Key Factors in Comparing Health Plans : Benefits: The variables include cost of existing systems and job security. The Clinton proposal emphasizes portability and simplicity.

Is the Clinton health reform plan a good deal if you have a steady job with generous health benefits?

That’s the key question for millions of American workers as the heated debate begins over the proposal for massive overhaul of the nation’s health care system.

The answer depends on several variables, chiefly the cost of your current plan, your job security and your level of satisfaction with today’s health care system. Most American workers already are covered by health insurance, with a dizzying variety of co-payments, deductibles and premiums.

President Clinton’s approach has a strong selling theme: security and simplicity. You will always be covered, whether you change jobs, get fired or become sick. You and your family will never be denied insurance because of your employment status or medical condition.

Currently, health insurance is a benefit that companies grant voluntarily. Each employer is free to offer health insurance or ignore it and to provide any combination of benefits. Businesses also are free to decide how the burden of payment is divided between company and worker. About 200 million people have insurance, almost all through the workplace.

If the President’s plan is approved, the voluntary and complex system would give way to a mandatory and comparatively simple one.

Under the proposal, your employer would be required to provide coverage and to pay 80% of the average cost of a comprehensive plan in your geographic area.

You would choose a plan, picking from among approximately three to seven alternatives offered in each area, and pay the difference between 80% of the average cost and the actual charges for the plan you select.

For example, if the average plan costs $2,100 a year--which is close to the current national average for an individual--the company would pay $1,680 and the worker $420, an 80-20 split.

However, if a worker chooses a more expensive plan, perhaps offering a wider choice of physicians and services, the employee would be responsible for the difference. For instance, if the plan costs $2,500, the employer would still pay $1,680 and the worker would be responsible for the other $820.

The goal of the health plan is to limit a worker’s health insurance premium payments to no more than 1.9% of his or her total income, although workers who choose more expensive plans might pay more and those who choose less elaborate plans might pay less.

American workers now typically contribute part of their income to company-sponsored health plans, with the amounts varying widely from business to business, although some union contracts require companies to pay 100% of health care costs.

Administration health planners argue that, even for those who would have to pay more, the Clinton plan can be sold on the basis of security. Their message: You might have good coverage now, but you can lose it at any time. We will guarantee coverage forever, so don’t be afraid if you have to pay more.

That argument has special resonance today, as massive waves of corporate layoffs among skilled workers and middle managers, even at highly profitable firms, have created fears that health benefits can be lost. A departing worker can continue health insurance for 18 months, but must pay the full premium, which can be very costly.

Even if the laid-off worker gets another job with little delay, the new employer may lack insurance or may impose a waiting period before coverage begins.

For low-wage workers, whose 1.9% contribution might not be sufficient to pay 20% of health care coverage, the Administration promises help through a subsidy paid either by the government or the employer. For families with incomes up to 50% above the federal poverty level, the government would pay most or all of the premium.

Worker premiums could be collected from an employee’s paycheck on a payroll deduction basis. Or the worker could choose to make regular payments, perhaps on a quarterly or monthly basis, directly to a health alliance in his or her area.

In addition to the premium payments, workers would have some additional costs, depending on the plans they choose.

The copy of the Clinton proposal obtained by The Times says that consumer out-of-pocket costs “are limited, to ensure financial protection, and standardized to ensure simplicity in choosing among health plans.”

Under a low-cost plan, the insured might pay $10 for an office visit, $25 for a visit to an emergency room and $10 a visit for services such as physical therapy. There would be no annual deductible.

The high-cost version might require an individual to pay the first $200 in medical bills each year with a family required to pay the first $400. In addition, there would be a 20% co-insurance cost, with the individual responsible for 20% of the bill for each visit to a doctor’s office or for each hospital stay or other service.

Under any of the plans, the maximum out-of-pocket spending would be $1,500 a year for an individual or $3,000 for a family. This means that, no matter how high total medical spending were to go--whether a member of an insured family has an appendectomy, a heart transplant or other expensive procedures--the family would spend no more than $3,000 a year.

This is comparable to the best “stop loss” protection--limits on total financial exposure--now enjoyed by workers with good private insurance plans. These limits on how deeply your pocketbook can be tapped will be an integral part of the Clinton sales pitch for national health reform.

The Health Care Proposal

Who Would Participate

* American citizens

* Foreign citizens legally living in the United States and some illegal immigrants who are employed.

Who Would Not

* The elderly: Covered by Medicare, with new coverage for prescription drugs

* Military personnel: Covered by Defense Department, although they may gradually integrate into the plan.

* War veterans: Covered by Veterans Affairs Department, although they may gradually integrate into the plan.

* American Indians: Covered by Indian Health Service, although they may gradually integrate into the plan.

How It Would Work

* All eligible individuals would receive a health security card entitling them to join a corporate or regional “health alliance.”

* Corporate alliances: established by large firms (with at least 5,000 workers) that choose not to join regional alliances.

* Regional alliances: established by states for everyone else.

* Alliances negotiate with health plans--that is, groups of health care providers--over services and fees.

* Health plans must meet national quality standards and may not deny enrollment to the sick or the poor.

* Alliance members may select the available health plan of their choice.

Who Would Pay

* Employers: For each worker, 80% of the cost of the average-priced health plan.

* Workers: 20% of the cost if they choose an average-priced health plan. If they choose a cheaper-than-average plan, they would pocket the savings; if they choose a more expensive plan, they would pay the excess.

* The unemployed: Contributions according to unearned income. Those without income would pay nothing.

* The federal government: Subsidies for small employers and to cover the insurance costs of the unemployed, low-income workers and retirees between 55 and 65.