Survey Finds CDHPs Gaining Momentum

According to a press release, of those with a CDHP, goals range from introducing “consumerism” into the purchasing of health care (36%) and controlling rising health care costs (35%), to providing a vehicle for retiree medical savings (3%) and encouraging better use of health care services (2%). Twenty-four percent of employers have between 11% and 35% enrollment in their plans, while 17% have between 36% and 60% enrollment and 20% have more than 60% enrollment.

Employers indicated they believe workers do not enroll in CDHPs due to concerns of high out-of-pocket costs (59%); traditional plan design preference (18%); lack of knowledge about CDHPs (9%); and a perception that CDHPs are too complex (6%).

Of employers not currently offering a CDHP, 11% are planning to offer one this year or next year and 28% are undecided on an effective date. The remaining 61% indicated they are not seriously considering a CDHP in the near future. Reasons for this include:

• satisfaction with their traditional plan designs (27%);
• a belief that not enough employees will enroll in the plan to make it worth offering (17%);
• a feeling that a CDHP will siphon off healthy employees from their traditional plans, hurting overall plan costs (17%);
• a belief that the CDHP concept is too new (17%);
• a concern of exposing their employees to potentially high-claim costs (10%); and
• a belief that consumerism will not change employee purchasing behavior (7%).

Looking ahead, 73% of all employers surveyed thought they would be offering a CDHP in the next five years, while 7% said that likely would not be the case and 20% said they do not know. Almost half (45%) of those surveyed said they believe that a CDHP will prove to be successful in controlling health care costs in the next five years; 19% said it will not; and 36% said they do not know.

Aon and ISCEBS found the split between Health Reimbursement Arrangements (HRA) and Health Savings Accounts (HSA) in CDHPs is similar to 2007 with 49% of employers using the HSA model, 38% the HRA model, and 12% offering both (versus 48%, 42%, and 10%, respectively, in 2007).

Eighty-four percent of survey respondents offer the HRA or HSA as an optional plan, while the remaining 16% have implemented a "total replacement" CDHP where the only plan choices offered to employees are CDH plans, the news release said.

Nearly 60% of organizations offering an HSA contribute employer money to the plan. Ten percent contribute a flat dollar amount of less than $500 per person; 44% contribute a flat dollar amount of $500 or more; and 4% make a matching employer contribution. Employers in the survey offering an HRA plan make varying amounts of contributions to the account, including, for single coverage:

• less than $300 - 5%;
• $300 to $499 - 6%;
• $500 to $799 - 62%;
• $800 to $999 - 4%; and
• $1,000 or more - 23%.

As for HRA and HSA deductibles, 7% of employers surveyed have an individual deductible of less than $1,000; 37% have a deductible between $1,000 and $1,499; 27% have a deductible between $1,500 and $1,999; 11% have a deductible between $2,000 and $2,499; and 18% have a deductible of $2,500 or more.