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The bright side of high-deductible health plans

BY Stephen Miller

Satisfaction levels are rising among Americans enrolled in consumer-driven health plans (CDHPs), while they are declining among those in traditional health plans, according to a new report by the nonprofit Employee Benefit Research Institute (EBRI).

In particular, satisfaction rates for out-of-pocket costs appear to be trending downward among those with traditional coverage and upward for those with consumer-driven plans, according to the report.

CDHPs typically combine high-deductible health plans (HDHPs) with a tax-exempt health savings account (HSA) or health reimbursement arrangement (HRA) to help enrollees pay for out-of-pocket expenses.

A growing number of U.S. employers have adopted CDHPs over the past decade to provide employees with incentives to make cost-conscious decisions when selecting health care services and to limit unnecessary health care spending.

In EBRI’s 2011 survey, individuals with a CDHP or HDHP had deductibles of at least $1,000 for individual coverage or $2,000 for family coverage in addition to an HSA or HRA with a rollover provision they could use to pay for medical expenses. The report, which incorporated earlier years of the survey, was published in the August 2012 EBRI Notes, “Satisfaction with Health Coverage and Care: Findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey.”

Key findings include the following:

Overall satisfaction with health plan: Overall satisfaction levels among CDHP enrollees increased from 37% to 52% between 2006 and 2009, although there was a drop in satisfaction rates between 2009 and 2010. Satisfaction rates increased from 43% to 46% between 2010 and 2011.

Satisfaction rates among traditional enrollees decreased in most years. Between 2006 and 2008 they slipped from 67% to 63% and, after increasing between 2008 and 2009, they fell from 66% to 57% between 2009 and 2011.

Out-of-pocket costs: Attitudes about out-of-pocket costs may explain some of the difference in overall satisfaction rates among enrollees in traditional plans, HDHPs and CDHPs. In 2011, 41% of traditional-plan participants were either extremely or very satisfied with out-of-pocket costs (for health care services other than for prescription drugs), while 16% of HDHP enrollees and 24% of CDHP participants were extremely or very satisfied. Satisfaction rates appear to be trending downward among those with traditional coverage and upward for those with a CDHP.

Access to doctors: Satisfaction levels with getting doctor appointments were high relative to other aspects of health care, regardless of plan type, yet some differences were found. In 2006, traditional-plan enrollees were more likely than CDHP enrollees to be extremely or very satisfied with their ability to get doctor appointments. However, between 2007 and 2010, differences were not statistically significant, and in 2011 CDHP enrollees were more likely than traditional-plan enrollees to be extremely or very satisfied with their ability to get doctor appointments. In 2011, 73% of CDHP enrollees were extremely or very satisfied with their ability to get doctor appointments, compared with 68% of traditional-plan enrollees.

Within those overall trends, EBRI noted a few divergent findings, such as that enrollees in CDHPs and HDHPs were less likely than those in traditional plans to recommend their health plan and to indicate a desire to stay with their current plan, if given an opportunity to switch. While their experience with high-deductible plans may be proving better than they expected, if given the option many still would prefer lower deductibles with the same or better coverage.

Stephen Miller, CEBS, is an online editor/manager for SHRM.

Have HR-related questions and concerns? Get access to essential forms, policies and guides, plus a live call center, at ToolkitHR.com, powered by HCN and the Society for Human Resource Management (SHRM).

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Builder confidence continues to rise

BY Brae Canlen

Builder confidence in the market for newly built, single-family homes rose for a fifth consecutive month in September to a level of 40 on the National Association of Home Builders/Wells Fargo Housing Market Index (HMI), released today. The three-point rise brought the index to its highest point since June 2006.

"Builders across the country are expressing a more positive outlook on current sales conditions, future sales prospects and the amount of consumer traffic they are seeing through model homes than they have in more than five years," noted NAHB chief economist David Crowe. "However, against the improving demand for new homes, concerns are now rising about the lack of building lots in certain markets and the rising cost of building materials. Given the fragile nature of the housing and economic recovery, these are significant red flags." 

Derived from a monthly survey that NAHB has been conducting for the past 25 years, the NAHB/Wells Fargo Housing Market Index gauges builder perceptions of current single-family home sales and sales expectations for the next six months as "good," "fair" or "poor." The survey also asks builders to rate traffic of prospective buyers as "high to very high," "average" or "low to very low." Scores from each component are then used to calculate a seasonally adjusted index where any number higher than 50 indicates that more builders view sales conditions as good than poor. 

All three HMI components posted gains in September. While the component gauging current sales conditions increased four points to 42, the component gauging sales prospects in the next six months rose eight points to 51, and the component measuring traffic of prospective buyers edged up one point to 31.

Builder confidence also rose across every region of the country in September. Looking at the three-month moving average for each region, the Midwest and West each registered five-point gains, to 40 and 43, respectively, while the South posted a four-point gain to 36 and the Northeast posted a two-point gain to 30.

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Judge restricts Facebook access in discrimination case

BY HBSDEALER Staff

A federal judge has ruled that Home Depot was overly broad in seeking to obtain all Facebook, Twitter and other social networking posts made by a former employee now suing the retailer for unlawful discrimination.

According to a report by cnet.com, Danielle Mailhoit, a Home Depot store manager in Burbank, Calif., was fired after a 2010 investigation of her on-the-job performance. She filed a federal lawsuit in 2011, claiming her bad review and her termination were due to unlawful discrimination based on gender and vertigo, a physical disability her employer was already aware of.

Home Depot’s lawyers requested any photos, profiles, postings or messages from social networking sites from October 2005 — when Mailhoit claims she was first discriminated against — up until the present. A U.S. Magistrate ruled against them.

The judge did, however, grant Home Depot’s request for any posting by the plaintiff relating to her job or the lawsuit, including social networking communications between Mailhoit and any current or former Home Depot employees.

Home Depot has denied the claims. Mailhoit was terminated for “legitimate, non-discriminatory and non-retaliatory reasons," according to the company.

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