Massachusetts remodeler Ray Wiese was thinking about survival, not national health care reform, when he made the difficult decision to reduce his employees’ health coverage to a 50% copay in 2009.

“Health insurance is a constant rising cost that has outpaced inflation since I started offering health benefits 15 years ago,” says the owner of The Wiese Co., in Natick, Mass. Squeezed between dwindling revenue and rising costs, remodelers like him are finding breathing room by asking their employees “to share in some of the challenges of the current economy,” as Wiese puts it, through higher health care copays, premiums, and deductibles.

Health reform could accelerate the trend. Though very small businesses may be exempt from mandated coverage, “health insurance is still a benefit small businesses may want to provide as a recruiting and retention tool,” says Molly Brogan of the National Small Business Association. If insurance remains too expensive, “small businesses will be in the same place we are today: unable to afford health insurance and unable to compete with larger companies for good talent.”

Individual health coverage can cost 30% less than a comparable group plan, says Joseph Faraldi of Lockton Affinity, which offers custom plans through the National Association of the Remodeling Industry. “I believe that 2010 will be a turning point” toward “non-traditional” means of offering health benefits, he says.

Simple lifestyle changes can control costs as well, even without the wellness programs that many large firms offer. To maintain “Cadillac coverage” at Strite Design + Remodel, in Boise, Idaho, owner Jim Strite hosts companywide discussions about individual responsibility. “Some companies tell their people to speed up. We tell them to slow down,” he says.

—Leah Thayer, senior editor, REMODELING.