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Preview: Healthcare Benefits Changes Coming to Open Enrollment

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

Other techniques include mandatory mail order for maintenance medications and mandatory generic substitutions.

To manage specialty pharmacy benefits, most employers will continue to use prior authorization, utilization management, and step therapy. Some 40% will use a carve-out from the health plan, while 13% will use a four-tier benefit design.

Also, 39% of the survey respondents indicated that they require employees to pay the cost difference between generic and brand names drugs.

Retiree health benefits. To control retiree healthcare costs 45% of respondents are capping company contributions, 31% are increasing employee contributions and 18% are eliminating retiree health benefits for new hires.

In addition to plan design changes, employers are doing more than simply offering healthcare benefits, through on-site health clinics and wellness programs they are getting involved in maintaining the health of their employees to help reduce costs.

Although only 37% of survey respondents said they provided on-site clinics, the services provided at these clinics has expanded. Occupational health continues to be the mainstay, but clinics are adding chronic care management, health improvement programs, and acute and primary care for their employees.

This is just the beginning of significant changes expected in benefit packages as healthcare reform is implemented.

One question on almost every employee’s mind is whether employers will continue to offer healthcare benefits once federal health insurance exchanges open for business in 2014.The good news is that 71% of companies surveyed by Towers Watson, the benefits consultant, expect to continue to offer those benefits. Only 10% have made the decision to drop healthcare coverage; the remainder are undecided.

Employers that plan to drop coverage are still exploring their options in terms of how they will help their employees access insurance. One idea being floated is to provide a salary increase equal to the cost of benefits.


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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