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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