Many U.S. workers can expect higher costs for their employer-sponsored health care benefits when they receive their fall open enrollment benefit packages for 2010. But in addition, employees might find that their 2010 employee benefit packages include financial rewards for promoting healthy lifestyles, full coverage for preventive services, closer scrutiny of dependent and spousal coverage, and greater use of consumer-directed health plans (CDHPs).
“Faced with an uncertain economy and rising health care costs that show few signs of slowing, many employers have made changes to their health benefit plans for 2010,” says Tom Billet, a senior consultant with HR consultancy Watson Wyatt. “While next year’s benefits will reflect these higher costs, workers can also expect employers to continue their commitment to encourage employees to lead healthy lifestyles.”
Billet identified six trends that employees can expect to see in their benefit packages during open enrollment:
• Higher out-of-pocket costs. More than four in 10 employers in a recent Watson Wyatt survey said they will raise deductibles, co-payments and out-of-pocket maximums because of the economic crisis. Some employers might raise doctor visit co-payments by $5. Others might no longer provide 100 percent coverage for in-network services, opting instead to introduce some level of co-insurance to encourage workers to be more aware of the cost of services. Deductibles for individual and family coverage are expected to increase by $50 to $100 or more among some employers. (See U.S. Health Care Inflation to Far Outpace Salary Increases in 2010.)
• Greater use of incentives to stay healthy. Employers are continuing their push to improve the health of employees and their families. In addition to continuing the focus on wellness communication, employers are offering workers (and, in some cases, spouses) more incentives like gift cards, cash and discounted premiums for undergoing a health risk assessment or participating in smoking cessation, weight management or fitness programs. They are giving workers access to on-site health coaching as well as using health service providers to deliver web-based and telephonic coaching. (See Size and Scope of Wellness Incentives Grow Larger.)
• Consumer-directed health plans. More employers will offer CDHPs, as they are increasingly viewed as an effective way to control rising costs. Those employers adopting new plans are generally adding a high-deductible plan, often with a health savings account. Most employers adding these plans will offer them as an option to workers rather than replacing their traditional health plans. (See CDHPs Increasingly Favored Over HMOs.)
• Consolidation of health plan offerings. Some employers plan to reduce the number of health plan options they offer to workers. As more employers consolidate and change their health plans and networks for 2010, some employees might have to change physicians or pay higher out-of-network costs. (See Renegotiate Benefit Contracts and Cut Costs.)
• Prescription drug benefits. Some workers will see changes to their prescription drug benefits in 2010. As part of an overall movement to CDHPs, a number of employers are introducing a CDHP prescription drug benefit option that typically offers workers 100 percent coverage on a list of preventive medications. Other companies are introducing value-based designs that include zero co-pays on certain prescription drug therapies that are known to help lower health costs and reduce hospitalizations. (See Employee Cost-Sharing Up in Prescription Drug Plans.)
• Closer eye on spousal and dependent coverage. Employers are increasingly revisiting spousal and dependent coverage in their efforts to control costs. Some employers are requiring spouses to complete health risk assessments, while others are charging higher premiums for working spouses who have access to other health care coverage. More employers are expected to audit their workers to eliminate dependents who are not eligible for coverage. (See Tips for Auditing Dependent Eligibility.)
Open Enrollment Tips for Employees
In a nationwide U.S. survey conducted on behalf of health insurer CIGNA in July 2009, nearly half of the respondents (46 percent) said they spend 30 minutes or less reviewing their health care insurance options during open enrollment season (September through December for most companies). In comparison, Americans have said that that they would spend four hours researching a computer purchase, five hours researching a vacation, and eight hours researching a car purchase.
Employees need access to the right information to make the best possible health decisions for themselves and their families. And, given the current economic pressures and rising costs of health care, they could also use some ideas for saving money on health costs. Case in point, the CIGNA survey also revealed that Americans want to save money on their health care costs, with 64 percent saying they’d be willing to spend the time online to save $100 or less.
CIGNA suggests communicating to employees the following tips to help them choose their benefits and maximize their health care dollars.
• Educate yourself about health care. With multiple health care options available, people increasingly need to understand what their health care needs are and which plans best fit those needs. Make use of free online resources from your health insurance provider to educate yourself on how to make sense of your health plan options, improve your overall health and reduce out-of-pocket costs.
• Know when open enrollment begins and know the enrollment deadline. Don’t assume because you’re enrolled now that you don’t have to do anything. Some employers require people to reenroll each year.
• Find out if your employer is offering an enrollment fair and if so, go. The people at the fairs are there to help you best understand how your plan options work, so use the face time!
• Go to in-network doctors. Confirm that your doctor participates in your health plan’s network, and use in-network health care professionals so you can take advantage of the lower prices for services that your health plan has negotiated on your behalf.
• Don’t guess. Spend some time thinking about your health care needs. Many people can anticipate at least some of the health care services they and their families will need in the upcoming year, especially for preventive care like well-child visits, care for a chronic medical condition, prescription needs or a teen who will need braces. Taking time to anticipate your needs can help you choose the option that will suit your specific situation the best. Even if you’re not offered a choice of plans, this step will help you better budget for health care costs.
• Check if your medications are covered. Most health plans post a list of covered drugs online.
• Compare and save. See if the health plan you’re considering gives you a way to compare quality and costs of different health care services. Use this information as part of your decision-making.
• Don’t forget about dental, vision and disability insurance. These are important coverages and usually cost less if you purchase them through an employer.
Stephen Miller is an online editor/manager for SHRM.
Open Enrollment for 2010 Will Be Different, SHRM Online Benefits Discipline, September 2009
Pointers Can Help Workers Make Informed Benefits Choices, SHRM Online Benefits Discipline, September 2009
How to Develop an Effective Benefits Communication Strategy, SHRM Online Benefits Discipline, September 2009
SHRM Online Benefits Discipline