"The point-of-service plans probably need to be fine-tuned," he said.

These point-of-service plans have gone from a little-used option to become the nation's fastest-growing type of health plan.

A wide variety of provider panels and point-of-service plans are available for $6,500 to $9,500.

Oxford said it planned to raise rates on its point-of-service plans.

SOME consumer advocates say point-of-service plans are worth the cost.

Most companies were also unwilling to describe precisely what risks the insurers had assumed in selling the point-of-service plans.

Also, employers offer point-of-service plans not in response to the "public's fears," but as a bait-and-switch tactic.

"People tend to think of the point-of-service plans as the best of both worlds."

The growth of point-of-service plans where enrollees have greater choice of doctors may further weaken managed care's ability to control costs.

The ruling applies to so-called point-of-service plans, which generally allow customers to receive care outside their health maintenance organization's network if they pay extra.