Premium increases moderated in the Carolinas in 2008 with health plan costs per employee rising by 6 percent to 10 percent, but the increases are expected to accelerate in the coming months. Brokers also expect a broader acceptance of consumer-driven health plan designs in North and South Carolina. Even though insurers are pushing wellness, few employers have adopted comprehensive wellness programs at work states in the region. One of the first to do so, utility company Scana Corp., operates an on-site pharmacy primarily to provide counseling from pharmacists to employees. In the Medicare sector, private fee-for-service products dominate the market in both states, but with recent legislation putting new rules on PFFS, many of those seniors are expected to migrate toward PPOs. Humana, the PFFS leader in the region, is building a network to serve regional and local PPO members. The South Carolina Medicaid market is losing a managed care plan with AMERIGROUP agreeing to shift its members to Centene Corp. in the state, while the reverse will occur between the two companies in New Jersey. Finally, the PPO that is part of the South Carolina Employee Insurance Program will not see a price increase for 2009, but the HMOs offered by CIGNA HealthCare and BlueCross BlueShield of South Carolina will have rates rising from 15 percent to 41 percent.