Employers are planning only moderate changes to their healthcare plans in 2012, according to a survey by Towers Watson. Ron Fontanetta of Towers Watson said, “With so much still unknown regarding both the short- and long-term impact of healthcare reform, most employers will not make wholesale changes to employer-sponsored health plans in 2012. However, a small group of employers is driving more fundamental change in 2012 by using account-based platform designs, aggressively positioning incentives and rethinking subsidization levels.”
Eighty-eight percent plan to take steps to control their costs and avoid the impact of healthcare reform’s excise tax. The average annual cost of medical and pharmacy coverage is $11,204 per employee. Forty-five percent will rethink their healthcare strategy over the long-term and many are uncertain how they will respond to the looming impact of state-based insurance Exchanges in 2014. Employer healthcare costs are expected to rise 5.9% 2012 compared to 7.6% in 2011.
Seventy-one percent of employers plan to continue offering healthcare coverage through 2014. Most of the remaining 29% are not sure whether they will continue offering health benefits or offer a salary increase to offset lost benefits. Fifty-four percent of employers that offer healthcare benefits to retirees plan to discontinue them.
Fifty-three percent of employers say they are confident that healthcare reform will be implemented in the anticipated timeline, but 70% are skeptical that health insurance exchanges will provide a viable alternative to employer-sponsored coverage in 2014 or 2015.
Fifty-six percent of employers believe that they will trigger the excise tax by 2018. Yet more than three-quarters believe that healthcare benefits will continue to be a key component of their benefit offerings beyond 2014.
Employers are planning or considering the following actions between now and 2014:
• 58% plan to increase the use of preferred networks.
• 49% plan to use value-based benefit designs.
• 17% plan to add account-based health plans (such as HSAs or HRAs) in 2013 or 2014, which would result in nearly 74% of employers offering them.
For 2014 and 2015, 57% of employers are considering reducing employee healthcare contributions for lower-paid workers and 47% are considering making a substantial reduction in the value of the healthcare benefits they offer.
Sixty-six percent of employers will increase employees’ share-of-premium contributions for single-only coverage for 2012. Seventy-three percent of employers will increase the employees’ share-of-premium contributions for dependent coverage.Cost shifting is expected to continue well beyond 2012. By 2013 or 2014, 23% of employers are considering significantly reducing their subsidization of coverage for spouses and dependents. Nineteen percent are considering using spousal waivers and surcharges when other coverage is available.
The survey also reveals the following:
• 70% expect to lose grandfathered status by 2012.
• 57% are considering rewarding or penalizing their employees based on biometric outcomes compared to 8% today.
• 32% don’t offer healthcare coverage to part-time employees.