Higher premiums, fewer options in U.S. benefits plans

American employers are shifting costs to employees, consolidating plan choices, emphasizing account-based plans and requiring employees to do more in order to receive incentives, according to experts at Towers Watson.

“Unlike the last few years when many employees saw significant increases in co-payments, deductibles and coinsurance, 2012 looks like a year when we will start to see costs go up primarily via increased premium contributions, with a higher proportion of the increase being borne by families,” says Randall Abbott, senior health care consultant at Towers Watson. “Employers are becoming increasingly focused on raising the cost for dependents to capture the added expense and to encourage working spouses to shift to their own employer’s plan.”

The 2011 Towers Watson Health Care Trend Survey found that roughly two-thirds of employers (66%) will increase employees’ share-of-premium contributions for single-only coverage for 2012, and 73% will increase them for dependent coverage.

Employers continue to consolidate plan choices and are adopting account-based plans at a rapid rate, with 57% of large employers expecting to offer this option. This means employees will need to become more familiar with the advantages and certain limitations of high-deductible plans and health savings accounts. Employees will also be required to pay more for brand-name drugs, and will have access to specialty drugs only with prior authorization and participation in other therapies.

Incentives to participate in wellness programs, or awards to complete a personal health assessment or be screened for high blood pressure, cholesterol, blood sugar and other items continue to be popular, but employees will need to do more to get the same level of incentive awards.

A small but growing number of employers are requiring both health assessments and biometric screenings as a condition of plan participation. In other cases, those declining to undergo screenings face a higher premium or more limited plan choices.

“Employers will keep their focus on improving worker health and driving employees to consider the cost of care in 2012. As a result, we expect more companies to link benefits with individual employee behaviors and benefit decisions, requiring employees to be more accountable for their own choices,” says Abbott. “Employees who make smart decisions about their health care providers and prescription medications will be able to boost employer subsidies and incentives.”