. D istrib u tion of ca sh plans by daily room and board allow ance for re tire d w o rk ers and their dependents, late S u rg ica l - F - l. S u rg ica l B enefits Types of plans co verin g w o rk ers and dependents, late F - 2. C a sh plans with incom e lim ita tio n fe a tu re s, late IX

11 Contents - Continued P age T ables: - Continued S u rg ica l - Continued F - 3. D istrib u tion of plans by the m a x im u m schedule and appendectom y allow an ce fo r w o rk e rs and dependents, la te F - 4. D istrib u tion of plans by to n sille c to m y allow ance fo r w o rk e rs and dependents, la te F - 5. D istrib u tion of plans by the m a x im u m schedule and appendectom y allow ance fo r re tire d w o rk e rs and dependents, late M ed ical B en efits M ed ical - G - l. T yp es of plans co verin g w o rk e rs and dependents, late G -2. C a sh plans with incom e lim ita tio n fe a tu re s, late G -3. D istrib u tion of ca sh plans by allow ance provided fo r d octor*s treatm en t fo r w o rk ers and dependents, late G -4. D istrib u tion of ca sh plans a ccord in g to when p a y m ents begin fo r d o cto r1s treatm en t in o ffice and h o m e, fo r w o rk ers and depen den ts, late G -5. D istrib u tion of plans providing ca sh allow ance fo r doctor*s treatm en t fo r w o rk ers and dependents by m a x im u m am ount provided and b a sis of p aym en t, late G -6. T yp es of d o c to rfs treatm en t for which benefits w ere extended to r e tire d w o rk e rs and dependents, late G -7. D istrib u tion of ca sh plans by allow an ce provided fo r doctor*s treatm en t fo r re tire d w o rk e rs and dependents, late G -8. D istrib u tion of ca sh plans extending benefits to re tire d w o rk e rs and dependents by m a x im u m am ount p rovid ed, la te M aternity B en efits M aternity - H - 1. B en efits provided w om en w o r k e r s, late H -2. B en efits p rovid ed w o r k e r s 1 dependents, late H -3. A v a ila b ility of benefits to new ly in su red w ork ers and dependents, late H - 4. D istrib u tion of plans providing a flat accident and sick n e ss benefit by amount provided w om en w o r k e r s, late x

12 Contents - Continued P age T a b le s: - Continued M aternity - Continued H - 5. D istrib u tion of plans providing a graduated a c c i dent and sick n ess benefit by am ount provided w om en w o rk ers earning $ 3, 000 y e a r ly, late H -6. T yp es of h osp ital plans fo r w o rk e rs and dependents, late H -7. D istribution of plans providing h ospital benefits by duration of fu ll-b e n e fit p erio d and type of ro o m and board benefits fo r w o rk ers and dependents, late H -8. D istrib u tion of plans providing h ospital benefits by daily ro o m and board allow ance and duration of fu ll-b e n e fit p eriod fo r w o rk e rs and dependents, late H -9. D istribution o f plans providing h ospital ben efits by m axim u m ro o m and board allow ance fo r w o rk ers and dependents, late H Method of sp ecifyin g allow ance for h osp ital ex tra s for w o rk e rs and dependents, late H - l l. D istrib u tion of plans providing fu ll re im b u rsem e n t of ch arg es for h ospital e x tra s up to a fixed m axim u m by amount provided w o rk ers and dependents, late H D istribution of plans sp ecifyin g a flat amount fo r ro o m, b oard, and h osp ital extras for w o rk ers and d epen d en ts, late H D istrib u tion of plans by su rg ical allow ance sp e cifie d for d o c t o r s fee fo r d e liv e ry fo r w o rk e rs and dependents, late H T ypes of doctor*s treatm en t fo r which m e d ica l benefits w ere provided to w o rk e rs and dependents, by type of b e n e fits, late H D istribution of plans providing lu m p -s u m allow ance by amount fo r w o rk ers and dependents, late Other M ed ical C a re B en efits Other m ed ica l ca re benefits D istrib u tion of plans providing c a sh p olio m y elitis benefit to w o rk ers and dependents by am ount provided and p eriod of tim e during w hich e x p enses in cu rred w ere c o v e re d, late D istribution of plans providing c a sh p o lio m y elitis benefit to w ork ers and dependents by am ount provided and its relation to other b e n e fits, late x i

