Benefit design critical to protecting out-of-pocket costs for employees

In the past few years, employers have struggled with finding the optimal approach to healthcare benefit cost sharing. Recently, a leading actuarial firm analyzed employer out-of-pocket (OOP) data and the financial impact of OOP expenses on employers and employees. Findings were shared with a group of leading employers who meet periodically to discuss innovative benefit design strategies. Attendees viewed models that showed what effects various copayment and coinsurance amounts would have on employer and employee costs. Many attendees were intrigued with results that indicated increasing OOP costs for the sickest employees would do little to lower overall benefit costs.