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Financial Protection Afforded by Employer-Sponsored Health InsuranceCurrent Plan Designs and High-Deductible Health PlansWatson Wyatt Worldwide, Arlington, Virginia
National Organization for Research at the University of Chicago
Watson Wyatt Worldwide, Arlington, Virginia
Watson Wyatt Worldwide, Arlington, Virginia
National Organization for Research at the University of Chicago This article provides the first national estimates of actuarial values and out-of-pocket spending from the era of nonrestrictive managed care that began in the late 1990s. Employer plans paid about 84 percent of total medical expense for those with employer-sponsored coverage in 2004, about 1 percent less than in 2000, and high users faced potential out of pocket spending in the thousands of dollars when they received a portion of their care out of network. Since 2004, more employers have offered plans with higher deductibles coupled with employer-funded personal accounts. These arrangements can result in low out of pocket costs for many employees, but high users will face substantially higher costs. Many employers adopting high-deductible plans are not contributing to personal accounts. Those who are concerned about higher out-of-pockets might consider income-related cost sharing, educational efforts to communicate the savings that can result from using in-network providers, and continued availability of managed care options that limit out-of-pocket spending.
Key Words: actuarial value • out-of-pocket expenses • high-deductible health plans
Medical Care Research and Review, Vol. 64, No. 2,
212-228 (2007) This article has been cited by other articles:
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