Do a little homework before selecting health coverage for next year during open enrollment.
Employees with job-based health coverage are spending a greater share of their income on health insurance costs, even though those costs are growing more slowly in most states, a new report finds.
Health premiums for employees, as well as deductibles, rose more slowly on average in a majority of states from 2010 to 2015 than during the previous five years, a study published last week by the health research group Commonwealth Fund found.
But many families are still feeling squeezed. That is because wages, despite a recent rise, haven’t kept pace with health care costs, said Sara Collins, vice president for health care coverage and access at the Commonwealth Fund.
The finding suggested that workers should take time to do their homework, she said, when selecting health coverage for the next year during open enrollment, which is now underway at many employers. Employees should look beyond the plan’s monthly premium to consider other costs that they might have to pay out of pocket.
“It’s really important for consumers to understand their health benefits,” Collins said during a call with reporters. For instance, she said, plan deductibles may seem high, but many services, like preventive care, aren’t subject to deductibles, “and people don’t know that.”
While much attention has been focused this week on a steep increase in premiums for health plans sold through Affordable Care Act marketplaces, job-based health coverage remains far more prevalent. More than half of Americans younger than 65 — about 154 million people — receive health coverage through an employer or a family member’s employer, the report noted, compared with about 11 million through the government exchanges.
Families with employer plans spent an average of 10 percent of their income on health insurance premiums and deductibles nationally in 2015, up from 6.5 percent in 2006, the Commonwealth study found.
The study found large differences among the states, however. Families in Mississippi were at risk of spending nearly 15 percent of their income, on average, on health care costs, compared with about 7 percent in Massachusetts and the District of Columbia.
Workers with employer-based health plans who are considering options for next year can expect to see their premiums rise by about 5 percent, according to a recent report from the National Business Group on Health, which represents large employers.
Here are some questions and answers about workplace open enrollment:
Q: How should I go about choosing a job-based health plan?
A: Employees are often stressed by unfamiliar jargon and the generally boring process of choosing benefits, so they default to choosing the same plan, said Helen Calvin, senior vice president of customer success at Jellyvision, which creates human resources software. But you should consider what has changed in your health and your family’s health before deciding, she said. “Avoid autopilot.”
Give yourself time — 90 minutes, say — to work through the plan details, and try not to procrastinate, said Todd Katz, an executive vice president at MetLife. If the first time you look at your plan options is the last day to enroll, he said, “You’ve missed the boat.”
Q: What can I expect during workplace open enrollment this year?
A: Employees are more likely to encounter programs aimed at curbing rising costs for expensive, complex drugs, for example, known as “specialty” pharmaceuticals, said Brian Marcotte, president and chief executive of the National Business Group on Health. Specialty drugs, used to treat serious conditions like cancer and multiple sclerosis, can cost thousands of dollars and may require a health professional to administer them and monitor possible side effects. Employers may require previous approval before covering the drugs, he said, or may require that they be given in a doctor’s office, rather than in a hospital.
Q: What other lower-cost health care options are employers offering?
A: More employers are offering “telehealth” services, which allow employees to check in with a doctor or nurse by phone or video. The cost of such a visit is about $40, compared with $100 for an office visit, Marcotte said. While not every issue can be addressed using telehealth, it offers “an opportunity to save money and time,” he said, and can often be used after traditional office hours. Use of telehealth remains low among employees, he said, but is growing.
This article originally appeared in The New York Times.