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14 Analysis of Health and Insurance Under Collective Bargaining Late 1955 Major Features of Health and Insurance H ealth and in surance plans n orm a lly include one or m o re of the follow ing types of b e n e fits: L ife in su ra n ce, accidental death and d ism e m b e r m e n t, accident and sick n ess (excluding sick le a v e, State w o rk m en 's com p en sation and tem p o rary d isa b ility p a y m e n ts ),1 and h o sp ita l, su rg ic a l, and m e d ica l c a r e. Som e plans contain sp ecia l ben efits which supplem ent the allow ances n o rm a lly provided fo r h o sp ita l, su rg ic a l, and m ed ica l care (i. e., b a sic plan b e n e fits). Am ong these sp e cia l benefits are those provided fo r p o lio m y elitis and accidental in ju ry and during extended periods of illn e ss (catastrophe or m a jo r m e d ic a l). T h e se sp ecia l b e n e fits, as w ell as the p ro v isio n s under the b asic plan applying to m a tern ity c a s e s, are treated sep a ra te ly in this study. T his section d e sc rib e s the scope and m ethod of study and the nature of health and in surance plans as a w h ole, including the su bject of fin ancing. In su b sequent ch a p te rs, each of the individual benefits is an alyzed. Scope and M ethod of Study F o r this study, the B ureau analyzed 300 se le cte d health and in suran ce plans under co lle ctiv e bargain in g, 2 in e ffe ct in late The plans w ere se le cte d to provide a broadly rep resen ta tiv e picture of health and insurance b enefits under p ro g ra m s covering 1,0 0 0 or m o re w o rk e rs. In this se le ctio n, the fa cto rs given p rim a ry consideration w ere in d u stry, geographic lo ca tio n, union, type of bargaining unit, and size (as m e a su re d by w ork er c o v e ra g e ). The 300 plans studied covered 4,9 8 1,0 0 0 w o rk ers or o ver 40 p ercent of the estim a ted total num ber of w o rk ers covered by health and in surance plans under co lle ctiv e bargaining (table A - l ). 3 The plans varied in co vera g e fr o m the m in i m um of 1,0 0 0 w ork ers chosen for this study to h alf a m illio n. O n e -th ird of the p la n s, covering o ver tw o -fifth s of the w o r k e r s, w ere negotiated by m u ltie m p lo y e r g ro u p s. Slightly m o re than tw o -th ird s of the p la n s, coverin g about the sa m e p ro portion of w o rk e rs, w ere in m anufacturing in d u str ie s. V irtu a lly e v e ry m a jo r m anufacturing and nonm anufacturing industry group was re p re sen te d in the s e le c tion (table A - 2 ). T yp es of B en efits Studied. L ife insurance benefits are provided as either a flat amount; an am ount graduated according to e a rn in g s, s e r v ic e, occupation, e t c.; or a com bination of these two m ethods of providing b e n e fits. E ach type provides a cash paym ent in the event of death and frequen tly in the event of p e r m anent and total d isa b ility. 1 At the time of this study, 4 States had enacted temporary disability legislation. 2 The meaning of the phrase under collective bargaining as used in this study requires a brief examination. Many employers and unions independently sponsored and financed insurance plans for many years before they came under collective bargaining and a large number of workers are now covered by plans that are not collectively bargained. Many of the programs now under collective bargaining were originally instituted by the employer and subsequently brought within the scope of the agreement with or without change. Similarly, union sponsored and financed programs have been brought within the collective bargaining area, with the employer paying all or part of the cost. For the purpose of this study, plans under collective bargaining include: (1) Those established for the first time as a result of collective bargaining; and (2) those originally established by either employer or union but since brought within the scope of the agreement, at least to the extent that the agreement establishes employer responsibility to continue or provide certain benefits. 3 Throughout this bulletin, all coverage data relate to the number of active workers covered by the plans. For example, when reference is made to dependent coverage, the extent of such coverage is expressed in terms of the number of active workers covered by plans which extend or provide the specified benefits for dependents. No attempt was made to determine the number of dependents, retired workers, or dependents of retired workers covered by the plans in this study.

