HighRoads,
the industry leader in benefits plan management and health care
compliance, and CEB (NYSE: CEB), the leading member-based advisory
company, today released findings from their fifth annual Medical Plan
Trends Report. The study found that many employers are beginning to
scale back their medical plan designs in an effort to avoid the
“Cadillac tax” required by the Affordable Care Act (ACA) in 2018. The
result is an increasing share of cost for employees, including an
increase in high-deductible plans, a greater number of plans with
coinsurance charges, higher out-of-pocket maximums, and increases in
emergency room co-pays.
“The employer-sponsored medical plan landscape continues to shift in
response to the ACA and, as a result, it’s more important than ever for
employers to effectively communicate plan changes to their employees,”
said Cynthia
Weidner, vice president, client development, HighRoads. “It’s
evident that companies are embracing typical health plan consumerism
strategies that encourage a more thoughtful, cost-effective use of
medical benefits by exposing plan participants to more of the upfront
costs. With plan designs changing and the emergence of new options
including both public and private exchanges, benefits management
professionals should be armed with the information employees need to
make informed decisions on plan choices and efficient benefits usage.”
In 2018 the ACA will impose a 40 percent excise tax if the value of the
health insurance benefits exceed the threshold for a plan that costs
more than $10,200 for an individual and $27,500 for a family (indexed
for inflation). The 2014 Medical Plan Trends Report from HighRoads
and CEB shows that companies are starting to evolve their benefits plans
to prepare for this requirement. Top findings include:
-
Two-thirds of 2014 medical plans have individual, in-network
out-of-pocket maximums (OOPMs) of $2,500 or more. This is up from 58
percent of plans in 2013, and 49 percent in 2012.
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42 percent of plans charge coinsurance for office visits, up from 35
percent in 2013.
-
Emergency room (ER) visit co-pays have increased by roughly $3 per
year since 2009, with a 2014 average of $113 per visit.
-
The percentage of plans with high deductibles grew by 2 percent in
2014 from 23 percent to 25 percent.
In addition to trends related to greater plan participant cost sharing,
there were some positive trends to note that can be attributed to the
Affordable Care Act. These include:
-
More generous coverage for mental health. The average co-pay for an
inpatient mental health visit dropped by 3 percent from 2013 to 2014.
-
Greater free preventive coverage. In fact, nearly all 2014 plans cover
100 percent of patient costs for in-network cancer screenings,
immunizations and other preventive services.
“Our research shows that the changing face of health care plan design
will continue to evolve as employers work to meet ACA requirements while
avoiding added tax penalties by 2018,” said Laura Arpin, Associate
Director, Corporate Executive Board. “But, employers must recognize how
these changes may be reflected in the health care behaviors of their
plan participants. Without strategic communication processes in place on
the best practices for utilizing health plan benefits, plan participants
may be more apt to delay necessary care due to the uncertainty of its
actual cost. By making sure plan participants have cost information,
employers can reduce the likelihood of their employees and employee
families delaying or rationing care by as much as 50 percent.”
To receive a copy of the 2014 Medical Plan Trends Report by HighRoads
and CEB, please visit: http://www.highroads.com/resources/.
About HighRoads
HighRoads, the industry leader in benefits plan management and health
care compliance, has served as the benefits system of record for many of
the largest organizations in the country for 15 years. Its patented
technology collects, manages and repurposes benefits plan data
throughout systems, processes and documents. For more information, visit HighRoads.com,
become a fan on Facebook,
a follower on Twitter
@HighRoads.com or read the Compliance Connection blog.
About CEB
CEB
is the leading member-based advisory company. By combining the best
practices of thousands of member companies with our advanced research
methodologies and human capital analytics, we equip senior leaders and
their teams with insight and actionable solutions to transform
operations. This distinctive approach, pioneered by CEB, enables
executives to harness peer perspectives and tap into breakthrough
innovation without costly consulting or reinvention. The CEB member
network includes more than 16,000 executives and the majority of top
companies globally.
Copyright Business Wire 2014