It’s the annual “open enrollment” season in corporate America, when employees choose their medical plans for the coming year. But this time, even if they are fortunate enough to have a job at a company that still offers health benefits, many workers are finding that the buffet of options has been trimmed to a very short menu.
And typically the offerings now include a health plan with a financially daunting feature: a high annual deductible that is likely to be $1,100 or more for an individual, and much higher for family coverage. Under conventional insurance, the annual deductible — the amount an employee is obliged to spend on medical care before the insurance begins — may be only about one-third as high.
Employers generally try to offset the high deductible with a somewhat lower monthly premium than workers pay with conventional insurance. Another deal sweetener is the opportunity for the worker to put money in a tax-sheltered health savings account whose balance can grow year after year. Many employers also make contributions to those worker accounts.
Despite such lures, high-deductible plans have received only tepid acceptance from employees since they were introduced in 2002. But this year, at more than 100 large companies and hundreds of smaller ones, the high-deductible plans are the employee’s single take-it-or-leave-it option.
One of those companies is the automaker Nissan, which is offering only high-deductible plans to its 15,000 United States employees for the coming year. Another is Delta Airlines.
Most large companies still do offer a choice between high-deductible plans and more conventional insurance, which means workers must try to decide which approach is best for them.
Typically, if consumers run the numbers, they will find the high-deductible plans are most attractive to healthy single workers who do not expect many medical costs — or to families who know their medical costs will quickly exceed the annual out-of-pocket maximum, after which their medical care is covered 100 percent. But even for those people, the lower premium does not compensate for the much greater out-of-pocket payments they will make before reaching that high deductible.