15 TABLE A - l. Health and insurance plans: Distribution of plans studied by w orkers covered, industry division, and type of bargaining unit to A ll industries M anufacturing N onm anufacturing covered All plans Single em ployer M ultiem ployer Single em ployer M ultiem ployer Single em ployer M ultiem ployer (0 0 0 's) (000* s) (000* s) (0 00' s) (0 0 0 's) (0 0 0 's ) (0 0 0 's ) A ll plan s.studied _ ,487 1, 000 to 2, 000 w o rk e rs , 000 to 3, 000 w o rk e rs , 000 to 4, 000 w o rk e rs _ , 000 to 5, 000 w o r k e rs , 000 to 7, 000 w o r k e rs _ , 000 to 10, 000 w o rk e rs _ , 000 to 15, 000 w o rk e rs , 000 to 25, 000 w o rk e rs , 000 to 50, 000 w ork ers , 000 to 100, 000 w o r k e r s _ - 100, 000 w ork ers and o v er 11 2, , , , " NOTE: B ecause of rounding, sum s of individual item s do not n e c e ssa r ily equal tota ls. TABLE A - 2. Health and insurance plans: Distribution of plans studied by industry group Industry group (0 0 0 's) Industry group (000* s) A ll plans studied M anufacturing F ood and kindred products T o b a cco m anufactures T extile m ill prod ucts A p parel and other finish ed textile products L um ber and tim ber b a sic p ro d u c ts F urnitu re and finish ed wood products P a p er and a llied products P rinting and p u b lis h in g C h em icals and a llied products P etroleu m and coa l products R ubber p roducts L eath er and leather products Ston e, cla y, and glass products P rim a ry m etal industries F a b rica ted m etal p roducts 300 4, 981 M anufacturing - Continued 218 3,3 9 7 M ach in ery (excep t e le ctrica l) E le c tr ic a l m ach in ery T ran sp ortation equipm ent _ 25 1, Instrum ents and rela ted products M iscella n eou s m anufacturing N onm anufacturing , Mining crude petroleum and natural 6 24 gas production C onstru ction T ra n sp ortation U tilitie s : E le c tr ic and gas R etail and w h olesale trade H otels and restaurants S erv ice s M iscella n eou s nonm anufacturing NOTE: B ecause of rounding, sum s of individual item s do not n e c e ss a r ily equal tota ls.

16 3 A ccid en ta l death and d ism e m b erm en t benefits a lso provide cash paym ents and are g en era lly linked to the am ount of life in suran ce in effect fo r the individual. T his fo r m o f in suran ce m a y cover occupational in addition to nonoccupational c a s e s. A ccid en t and sick n ess co v era g e provides paym ents to com p en sate p artially for the lo s s o f wage in com e fo r a sp ecified p eriod usually a certa in num ber of w eeks fo r each d isa b ility or during the y e a r. It gen era lly applies to accid ents and illn e s s e s a risin g o ff the jo b ; so m e plans a lso cover occupational c a s e s, su p p lem enting w o rk m e n ^ co m p en sa tio n. Unlike other b enefits which m a y be extended to dependents and re tire d w o rk e rs, this b enefit is available only to active w o rk ers b ecau se it is dependent upon an em ploym en t rela tio n sh ip. P aid sick le a v e, State w o rk m e n ^ com p en sation ben efits and te m p o rary d isa b ility paym ents fr o m State operated plans are not analyzed in this stu d y.4 H o sp ita liza tio n, su r g ic a l, and m ed ica l care b enefits seld o m are availab le fo r other than nonoccupational d is a b ilit ie s.5 T h ese benefits are provided in two m a jo r fo r m s cash or s e r v ic e. C ash plans provide stipulated am ounts tow ard the ch arge m ade to the individual fo r hospital room and board and e x tra s e r v ic e s, and, in the event su rg ical and m e d ica l benefits are p rovid ed, fo r s e r v ic e s r e n d e re d. S e r v ic e -ty p e plans provide no cash paym ents to the individual, but pay the fu ll co sts of sp e cifie d h o sp ita l, su rg ic a l, and m ed ical ca re fo r sp e cifie d p e r i ods of tim e. The types of b en efits which m ay be designated as m ed ica l ca re ben efits (other than h osp italization and su rgical) are v a rie d. In this study, the te rm "m e d ic a l b e n e fits " is lim ite d to paym ent for d o c to r!s v is its, whether at