HighRoads and CEB Find that Less Than 20% of Health Plans will Retain "Grandfathered" Status in 2013
Fourth Annual Report Highlights Trends in 2013 Medical Plan Designs Across All Plan Types
BOSTON--(BUSINESS WIRE)-- HighRoads, the industry leader in health care compliance and benefits management, and CEB (NYS: CEB) , the leading member-based advisory company, today released findings from their fourth annual Medical Plan Trends Report. The study found that as 2014 and the enactment of more health care reforms approach, employers are focused on compliance as well as cost control by emphasizing consumerism and preventive care.
"Health care continues to be a significant component of the benefits packages that deliver the overall employment value proposition," said Cynthia Weidner, vice president, health and welfare consulting, HighRoads. "Yet, employers are looking for ways to maintain that value while working to control costs and assure compliance to increasing reform requirements. As a result, plan designs are changing but with careful attention to not damage the employee-perceived value of the benefits they have come to expect."
Top findings outlined in the 2013 Medical Plan Trends Report from HighRoads and CEB include:
- Fewer plans are retaining their "grandfathered" status. The study shows that 58% of employers that offered health care coverage in 2012 had at least one plan that was "grandfathered" (or exempt from specific compliance requirements such as free preventative care). An examination of 2013 plans reveals that, on average, less than 20% of plans are grandfathered. This may be due in large part to a greater need for employers to appear to have more competitive health benefit plan choices.
- More free preventive care. The study reports that 87% of plans offer free prostate screening, up from just 26 percent in 2012. It also found that 90% offer free pap smears and routine mammograms, an increase of 56% since 2012.
- More equal emphasis on adult and child wellness. In 2012 medical plans were almost 10 percent more likely to offer low-cost preventive care visits for children than adults. In 2013, 84 percent of plans include low-cost preventive care visits for both children and adults.
- Plans are at risk of incurring the "Cadillac Tax," a charge on plans with annual premiums exceeding $10,000 for individuals or $27,500 for a family that will take effect in 2018. Nearly one-in-five plans still have a $0 deductible, and 55 percent of plans charge $20 or less for a primary care physician visit co-pay. Thus, organizations must take a careful look at their plans and redesign them to mitigate the tax while protecting the employment value proposition.
"Research shows that reform is impacting health care plan design in ways that may deliver different benefits options to employees," said Ania Krasniewska Shahidi, senior director, CEB. "However, if employee communication about plan changes and new plan choices are not emphasized properly, their perceived value may be impacted. By delivering clear and consistent communication to employees and their families about how to best utilize their plans, employers will be able to balance compliance responsibilities with heightened employee satisfaction."
To receive a copy of the 2013 Medical Plan Trends Report by HighRoads and CEB, please visit: http://www.highroads.com/resources/
The world's leading organizations choose HighRoads to gain complete control over their health care costs and compliance. HighRoads' SaaS-based solutions provide organizations with complete benefits management capability, including benefits plan information and pricing, competitive benefits benchmarks, and compliance management. The privately-held company is headquartered in Woburn, MA. For more information, visit www.HighRoads.com, become a fan on Facebook, follow us on Twitter (@HighRoadsHR), or read our HR Compliance Connection Blog.
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.
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