Health coverage is being reshaped
By Sandra Block
USA Today
Eat your vegetables, get plenty of exercise and lay off the martinis. At the rate health costs are rising, you can't afford to get sick.
As the benefits-enrollment season begins, millions of workers in company-sponsored health plans face another cycle of higher premiums, co-payments and deductibles. But companies are rewarding those who take an active role in managing healthcare costs.
Here are some trends in employee benefits that may find their way into your enrollment package this year:
• More consumer-driven health plans.
These plans typically offer lower premiums in exchange for a high deductible. You also may get an annual allowance from your employer toward that deductible, which in theory gives you more control over your healthcare costs. For example, if your plan's deductible is $2,000 a year, you may get an allowance of $1,000. If the plan includes a health savings account, you can roll over unused money into a savings account. Withdrawals aren't taxed if the money is used for medical costs.
Nearly three-quarters of employers surveyed by Mercer Human Resource Consulting earlier this year said they were likely to offer health savings accounts by 2006, although not all plan to provide allowances.
• Fewer HMOs.
In the 1990s, many employers offered the choice of several health maintenance organizations, along with preferred provider organizations and conventional health plans. Now, many are offering fewer HMOs, if any at all. Some workers who are enrolled in an HMO may discover it won't be available in 2005.
Companies are backing away from offering multiple HMOs because it is expensive to do so, according to Tom Billet, benefits consultant for Watson Wyatt. With a PPO, employers can keep all their employees under one umbrella, which reduces administrative costs, he says.
• More customized plans.
Increasingly, companies are allowing employees to tailor their plans to fit their own needs, says Sara Taylor, enrollment expert for consulting firm Hewitt Associates. For example, you may be able to lower your premiums by agreeing to higher co-payments or a smaller network of providers within your PPO.
• More disease-management programs.
Companies are embracing these plans as a way to improve productivity and reduce healthcare costs. These programs are managed by an outside vendor to protect workers' privacy.
You may be asked to fill out a health assessment questionnaire. If you have a chronic health problem, such as high blood pressure, you may be assigned a nurse or case manager to help manage your care.
Participation is voluntary.
• Mandatory enrollment.
Some companies are requiring workers to re-enroll in their health plans even if they intend to stay in the same plan next year, according to Taylor. Employers want employees "to actively manage their benefits every single year," she says.
Workers who fail to re-enroll may be funneled into a high-deductible plan or other "default" option that may not meet their needs,Taylor says. At some companies, workers who don't re-enroll may lose their coverage, according to Taylor.