the h o s p ita l, d o c to r ^ o ffic e, or in the w orker*s h om e. T h ese benefits do not include v isits m ade by the attending surgeon in the h osp ital in connection with su rg ical p r o c e d u r e s.6 A llo w a n ces fo r su rg ical p roced u res are co vered in the section on su rg ic a l b e n e fits. Other fo r m s of m e d ica l care b e n e fits, such as o u t-o f-h o sp ita l allow an ces fo r diagnostic la b o rato ry and X -r a y p ro ce d u re s, are treated se p a ra te ly under the O ther M e d ical C are B en efits sectio n of this study. V a ria tio n s A m ong. The types and am ounts of benefits provided by health and in suran ce plans under co lle ctiv e bargaining vary w id ely. A plan m ay c o n sist of one benefit (e. g., life insurance) which applies to the w ork er only or it m ay include all types of benefits fo r the w ork er and his dependents. In addition, a plan m ay a lso extend som e benefits to the re tire d w orker and his d e pendents. In the sa m e m a n n er, benefit le v e ls and the length of tim e during which b enefits are provided d iffer co n sid era b ly am ong p lans. T yp es and am ounts of benefits m ay a lso v ary within plans operated by a m ultiplant com pany o r by a m u ltie m p lo y e r group coverin g a wide geograp hic a re a. F o r e x a m p le, h o sp ita l, s u r g ic a l, and m ed ica l benefits provided through Blue C r o ss If the accident and sickness benefit, under plans in those States having temporary disability legislation, was provided as part of a privately insured multibenefit program, then the benefit was considered within the scope of this study. 5 Two plans in this study provided these benefits for occupational disabilities and one plan made available hospital and surgical benefits for such cases. These plans specified that the level of benefit would be the difference between the workmen s compensation payment and the amount specified under the plan. In addition to the general exclusion of benefits for occupational disabilities, most plans specifically excluded one or more nonoccupational disabilities. Among such exclusions were treatment for alcoholism, narcotic addiction, se'f-inflicted injuries, and cosmetic surgery. Some plans, although covering certain types of disabilities, limited the duration of amount of benefits available for their treatment. Examples of disabilities subject to such limitations were mental and nervous disorders, tonsillectomies, and poliomyelitis. These restrictions and limitations are not discussed in this study. 6 Under some plans, medical benefits, as herein defined, are payable although surgery occurs during hospital confinement; various techniques are used to determine the amounts payable in such cases. These techniques are not described in this study.

17 4 and Blue Shield p ro g ra m s gen era lly v a ry fr o m loca lity to lo ca lity. 7 In this study, w h ere such variation s o c c u r r e d under a p a rticu la r m ultiplant o r m u ltie m p lo y e r plan, the p ro v isio n s cov erin g the la r g e s t grou p of w o r k e r s w ere an alyzed. V a r i ations in benefits a lso o c c u r r e d in som e of the plans studied b e ca u se of the r e qu irem en ts of State te m p o ra ry disability la w s. H e r e, too, an alysis was con fin ed to those p rov ision s co v e rin g the la r g e s t group o f w o r k e r s. F in an cin g C o n ce p ts. Taking a health and in su ran ce plan as a w h ole, financing m a y be d eterm in ed in 1 of 2 w ays: E ith er the e m p lo y e r pays the en tire c o s t (a "n on con trib u tory " plan) o r the w o rk e r con tribu tes a portion of the c o s t (a "co n trib u to ry o r "join tly fin a n ced " plan). When the em p lo y e r pays the en tire c o s t, ob v iou sly the ben efit package p rov id ed to each grou p co v e r e d (active w o r k e r s, dependents o f active w o r k e r s, re tire d w o r k e r s, and dependents of re tire d w o rk e rs) and each individual ben efit are e m p lo y e r finan ced or n on con trib u tory. H o w ev er, when