The rising profile of consumer-directed health plans (CDHPs) in the employer-sponsored health market shows up in surveys and statistics. For example, the 14th Annual National Business Group on Health/Watson Wyatt (NBGH/WW) Survey of 489 Fortune 1000 companies with a total of 7.9 million employees, conducted in January and released in March, showed that 51 percent have CDHPs as a choice among health offerings or as the only offering; the percentage is up 9 points from last year. Twelve percent of employees at responding companies offering CDHPs have joined such plans.
Similar results were obtained in the 2008 Annual Employee Health Benefits Survey by the Kaiser Family Foundation/Health Research & Educational Trust (Kaiser/HRET). Results of a telephone survey of 1,927 randomly selected public and private employers—a response rate of 48 percent—found CDHPs available at 13 percent of companies across the board.
In 2008, average annual premiums—employers’ and employees’ contributions—for employer-sponsored health insurance were $4,704 for single coverage and $12,680 for family coverage, according to the Kaiser/HRET survey, and the average employee contribution was $721 for individual coverage or $3,354 for family coverage.
At Humana under this year’s CDHP, an employee with family coverage who chooses the lowest deductible, $2,700, pays $1,882.92 per year; for the highest available deductible, $6,000, it’s $301.08 for the year.
In the Society for Human Resource Management’s Cost of Health Care Benchmarking Study in 2008, based on responses of 725 HR professionals, CDHPs had the lowest median employer contribution to the monthly premium for employee-only coverage—$257.
To encourage enrollment in CDHPs, many companies offer employees significantly lower premiums. Nearly 60 percent offer CDHPs that cost at least 30 percent less than participants pay in their traditional plans, according to the NBGH/WW survey.
Critics of the CDHP approach may argue that it’s just a cost shift from employer to employee, but it’s not, says Ted Nussbaum, director of Group and Healthcare Consulting in North America for Watson Wyatt in Stamford, Conn. "Employees pay more at the point of care but less in premiums. Overall, they may pay a little more, but it’s not a significant amount. More important, it’s a way to lower costs overall by asking employees to take better care of themselves."