Employers across Georgia are tucking a strong message into benefit enrollment packages going out to employees this fall: They want their workers to do more to get healthy.
Many employers will offer everything from a T-shirt to a $50 gift card just for filling out a health risks survey. Employees with chronic health problems who agree to work with a coach to manage the condition could get a bigger bonus — cash deposited into a health spending account or free prescriptions for a few months.
Employers also will be pushing high-deductible plans — with lower premiums — that encourage workers to be savvy health care shoppers. Meanwhile, some employers will swap the carrot for the stick this year and require significantly higher premiums for employees who do not agree to monitor their own health and work to address problems.
At a time when both employers and workers are weary of paying more for health coverage, experts say it’s important this year to closely study new wellness programs — as well as all the other options on the table — to take advantage of any savings.
“Health care costs are going to continue to grow significantly and for your own health and your own wealth and financial good, you need to get fully engaged in understanding what your choices are,” said Tony Holmes, an Atlanta-based partner with Mercer, the global consulting firm.
Holmes said employers across the country expect to pay 5.4 percent more for health plans in 2012 — about a half percentage point below the typical increase over the past decade. About a third of employers plan to increase premiums for employees, Holmes said. Charges to cover a spouse or children are even more likely to rise, with more than 40 percent of large employers planning to increase the costs for dependents.
Those increases will add to a health insurance bill that is already burdensome for many workers. Employees with family coverage paid an average of $4,129 for their portion of their health plan’s premium in 2011, up from $1,787 a decade earlier, according to a national study released last month by the Kaiser Family Foundation. Payments for deductibles and co-insurance add even more costs.
Open enrollment will bring fewer changes this year than in 2010, when some early elements of the new health care law kicked in, such as expanded preventive care coverage and the ability to add adult children up to age 26 to family plans. Those changes are tiny compared to the sweeping transformation of the health care system that will arrive in 2014 if the Patient Protection and Affordable Care Act withstands court challenges.
While preparing for the big changes on the horizon, employers this year are focused on encouraging better health and more price-sensitive decisions among employees.
“What is most different this year is a stronger focus on wellness,” said John Price, president of the Georgia market for Aetna.
The State Health Benefit Plan that covers about 700,000 of the state’s teachers, government employees and retirees also is implementing a dramatic new push for wellness. All premiums will increase. But those who sign up for the new wellness option will get lower premiums and lower out-of-pocket expenses. Employees are required to get screened to assess blood pressure, body mass index, cholesterol and glucose.
Rising premiums are the biggest concern for the teachers covered by the plan, said Tim Callahan, a spokesman for the Professional Association of Georgia Educators. Premiums for those who opt for the wellness plan will increase about 11 percent next year.
But those who do not take the wellness option will be paying 17 percent more. While the new wellness option is better for the pocketbook, Callahan said it may not be popular with everyone.
“Some may see this as the push that they need,” he said. “Others might say ‘This is social engineering and it’s none of their business what I have for dinner or that I don’t go to fitness clubs that I can’t afford.’ Some people may view that as an unwanted intrusion into their personal lives.”
While the cash-strapped state government is taking aggressive action to push workers to improve their health, most private employers are simply offering incentives for wellness programs that are optional.
At Sandy Springs-based UPS, for example, employees can get one gift card for taking a health survey and another card if they improve their health through a fitness plan or participation in a weight-loss or smoking cessation program. The health plan also offers “health care coaches” to employees with ongoing health issues.
Like many other companies, UPS also offers employees not covered by union contracts a chance to save money on premiums through a “consumer driven health plan” option. It comes with a lower premium and a higher deductible. The plans include Health Savings Accounts in which employees can deposit pre-tax dollars to pay for medical expenses. Unlike the flexible spending accounts that are an option with more traditional plans, money in an HSA can roll over from year to year and even earn interest. And it’s an account that the employee owns and can use for medical expenses even after leaving the company or retiring — sort of like a medical version of a 401k.
UPS employee Susan Rosenberg studied her medical spending and decided that the option made sense for her. Most preventive care is covered without any out-of-pocket costs to the employee. Rosenberg, who is on an individual plans, said she has a $1,500 deductible for other expenses. Since employees know they can hold onto money that isn’t spent, they benefit if they keep their expenses low. She especially likes the benefits of the HSA. “I can let that build up for more long-term health care needs,” she said.
The plans have been around long enough that many employees who have taken the option are starting to get especially savvy about how to use the plans to their own benefit, said Price of Aetna. “The people most satisfied are people accustomed to shopping and being consumers and people looking for value who are willing to make those trade-offs before they buy something,” he said.
While most employees can expect their health care bill to rise again this year, there are still some workers out there who don’t have to worry much about the cost of their health plan.
Marian Phillips is one of them. Phillips has worked for Kroger for three decades and is a member of the United Food and Commercial Workers Union Local 1996. Her health plan covers her family — which includes her 19-year-old daughter and 22-year-old son. Members pay $1.50 to $12.50 a week depending on their coverage. Phillips said she pays $6.25. “You can’t beat that,” she said.
Phillips credits the union for negotiating the kind of health benefits that most workers haven’t experienced in years — if ever. Phillips said she knows that she might make a higher salary if the benefits were not as generous, something she said some of her younger colleagues might prefer.
“As a family person speaking — I would rather see more of the money in the health benefit,” she said.”Benefits mean a lot.”
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