the w o rk e r con tribu tes to the c o s t o f the plan, in the va riou s ways in which join tly finan ced plans have been set up, the determ in ation o f the m ethod of fin a n c ing fo r each group c o v e r e d and each ben efit p ro v id e d b e c o m e s d ifficu lt. F o r p u r p oses of this study, plan and ben efit financing was d eterm in ed in the follow in g m an n er: 1. F o r each grou p, i. e., active w o r k e r s, dependents of active w o r k e r s, re tire d w o r k e r s, and dependents of re tire d w o r k e r s, the ben efit package was c la s sified as jointly finan ced if (a) both the e m p lo y e r and w o rk e r con tribu ted tow ard the c o s t of one o r m o r e ben efits p rovid ed the group o r (b) the w o rk e r m ade a g en era l con tribu tion tow ard the c o s t of all ben efits p rovid ed to all groups c o v e r e d by the p ro g ra m. B enefits fo r a group w ere co n s id e re d as e m p lo y e r fin an ced if the e m p lo y e r paid the entire co s t of these b en efits. S im ila rly, ben efits fo r a group w ere cla s s ifie d as w o rk er finan ced if the w ork er paid the entire c o s t of all ben efits extended to that grou p. 2. D eterm in ation of the m ethods of financing individual ben efits was m o r e co m p le x. T his d eterm in ation in volved not only the p ro b le m s inherent in the group con cep t but also the p rob lem s arisin g out of the v a riou s ways of identifying, ea rm a rk in g, o r d irectin g w o r k e r s 1 co n trib u tio n s.8 F o r exa m p le, P lan A p r o vided benefits fo r both the w ork er and his dependents. The plan ca lle d fo r a sin gle con tribu tion by the w o rk er tow ard the total co s t of the p ro g ra m ; the e m p loy er paid the balan ce of c o s t. The w o r k e r 's con tribu tion was not e a rm a rk e d fo r a s p e c ific ben efit n or fo r ben efits fo r a p a rticu lar g rou p, i. e., w o rk e rs o r dependents. Under P lan B, p rovid in g sim ila r b en efits, the w o r k e r 's con tribu tion was s p e c ific a lly alloca ted tow ard the c o s t of all ben efits fo r his dependents. He m ay have paid fo r this co v e ra g e in full o r in part, but his own ben efits w e re s o le ly e m p lo y e r fin an ced. P lan C ea rm a rk e d the w o r k e r 's con tribu tion fo r one of his own benefits and one fo r his dependents. W hen oth er groups (re tire d w o r k e rs and dependents) are brou ght under co v e ra g e of a plan, the variation s in m e th ods of financing individual ben efits are ob v iou sly m u ltip lied. In cla ss ify in g m ethods of financing individual b en efits, the follow in g a p p ro a ch was used: If both the w ork er and e m p lo y e r m ade a con tribu tion tow ard the co s t of sp e cific b en efits, the financing of the ben efit was c la s s ifie d as c o n trib u tory. If the w ork er o r the e m p lo y e r paid the en tire c o s t of s p e cific b e n efits, ^ Blue C ross plans are sponsored by nonprofit incorporated affilia tes of the Blue Cross Com m ission of the American H ospital A ssocia tion throughout the United States. They primarily provide hospital care benefits on a service b a sis. Blue Shield plans, sponsored by State or lo ca l m edical s o c ie tie s, make available allow ances for surgical expenses; a large majority also provided allow ances for m edical expen ses. T h ese allow ances are provided in accordance with fee schedules approved by the participating doctors. Under both Blue C ross and Blue Shield plans, individual and family coverage are available on a group basis. In most areas, the Blue Cross plan acts as the administrative agency for the 2 plans..,,,.., 8 Initially, many plans included only 1 or 2 benefits. Subsequently, additional benefits were provided, forming over time a com prehensive program. On the other hand, particularly in recent years, newly established programs have tended to be com prehensive at their inception. As a result of these variations in development, the financing arrangements of plans reflect considerable variations.

