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More health insurance changes on the way

McClatchy-Tribune Information Services

November 10, 2014


Employers are increasingly pushing enrollment in high-deductible, low-premium health insurance plans, according to benefits experts, which means it might be time to break out the calculator and reconsider current policies.

Employees across the country are getting their first looks at what they will be paying for health insurance in 2015 with the start of open enrollment, the annual window in which workers can make changes to their elected benefits, including health insurance. Open enrollment is typically held in October and November each year.

"Don’t assume that nothing’s changing even if your current option is still available," said Craig Rosenberg, practice leader of health and welfare benefits at consulting firm Aon Hewitt. "There are probably some new choices that are available for you."

Three-fourths of employers aim to offer high-deductible plans coupled with a health savings account in the next three years, and 20 percent will only offer those type of plans, according to data from Mercer, a financial services company with a health and benefits arm. To qualify for a health savings account, a plan has to have a minimum deductible of $1,250 for employee-only coverage and $2,500 for family coverage. Others are offering private health exchanges, which give employees several options for coverage.

Overall costs likely will rise again in 2015, by about 4 percent, according to Mercer, modest compared with previous years. But some employees are seeing much sharper increases, making high-deductible plans more attractive. Consumers who opt not to obtain coverage, either through their employer or through the federal Affordable Care Act, will also pay more. Those individuals will pay a greater penalty for not securing coverage, increasing to $325, or 2 percent of household income, whichever fee is greater, from $95 this year, or 1 percent of yearly household income.

High-deductible, low-premium plans are often called consumer-directed health plans and paired with a health savings account that allows workers to pay for eligible expenses with tax-free dollars, experts said.

Employers have a financial incentive to offer such plans. Under the Affordable Care Act, employers in 2018 that offer plans that cost more than $10,200 for an individual or $27,500 for a family will be charged a 40 percent tax on the amount exceeding the threshold. By raising deductibles and lowering premiums, companies will lower their chance of triggering the tax.

Beth Umland, director of research for health and benefits for Mercer, said more than one-third of companies would hit that excise tax threshold if they made no changes to their plan offerings.

Premiums in consumer directed plans typically cost about 20 percent less than a traditional PPO or HMO plan, she said.

"If you’ve been scared off of consumer directed plans, this might be the year to man-up and take a look," Umland said. "Employers want to get people into those plans for a variety of reasons. That’s the plan where they see long-term cost control, so to get folks to join it, it’s bargain basement premium contributions."

Nancy Coletto, a Chicago-based partner in Mercer’s health and benefits practice, said employer health insurance plans are more likely to add an additional fee for dependents (spouses and adult children) who have access to health insurance at another workplace this year.

"Health care reform puts more responsibility on employers to cover more of their employees," Coletto said. "Employers who are now covering more employees may make it more expensive to cover a dependent. Make sure you fully understand what costs are changing. That decision may be different than what it was before."

Private exchanges — run by companies like Aon Hewitt, Mercer, Buck Consultants and Towers Watson — are predicted to grow in popularity in coming years, with 33 percent of more than 1,200 companies surveyed by Aon Hewitt saying they would prefer to offer a private health exchange in the next three to five years. Just 5 percent will use a private health exchange in 2015.

Aon Hewitt started its private exchange program for active employees three years ago with three companies. In 2015, Aon Hewitt anticipates about 30 companies will enroll its exchange, covering 850,000 employees and dependents. Mercer has signed up 170 companies in its private exchange for 2015, covering 975,000 active employees and dependents. The private health exchanges offer a variety of plans, from PPOs, more expensive month to month, to low-premium consumer directed plans.

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TIPS FOR HEALTH INSURANCE ENROLLMENT

—Assess your needs

How much did you spend on health care out of pocket last year? Ask your health plan provider for your past medical and dental claims to calculate last year’s costs.

—Account for any big changes

Are you planning to have a baby? Did someone in your family develop a new medical condition?

—Evaluate the network

Mergers among doctors groups as well as hospital systems are reshaping the provider community, which could affect your choices.

—Decide whether a consumer driven health plan is right for you

These lower how much money is taken out of each paycheck but leave you with a large deductible if anything happens. Couple this with a health savings account to help pay for out-of-pocket costs.

—Determine whether to put a dependent on the same plan

If your spouse or adult child has access to health care through another provider, it may be more cost-effective to have him or her enroll with his or her employer plan, depending on fees.

—Take advantage of health and wellness programs

Some companies offer financial incentives for completing certain questionnaires or various health-related activities.

—Know how your coverage relates to public Affordable Care Act exchanges

If you’re eligible for health care through your employer, you won’t get federal tax credits to buy insurance through the public exchanges.

—SOURCES: Adapted from materials and interviews with experts from Aon Hewitt, Mercer and the Employee Benefits Research Institute