If it's November, that means health-insurance renewal season is wrapping up.

About the same time that most of the leaves have fallen and everybody is thinking Thanksgiving, thousands of companies or workers are quaking over the latest round of increases for health insurance.

Higher deductibles, higher co-pays, higher premiums usually lead companies in one direction.

"It's the resurgence of what I call the hunt for tax savings," said Erik Freudenberg, marketing director for Chard, Snyder & Associations, employee benefit specialists based in Mason, where 26 people are employed.

The company, founded in 1988, urges clients to bore into Internal Revenue Service regulations that pertain to health insurance, and Freudenberg says far too few companies explore a corner of the tax code called Section 125.

At the risk of oversimplification, Freudenberg explained, that portion of the code allows:

• Flexible spending accounts that bring companies a savings of 7.5 percent for every pretax dollar that employees plug into the account to pay for prescriptions, deductibles, over-the-counter medicine, glasses and other eye care.

• Pretax vacation purchase where employees could pay for an extra week through a voluntary pretax deduction, and that in turn brings a tax break on the cost of the week to the employee and a savings for the employer of another 7.5 percent on each dollar set aside.

• Cafeteria plans, flex credits and other approaches like higher deductibles with employer-sponsored reimbursement arrangements can also bring savings.

Clearly health insurance is a critical autumn issue for companies and employees alike.

Health insurance premiums increased 13.9 percent in 2003, according to the annual Employer Health Benefits Survey release in September by the Kaiser Family Foundation and Health Research and Education Trust.

It was the largest jump since 1990, and most employers have passed it on to employees.

The Kaiser survey also found that in the last three years, the amount employees pay for family coverage has increased 50 percent, from $1,619 to $2,412.

A typical family health insurance policy now costs $9,068 with employers on average paying 73 percent and employees paying 27 percent.

So it's back to Section 125 for many companies and employees.

"A hidden area of savings," Freudenberg says. "People have some knowledge of it but not full knowledge of the benefits."

Earl Walz is the chief operating offer of The Urology Group, a 31-physician group that faced another double-digit increase in premiums this year - about 23 percent.

"We couldn't continue to absorb that," Walz said.

By implementing a pretax flexible spending account and raising the pharmacy deductible to $100 a person, the group was able to keep increases to 9 percent.

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E-mail jeckberg@enquirer.com