By Eileen Ambrose, The Baltimore Sun
2:50 PM EDT, November 2, 2012
You might not have received your open enrollment package yet, but you probably know what to expect: Higher premiums. More out-of-pocket costs. Enticements to participate in wellness programs.
This may be the last predictable open-enrollment season. Next fall, open enrollment will incorporate the changes from the Affordable Care Act, which takes full effect in 2014.
"We will see a lot of change for 2014," said Melissa Jimeno, a principal in the Baltimore office of benefits consultant Mercer. "This is the calm before the storm."
(Of course, if President Barack Obama loses this week and Congress scraps the health care act, this too could change.)
More than half of workers passively default into their current plan. Benefit experts say you shouldn't be surprised if your employer warns that you will lose coverage unless you actively make a selection — even if it's the one you already have. Employers want to make sure workers have reviewed their health care needs and looked at coverage options.
"Both those things can change," said Craig Rosenberg, the national leader for Health & Welfare Benefits Administration for Aon Hewitt, an Illinois-based benefits consultant. "The plan you have this year might not be the best one for next year."
Employers struggle each year with rising health care costs, and next year is no exception. The costs are expected to go up an average of 6.3 percent, to $11,188 per employee, according to Aon Hewitt. Employers continue to pick up the bulk of that, but workers can count on paying more, too.
Aon Hewitt predicts that an employee will pay an average of $2,385 in premiums next year, plus $2,449 for out-of-pocket costs.
Here are other changes you might see:
Lower flexible spending account limits: Next year, the most you will be able to contribute to a pre-tax flexible spending account to cover health care costs will be $2,500. There hasn't been a cap up until this, unless the employer set one. This cap might not be a big inconvenience for many workers, given that the employees of Aon Hewitt's clients typically set aside $1,600 in these accounts each year.
Benefits summary: Information about health plans and coverage are often confusing. But as of September, the Affordable Care Act requires that workers receive a clear summary of benefits so they can compare their options. They also will receive examples of the cost of each plan for two medical scenarios: diabetes and having a baby.
Wellness efforts: Employers still are trying to get workers to take better care of themselves to help contain health care costs. Many encourage workers to fill out a health risk questionnaire or undertake biometric screening for, say, blood pressure, cholesterol levels or body fat. These can help identify health problems early before they get serious — and expensive.
Companies continue to offer rewards, such as a lower premium, for those who participate in these wellness efforts. But benefits experts say some employers are taking a different tack, making workers pay more for insurance if they don't participate.
Voluntary benefits: Employers don't like to be seen cutting benefits, so increasingly they are adding so-called voluntary benefits, such as legal services. Employers don't pay for these benefits, although they can negotiate lower fees so employees pay less than if they purchased these extras on their own.
One increasingly popular voluntary benefit is a critical illness plan that pays cash if the employee is diagnosed with certain illnesses, such as cancer, Rosenberg said. The money can help cover costs the worker would incur while undergoing treatment, he said.
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