As employers evaluate different
options in managing their benefit offerings, they often
maintain a keen eye on the trends in the group benefits
arena. Many of the plan designs from North Carolina
employer groups reflect trend projections from the national
market, yet there are also several differences that are unique
to our local area. The following is a list of some of
the major trends HCW has identified for this year in regard to
NC plans:
1. Leaner Benefits / Higher
Out-of-Pocket Costs
In response to the economic
downturn, many employers are looking to either trim their
benefit offerings or shift more of the costs to the
employees. In fact, the NC Healthcare Benefit & Cost
Survey conducted by HCW and Capital Associated Industries has
consistently indicated more groups are moving away from
full-coverage designs and introducing higher deductibles,
higher copayments and other concepts that help employees
become more aware of the hidden costs of their benefits.
As a result, workers may experience higher out-of-pocket
costs, but they will have a greater understanding of the
economics behind their plan.
2. Enhanced Wellness
Incentives
Preventive measures to address employee
health continue to be a common theme for forward-thinking
employers, and the use of incentives (monetary gifts, reduced
payroll deductions, health club discounts, etc.) and/or
disincentives (increased deductible limits, higher payroll
deductions, etc.) to increase participation is growing
concurrently. Employers are also moving from
participation-based platforms to more standard-based designs
to challenge participants in meeting certain screening
criteria to qualify for rewards or incentives.
3. Low-Cost Wellness
Programs
Employers wanting to keep pace with the
medical management culture but on a reduced budget are looking
more for programs that still provide a significant return but
at a lower cost. Many of these include initiatives
provided by their medical carriers or third-party
administrators as part of their business agreement.
4. Better Benefit
Communications
As employers continue to find more
effective ways of educating their employees about plan
details, they are also providing enhanced communications to
convey the overall value of their benefit programs.
Messages of cost transparency, better utilization, and
correlations to claims costs are being used to create more
awareness around the benefit plan and ultimately turn workers
into better healthcare consumers.
5. Consumer-Driven
Plans
Businesses will continue to adopt
consumer-driven health plans (CDHPs) but not at the rate that
some had been projecting. Actuarial analysis is not
projecting reduced trends for these plan designs, and there is
little evidence that they actually modify behaviors.
However, employers will continue to use them because they
remain an effective measure of cost-shifting.
6. Continued Scrutiny of
Spousal or Dependent Coverage
Many employers are
reviewing spousal and dependent participation, especially in
situations where these people have access to other coverage
but choose to remain on the primary employee’s plan.
Some of the tactics that are being enacted include: requiring
spouses to complete health risk assessments, charging higher
premiums for working spouses (spousal surcharges), shifting
contributions, and removing dependent eligibility from their
plans altogether.
7. Prescription Drug
Designs
Several companies are looking at their
prescription drug benefits to help manage costs, including new
carrier options to help employees adhere to their doctors’
prescribed regimens. Some are introducing a prescription
drug benefit option that offers 100 percent coverage on
certain medications, while others are offering value-based
designs that eliminate copays for certain prescription drug
therapies that are known to help lower costs and reduce
hospitalizations.
8. Tiering
Contributions
Some
workers are finding that payroll deductions are not as simple
as they once were due to another increasingly-popular
strategy: tiering contributions. Various employers are
offering differing levels of benefits to employees based upon
their salary, length of service, or even class level. In
most instances, reverse discrimination along tiered
contributions is acceptable, as long as it is to the
disadvantage of the higher-income segment.
For more information on national
trends, please click on the following links:
