As employers continue to shift the burden of paying for health insurance to employees, the high deductible health plan has become the plan design of choice for many.

The only problem with that is that, while it may save the company lots of dough, it could also drive workers into bankruptcy — not a good place for them to be if you are seeking a productive, happy workforce.

That’s one conclusion that can be drawn from the 2014 Aflac WorkForces Report. The results were based upon input from 1,856 benefits decision-makers and 5,209 employees.

The study found that workers readily agree that they regularly underestimate the cost of most medical procedures, especially major ones with which they might not have had prior experience. They worry the new workplace health plan designs will place too much of the cost burden on themselves, and they also say they’d generally be happier at work and do a better job if they felt they had good employer-sponsored coverage.

However, here’s what’s happening:

  • 56 percent of companies increased employees’ copayments and/or shares of premium last year;
  • 59 percent plan to do the same before the end of 2014;
  • 19 percent of companies moved away from traditional major medical insurance in 2013 and instead paired health savings accounts with high-deductible health plans;
  • That’s a 33 percent increase over the 14 percent of companies that participated in the 2013 Aflac WorkForces Report that said they planned to make this type of change.

Why is this a worrisome trend to employees? Here’s what they said about their ability to cover part of the cost of medical treatments, especially those involving a major accident or surgical procedure:

  • 53 percent would borrow from their 401(k)s and/or use a credit card to cover the costs;
  • 49 percent have less than $1,000 on hand to cover out-of-pocket expenses associated with a serious illness or accident;
  • 27 percent have less than $500 on hand to cover those costs;
  • 42 percent say they’re not prepared at all or are not very prepared to pay such out-of-pocket expenses;
  • 10 percent say high medical costs have affected their credit scores;
  • 13 percent have been contacted by a collection agency about outstanding medical bills. 

“Understandably, few employees have the medical knowledge needed to evaluate the quality of health care providers and the appropriateness of proposed treatment or medication needs. Further, they don’t generally understand the true cost of medical services — information that can be difficult to find,” Aflac said. “These knowledge gaps make it challenging for employees to embrace the move to consumer-driven health care.”

Clearly, there’s an employee educational curve to be climbed. But once again, employees and employers who participated in the survey don’t agree on who should shoulder that responsibility.

“Nearly 7 in 10 employees (68 percent) believe their companies will educate them about changes to their health care coverage as a result of health care reform. However, 60 percent of employers strongly or somewhat agree that workers themselves should be more responsible for learning about their benefits options,” the survey said.

Aflac opined that top-performing organizations are going to take the lead in educating employees about health care choices, and will also study data such as that contained in the study before designing a health insurance plan that may save money but could undermine performance, productivity and engagement.

“Employers are making key decisions as many of health care reform’s significant provisions take effect. The impact of these decisions is already beginning to take shape. Decisions that not only impact their organization’s performance, but that also affect their workers’ engagement, productivity and loyalty. Successful organizations are identifying and implementing strategies that balance robust employee benefits packages with the containment of health care costs,” the study concluded.