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More Employees Take Active Role in Selecting Health Benefits
Nearly half chose benefits actively for 2010, rather than defaulting passively

By Stephen Miller  4/1/2010
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With U.S. health care in the media spotlight, a new analysis shows that a record percentage of U.S. workers took an active role in selecting their health care benefits during open enrollment for the 2010 plan year. But despite being more engaged in the enrollment process, most chose to enroll in health plans similar to what they had.

"Employee inertia continues to play a large role in enrollment decisions. It’s encouraging to see that people are more engaged in assessing their benefits, but that doesn’t mean they are necessarily making different choices," says Sara Taylor, health and welfare strategy leader at consultancy Hewitt Associates, which conducted the analysis. "If employers want workers to make different elections, they might need to adopt a more aggressive approach—whether it's changing or reducing plan options or offering plans with widely differing price points."

Hewitt's analysis of 6 million U.S. workers in the fall of 2009 revealed the highest number of active enrollees since the firm began tracking benefits enrollment data in 2003. Nearly half (45 percent) of all employees chose their benefits actively for 2010 instead of defaulting passively into the same coverage or no coverage through their own employer. This was up significantly from the 2009 open enrollment period, when just 39 percent of employees enrolled actively.

As Taylor noted, despite active enrollment, few chose to change their health insurance plan. Enrollment in exclusive-provider organizations (EPO), preferred-provider organizations (PPO) and high-deductible health plans (HDHP) remained consistent with previous years. Enrollment in health maintenance organizations (HMO) dipped slightly, while point of service (POS) plans and indemnity plans saw slight upticks. 

Enrollment by Plan Type Open Enrollment Year




























Source: Hewitt Associates

HSA Enrollments Up

One noticeable change, however, is increased enrollment in spending accounts linked to consumer-directed health plans. Hewitt’s analysis shows that enrollment in health savings accounts (HSAs) rose steadily over the preceding five years, from 5 percent in 2005 to 14 percent for the 2010 plan year. Similarly, the 15th Annual NBGH/Towers Watson Employer Survey on Purchasing Value in Health Care shows that for plan year 2010 nearly half (46 percent) of large U.S. companies that offer an HSA or health reimbursement arrangement (HRA) report that at least 20 percent of their workers enrolled, an increase of nearly 70 percent in five years (see the SHRM Online article, Employers Weigh Health Care Strategies).

Enrollment in flexible spending accounts (FSAs) remained consistent, Hewitt found, with one in five U.S. employees enrolling in a FSA for 2010, up slightly from 18 percent in 2009.

Use of Decision-Support Tools Rises

Hewitt's analysis shows across-the-board increases in the percentage of employees using online decision-support tools to compare health care coverage options and make trade-off decisions about how to spend their health care dollars. For example, use of Hewitt’s People Like Me tool—which provides employees with examples of the benefits selections of people in similar circumstances—increased from 8 percent in 2009 to 26 percent for the 2010 plan year. Additionally, 22 percent of participants used a medical expense estimator, up from 11 percent in 2009.

Stephen Miller is an online editor/manager for SHRM.

Related Articles:

Employers Weigh Health Care Strategies, SHRM Online Benefits Discipline, March 2010

For Employee Benefits Enrollment, U.S. Trending Toward a Paperless Workplace, SHRM Online Benefits Discipline, March 2010

Missed Open Enrollment Can Mean Higher Costs for Workers, SHRM Online Benefits Discipline, October 2009

Quick Links:

SHRM Online Benefits Discipline

SHRM Online Health Care Reform web page

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