Instead of reviewing their plans options and comparing coverages, 55 percent of U.S. employees default to their current benefit coverage for the coming year, according to a 2012 survey by HR consultancy Aon Hewitt.  Without an active comparison of plan options and coverages, many workers do not realize that their previous year’s plan selection may not be the best option for them and their family.

Health care costs are expected to rise over 6 percent in 2013 to $11,188 per employee.  In most cases, workers should expect to see their portion of the total cost rise in the form of increased premiums and out-of-pocket costs.  According to the Aon Hewitt survey, the amount employees will pay for their health care benefits in 2013 is expected to be $2,385 in premiums and another $2,449 in out-of-pocket costs. 
 

Below are some tips for employers and employees during the open enrollment season:

• Educate employees on any changes to their health benefits and HCR regulations.
• Make sure employees have access to Summary of Benefits and Coverages (SBC) Statements.  The new SBC statements will be a helpful tool in comparing coverage from their employer with coverage available from a spouse’s employer and/or other sources.
• Encourage employees to evaluate their health care spend in 2012 and determine how much was spent out-of-pocket on deductibles, flat-dollar co-payments and percentage-of-cost co-insurance, the number of doctor visits, and the cost of ongoing medications.
  • Those participating in a flexible spending account (FSA) should evaluate if the contribution is too little or too much based on actual expenses.  Under PPACA, FSAs will be capped at $2,500 annually in 2013.
  • Those that have a health reimbursement arrangement (HRA) or health savings account (HSA) should determine what remaining balance they might have to apply to 2013 expenses, even though amounts in HSAs always—and HRAs typically—roll over from year to year.
• The employee’s individual financial analysis should be used when considering whether a Customer-Driven Health Plan (CDHP) meets their needs (if offered as a group plan option).
• Offer tools to help employees and their families better understand their health risks — biometric screenings for cholesterol, blood pressure and blood glucose, with follow-up consultations so employees can take steps to improve their health — and encourage employees to take advantage of incentives and opportunities to improve their health and reduce their out of pocket health care spend.

(Photo credited to: countonoptima.com)

DISCLAIMER: Because of the generality of this update, and based on particular situations, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice, financial advice and/or the advice of a licensed insurance or certified human resource professional.

© Connelly, Carlisle, Fields & Nichols 2012