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Employers plan to shift more health-care costs to workers, survey reports

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He predicts that employers will use other approaches.

So-called spousal surcharges impose a fee if an employee's spouse enrolls in the company plan, despite having the option of getting coverage through his or her own job. The theory is that spouses who take advantage of the company plan are likely to be heavier consumers of health care. Twenty-eight percent of employers plan to use spousal surcharges next year, up from 21 percent this year, the survey found.

Although only 3 or 4 percent of employers give employees financial incentives to meet targets for blood pressure, weight and cholesterol, 13 to 14 percent are considering doing so, the survey found. Six to 7 percent are considering declaring that only employees who meet targets can enroll in "preferred" health-care plans, up from 1 percent now.

Nineteen percent of large employers are considering giving workers incentives to undergo biometric screening and health-risk appraisals, on top of 22 percent that already do.

In addition, employers are increasingly moving toward high-deductible plans, which carry lower premiums while leaving workers responsible for higher out-of-pocket expenses. Next year, 12 percent of employers plan to offer only high-deductible coverage, the survey found.

Employers and insurers have placed great hope in high-deductible plans, but the survey found that although companies can save money by switching to such plans, it now appears that over time their costs rise as fast as those for other types of coverage.


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