18 5 they w e re c la s s ifie d as w o rk e r financed or em p loy er finan ced, re s p e c tiv e ly. If a contribution w as m ade by the w o rk e r tow ard the cost of all ben efits for a given group (with the em p loyer paying the balan ce of co st), each ben efit p ro v id e d the c o v e r e d group was cla s s ifie d as jointly fin an ced. If either the w ork er or the e m p loy er u nderw rote the entire cost of all ben efits for a given grou p, each ben efit w as cla s s ifie d as w o rk e r finan ced or em p loy er fin an ced, depending upon which party m ade the co n trib u tio n.9 P re v a le n ce of B enefits A ctiv e. N ea rly a third of the plans (94), cov erin g about the sam e p rop ortion of w o r k e r s, p ro v id e d all ben efits within the scop e of the study---- life in su ra n ce, a ccid en tal death and d ism e m b e rm e n t, accid en t and sick n e ss, h o s pital, su rg ica l, and m e d ica l ben efits (table A -3 ). The next m o st frequent c o m bination, found in 51 p la n s, included all ben efits excep t accid en tal death and d ism e m b e rm e n t. Slightly few er plans (47), in addition to excluding a ccid en tal death and d ism e m b e rm e n t, did not p rovid e m e d ica l b e n efits. N ea rly tw o-th ird s of the plans coverin g about the sam e p rop ortion of the w o rk e rs p ro v id e d at lea st 5 of the 6 ben efits studied. TABLE A H ealth and in su ran ce plans: B en efits provided active w orkers by m ethod of financing, late L ife in su r a n c e A c c id e n ta l death and d is m e m b e r m e n t (x in d ica tes ben efits provided under plan; d a sh es, no b en efits provided ) P la n b e n e fits for a c tiv e w o rk er B en efits provided A ll fin a n c ed by W eek ly p la n s E m p lo y e r and E m p lo y e r only w o rk er a c c id e n t H ospital Surgical M edical W o rk ers and W o rk ers W orker s N u m b er sickne ss (000 *s) (000 *s) (0 0 0»s) , , X X X X X X 9 4 1, ,0 5 1 X - X X X X X - X X X X X X X X _ X - - X X X X - - X X X X - X X X X X X X X X X X - X X X X X X X - X X X X - X _ 9 _ X X X X X X X X _ ~ X X X ~ w e r e c la s s if i e d a s jo in tly fin a n c ed if the w o rk er co n trib u ted, to w a rd the c o s t of 1 or m o r e of the ben efits or if the em ployer contributed only a part of the co sts of the b en efits. NOTE: B ecau se of rounding, sum s of individual item s do not n e c e s s a r ily equal to ta ls. A ll but a few of the plans studied p rov id ed hospital and su rg ica l ben efits and life in su ran ce to active w o rk e rs (table A - 4). F our out of 5 plans p rov id ed accid en t and sick n ess co v e ra g e and n ea rly 2 out of 3 p rov id ed m ed ica l b e n e fits. A bout h alf of the plans included accid en tal death and d ism e m b e rm e n t b en efits. D ependents of A ctiv e. The vast m a jo rity of plans (279) extended som e type of ben efit to dependents of active w o r k e r s. The m o st com m on package for this g rou p, p rov id ed in h alf of the plans extending b en efits, included h osp ital, B enefits which were entirely worker financed were considered within the scop e of the co lle c tiv e ly bargained program. In the ca se of benefits for the active worker and his dependents, the p ractice of having the worker pay for a particular type of coverage can be view ed m erely as 1 variation of countless financing arrangements. The same reasoning applies to benefits for retired workers. In any event, the worker or retired worker gains the advantage of group rate participation under the plan, which otherwise may not be available.

19 TABLE A - 4, Health and insurance plans: Prevalence of benefits by groups covered, industry division, and type of bargaining unit, late 1955 All industries M anufacturing Nonmanufac tur ing B en efits and groups covered A ll plans Single em ployer M ultiem ployer Single em ployer M ultiem ployer Single employer M ultiem ployer P lans P lans P lans P lan s P lans P lan s P lan s (000 * s) (000* s) (000* s) (00 0* s) (000* s) (000* s) (000* s) A ll plans studied 300 4, , , , ,4 8 7 L ife in su rance A ctive w orkers , , , , Dependents of active workers R etired w orkers , , , A ccidental death and di s membe r ment A ctive w orkers 154 2, , , R etired w o r k e r s W eekly a ccid en t and sick n e ss A ctive w ork ers , , , , H ospitalization A ctive w o r k e r s , , , , ,4 2 3 D ependents of activ e w o r k e r s , , , , R etired w orkers , , , Dependents of retired w orkers 56 1, , , S u rgical A ctive w ork ers , , , , ,4 2 3 Dependents of a ctiv e w o r k e r s 263 4, , , , R etired w orkers , , , Dependents of retired workers 48 1, , , M ed ical A ctive w o r k e r s 193 3, , , , ,1 7 5 D ependents of active w o r k e r s 145 2, , , R etired w ork ers 35 1, , , Dependents of retired w orkers 31 1, , NOTE: B ecause of rounding, sum s of individual item s do not n ecessarily equal totals. All coverage data shown in this study relate to number of active w orkers covered by the plans. See footnote 3, p. 1.

