For millions of American workers, the final quarter of the year is when they receive information about their company's benefit plans for the coming year. This is the workers' chance to add or drop various kinds of insurance, change plans or otherwise adjust their benefits.
For better or worse, it's the time when employers, too, can make changes. And if this year follows the pattern of recent history, the most common change most workers will see is a rise in the cost of their health insurance.
Workers will also find less choice in health insurance plans, more pressure to use "in-network" doctors and hospitals (those that have cut deals on prices with the employer or insurer) and in some cases enticements to join programs to help insurers gauge their health risks and take steps to ease them.
The most dramatic change, which some workers, including federal employees, will see is the offering of full-scale "consumer-driven" health insurance plans, which let workers make many of their own health care spending decisions.
Talks with benefits consultants here and elsewhere in the country suggest that the most common changes workers can expect to see for next year are:
• Higher costs. No surprise here. Although several recent surveys have found that the rate of medical cost increases has eased somewhat, the increases have certainly not stopped. Thus, premiums are likely to rise again, and many employers expect to shift a bit more of the rise to workers.
But Tom Billet, a benefits consultant with Watson Wyatt Worldwide in Stamford, Conn., noted that many employers are trying to hold the line on premiums while shifting the cost of their plans more toward those who use them. This typically means higher co-payments -- the amount, typically a flat fee, that workers pay when they visit a doctor or other health care provider. It could also mean co-payments for services such as hospital visits where there may not have been any before.
Similarly, deductibles may rise, meaning the amount employees have to pay before their insurance kicks in could be higher.
"What we see consistently with companies who manage costs well is a bias toward more cost sharing in the plan rather than in the [premium]. This channels more cost to the users of the plan, which most would say is fair," Billet said.
Also, he said, "that's the point where people can make decisions about how much care to get and how much to spend. If you pay a lot through your paycheck and very little to use the plan, you say, 'I might as well use it.' That's not a good incentive."
