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Preview: Healthcare Benefits Changes Coming to Open Enrollment

Margaret Dick Tocknell, for HealthLeaders Media, August 24, 2011

Incentives. Employers are adding more services like weight management programs and increasing the average annual incentives for healthy lifestyles programs. Average incentives are expected to increase to $383 in 2012 from $303 in 2011.

Controlling costs. About 25% of the survey respondents identified increased employee cost sharing as the most effective way to control healthcare costs; 23% tapped consumer-directed health plans and 17% identified wellness initiatives as the most effective way to reduce costs.

Consumer-directed healthcare. There's growing interest among employers in adding CDHPs as an option to a benefits package. Some 56% said they will take that step in 2012. Only 17% said a CDHP would be the only option offered.

Cost sharing. About 54% of employers said they will increase the employee contribution to premiums. The spike in employees' costs will probably be less than 10%. Look for across-the-board increases in deductibles, out-of-pocket maximums, and copayments for patient care and prescription drugs.

Coverage tiers. More than one-third of employers use a four-tier design: employee, employee and spouse, family coverage, and employee spouse and children. But about 20% of employers are using a five-tier system that takes into account the number of children in a family.

Pharmacy. Most employers will continue to use a three-tier formulary design. About 15% of employers expect to increase pharmacy copays but the increases will be less than 10%. To manage pharmacy benefits, employers will continue to rely on prior authorization, quantity limits, and step therapy.

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