20 7 s u rg ica l, and m e d ica l ben efits (table A - 5 ). 10 P lans extending only h osp ital and su rg ica l ben efits a ccou n ted for an additional 115 p lan s. T hu s, both h ospital and su rg ica l ben efits w e re p ro v id e d by m o st of the plans studied; m e d ica l ben efits w e re le s s co m m o n ly extended to dependents (table A - 4 ). A ccid e n t and sick n e ss b e n efits, fo r the re a so n p r e v io u s ly given, w e re not available to dependen ts. L ife in su ra n ce, although a p p lica b le, w as p rov id ed to dependents in only seven p lan s. T A B L E A - 5. H ealth and in s u r a n c e plan s: B e n e fits p r o v id e d d ep en d en ts of a c tiv e w o r k e r s by m ethod of fin ancing, late (x in d ica tes b en efits provided under p lan, d a sh es, no b en efits provided ) A ll p la n s p ro v id in g P la n b e n e fits or d ep en d en ts of B e n e fits p r o v id e d ben efits for a c tiv e w o r k e r s fin a n c ed by 2 A c c id e n ta l d ep en d en ts of E m p lo y e r and E m p lo y e r on ly W ork er on ly death a c tiv e w o r k e r s w o r k e r L ife and H ospital Surgical M edical W o rk ers W o rk ers W o rk ers W o r k e rs in s u r a n c e d is m e m N u m b er b e r m e n t ( 's) (000 s) (00 0 * s ) (00 0 * s ) , , , X X X , , , X X , _ - X - _ X _ X X X X - X X X X B a sed on a study of 300 health and in su rance plans under c o lle ctiv e bargaining coverin g ap p roxim ately 5 m illio n w o r k e r s. 2 P lans w ere c la ss ifie d as join tly financed if the w orker contributed tow ard the c o st of 1 or m ore of h is d e pen d en t s b en efits or if the em ployer contributed only a part of the c o sts of the b e n e fits. NOTE: B eca u se of rounding, sum s of individual item s do not n e c e s s a r ily equal to ta ls. A ll coverage data shown in th is study rela te to num ber of a ctive w ork ers cov ered by the p la n s. See footnote 3, p. 1. With the excep tion of life in su ra n ce, the lev el of the ben efits extended to dependents of a ctive w o rk e rs w as identical to that p ro v id e d the w o rk er in a la rg e p rop ortion of the plans (table A - 6 ). In each of the few c a s e s of d ep en d en ts1 c o v erag e under life in su ra n ce, the ben efit le v e l w as low er fo r dependents than for w o r k e r s. TA BLE A - 6. H ealth and insu ran ce plans: R elationship of b en efits provided a ctive w orkers and th eir dependents, late B e n e fit le v e l fo r d ep en d en ts of active w orker L ife in s u r a n c e H o s p ita l b e n e fits S u r g ic a l b e n e fits M e d ic a l b e n e fits W o rk ers W o rk ers W o rk ers W o r k e rs ( 0 0 0» s ) ( * s) ( s) ( s) A ll p la n s p r o v id in g b e n e fit s fo r a c tiv e w o r k e r s and d e p e n d e n t s , , , 7 50 B en efits for dependents: S a m e a s fo r a c tiv e w o r k e r , , , L e s s than fo r a c tiv e w o r k e r in one o r m o r e r e s p e c t s B ased on a study of 300 health and in su rance plans under c o lle ctiv e bargaining coverin g app roxim ately 5 m illio n w o r k e r s. NOTE: A ll c o v e r a g e d ata show n in th is stu d y r e la te to n u m b er of a c tiv e w o r k e r s c o v e r e d by the p la n s. S e e fo o tn o te 3, p. 1. Six plans provided hospital and surgical benefits for dependents but not workers; 4 plans provided medical benefits for dependents but not workers. These plans covered workers in the maritime industry who received free medical and surgical care in U. S. Public Health Service hospitals and out-patient facilities under the United States Maritime law.

21 8 R etired, Slightly m o r e than half (155) of the plan s, co v e rin g about tw o-th ird s of the w o rk e rs in the study, extended one or m o r e ben efits to re tire d w o rk e rs (table A - 7). The m o s t co m m o n exten sion co n siste d o f life in su ra n ce a lon e, accou ntin g fo r m o r e than half of all plans p rov id in g ben efits fo r re tire d w o r k e r s. This ben efit in com bin ation with h osp ital, s u rg ica l, and m e d ica l c o v e ra g e re p resen ted a fa r le ss p revalen t p a ck a ge, but the n um ber o f w o rk e rs co v e r e d b y the 26 plans extending these ben efits to re tire d w o rk e rs w as about equal to the n um ber co v e re d by the 86 plans p rovid in g life in su ran ce on ly. A l though exten sion to re tire d w o rk e rs of a il ben efits available to a ctive w o rk e rs (with the excep tion of a ccid en t and sick n e s s ) is p o s s ib le, on ly 4 plans in the study p ro v id e d this full pack age. A bout half of the plans p rovid in g life in su ra n ce fo r a ctive w o rk e rs a ls o extended this ben efit to re tire d w o rk e rs (table A -4 ). Substantially s m a lle r p r o p ortion s of those plans p rovid in g h osp ital, s u rg ica l, and m e d ica l ben efits fo r a ctiv e w o rk e rs m ad e co v e ra g e available to r e tire d w o r k e r s. In a m a jo r ity of plans w hich extended a ccid en ta l death and d is m e m b e r m en t, h osp ital, su rg ica l, and m e d ica l ben efits to the re tire d w o r k e r, he was c o v e r e d b y the sam e le v e l of benefits p rov id ed the w o rk e r b e fo r e re tire m e n t (table A - 8 ). 11 U nder such p r o v is io n s, the w o rk e r fa ce d no red u ction in p ro te ctio n w hen he re tire d at age 65. M ost p lan s, h o w e v e r, red u ced the am ount of life in su ran ce fo r the re tire d w o r k e r. This p r a c tic e m a y be attributed to s e v e r a l fa c t o r s : (a) the co s t of p rovid in g fu ll co v e ra g e when paym en t is a certa in ty, as it w ould be in the ca se of life in su ra n ce, m a y be e x c e s s iv e in co m p a ris o n with the co s t of other ben efits that m ight be obtained; (b) th ere m a y be less need to p rov id e in com e fo r a su rvivin g dependent; and (c) su ch in su ra n ce m a y be c o n sid e re d p rim a r ily a m eans to c o v e r the co st of final illn e sse s and fu n eral e x p e n s e s. Although m an y w o rk e rs stood to lo s e a ll health and in su ran ce p ro te ctio n upon re tirem en t and oth ers w e re su bject to red u ced p ro te ctio n upon re tire m e n t, r a r e ly did a plan that extended benefits to re tire d w o rk e rs include p ro v is io n s fo r d iscon tinu an ce of such benefits during the retire m e n t p e r io d (table A -9 ). Thus, as long as a w o rk e r so c o v e r e d was in a re tire d status, w hich g en e ra lly m eant as long as he lived, he did not fea r loss of a ben efit b e ca u se of his age. Dependents of R etired. Slightly m o r e than a third of the plans p rov id in g benefits fo r the re tire d w o r k e r, co v e rin g m o r e than half of the w o rk e rs under such plan s, a ls o extended one or m o r e benefits to his dependents (table A - 10). T h ese ratios w ere low in co m p a riso n with the exten sion of ben efits to dependents of active w o r k e r s, and w e re attributable in la rg e pa :t to the fact that life in s u r an ce was the only ben efit p rov id ed re tired w o rk e rs under m o r e than half the plans fo r that grou p. H ow ev er, m o st of the plans extending h osp ital, s u r g ic a l, and m e d ic a l ben efits to re tired w o rk e rs a ls o m ade such p ro te ctio n available to their dependents (table A -4 ). B enefits p rov id ed dependents of r e.ir e d w o rk e rs included h osp ita liza tion, s u r g ic a l, and m e d ica l c a r e. The m o st frequ en tly p rovid ed package (in 31 of 5 6 plan s) included all three b en efits. T hese 31 plans accou n ted fo r n ea rly 80 p e rcen t of the w o rk e rs c o v e re d by all plans extending b en efits. E v e r y plan extending ben efits to dependents of re tire d w ork ers in cluded h osp italization. Six out of 7 and 4 out of 7 plans p rov id ed su rg ica l and m e d ica l b en efits, re s p e c tiv e ly. F o r th is a n a ly s is, b e n e fits a v a ila b le to the w orker retirin g at a ge 65 w ere com p ared with th o s e a v a ila b le to him im m ed ia tely p rior to retirem en t (i. e., at age 6 4). It is s u b s e q u e n tly n oted (ta b le A -1 3 ) that b e n e fits fo r the m liv e w ork er m ay h ave b een r e d u ce d as he r e a c h e d a ce r ta in a d v a n c e d a ge.