When the going gets tough, the tough go shopping," as the saying goes, and now is a good time to be shopping for health insurance, but not because the going is tough. On the contrary, the escalation of health insurance costs has slowed in the past year. After rising 25% or more for several years, premiums increased an average of 10% in 1985 and, for some companies, may level off in 1986. Some insurers are even providing more coverage for the premium dollar this year -- lowering deductibles, for example, without increasing rates.

At the same time, insurance companies are searching for new business, and many have targeted the small-business market, offering health insurance plans with cost-saving restrictions and incentives intended to discourage unnecessary hospitalization, shorten lengths of stay, and promote the use of outpatient facilities.

Experts generally agree that such plans can provide significant benefits in the long run, by involving employees in the effort to control insurance costs.But all cost-containment plans are not equal. The reason has to do with the fact that insurance companies pool their small-business customers, the better to predict medical costs. "Insurance company A may do a lot of business with small companies," explains David Schorr, a managing consultant in the San Francisco office of The Wyatt Co., the international benefits consulting firm, "but they may offer 'richer' plans with more benefits as well as cost-containment plans. Regardless of the plan design, they may pool all of this experience. Company B may specialize in cost-containment plans [only]. Odds are that Company B will have better rates because Company A may be losing money on the richer plans."

In addition, there is the hidden cost of educating employees to that they understand the incentives and penalties involved in the plan. "That can take up to a year," notes Thomas Farr, an independent insurance agent in Newport Beach, Calif.

So, in choosing such a plan, companies have to consider more than rates. They should also take into account the expense of educating employees about the plan, how difficult it may be for employees to use the services offered, and which costs they want employees to share.