We’re all familiar with the necessary evils of today’s society:paying taxes, going to the dentist and sitting in rush-hourtraffic. Now, there’s another one to add to the list — highdeductible health plans (HDHPs). They’re on the rise due toincreasingly unmanageable health care costs caused byfactors such as increased carrier and hospital consolidation,unregulated pharmaceutical prices, and a lack of financialawareness among medical providers.


In response, prudent employers who want to continue providing health benefits but can’t keep upwith the costs are turning to HDHPs to share the financial burdenwith employees and encouraging those employees to become moredisciplined shoppers. This is predictably being met withresistance.


But there’s a more urgent matter at hand: until we find a way toflip the health-care system on its head, we’re anticipating afuture where networks get narrower and significantly limit optionsand deductibles rise to catastrophic heights.


Employers may not be thinking ahead for these drastic changes,which is why brokers can be instrumental in helping clients guidetheir employees toward the necessary mental and financialpreparations. Here are a few ideas to get them started.

1. Shift gears to plan beyond the calendar year.

For most, health care is an infrequent experience that’s handledreactively: you get sick, you go to the doctor, your insurancefoots the bill. However, now that employees are on the hook forpotentially thousands of dollars, it’s crucial that they planahead.


To facilitate this shift in mindset, employers should encourageemployees to:

  • Utilize a health savings account (HSA): When itcomes to HSAs, people tend to fall into one of twoschools of thought: “HSAs are a silver bullet” or “HSAs are aterrible excuse by politicians to allow the existence of HDHPs.”Rarely is a situation so black and white, and this one is noexception. HSAs aren’t the best choice for everyone. Certaindemographics can’t afford to juggle the high costs of health care(and life) while also contributing funds to an account. However,it’s important to keep in mind that as costs continue to rise, morepeople will be pushed above the HSA qualification line and havingan account may be the only life raft available when drowning inhigh deductibles — a trend we’re already starting to see.

    In an ideal world, the HSA wouldn’t exist. Out-of-control healthcare costs bear the blame for solutions like HDHPs — and the HSA isour consolation prize. The reason I advocate the utilization ofthese accounts for long-term planning is because they are the onlyhealth care benefit we have that encourages people to think beyond12 months. Unlike the flexible spending account (FSA), the money inan HSA rolls over every year and grows over time, so it lets peoplesave for years down the road (maybe when the pediatrician billspile up, or you finally have that major surgery) vs. scrambling tospend their funds before the end of the year. Also, if an employeris contributing to an employee’s HSA, it’s leaving money on thetable not to sign up for an account.

  • Shop for the best “deals”: Unless someone is afrequent flyer in the health care system, they might brush offshopping for healthcare since it seems like a lot of effort for asingle doctor’s visit. However, considering the fact that the costof an ACL surgery can vary as much as $17,000, those numberscertainly add up over time. (Even more so if a patient fails tofind care that’s in network.) Helping employees understand thisconcept, and pairing it with an easy-to-use transparency solution,can save them tons of money in the long run — especially if thecost savings from each doctor’s visit are deposited into an HSA forfuture use.

2. Recognize that options are still available.

I’m not going to try to frame high deductibles in a positivelight. It’s not the ideal situation for consumers or employers. Butsometimes, just knowing there are options in a seemingly bleaksituation can provide temporary relief. Here are some tips foremployers to share with employees when they’re frustrated abouttheir HDHPs:

  • Ask questions: Employees shouldn’t be afraid toask questions. Healthcare is known for being convoluted, so it’slikely they’re not alone in any confusion they experience. Theyshould start with health insurance and take time with the HRmanager to understand the specifics of their coinsurance, copays,deductibles, and benefits so they’re aware of all their options,such as free preventive services. Another great place for questionsis at the doctor’s office. Asking about and negotiating costs (yes,you can do that!) can have huge payoffs — Consumer Reports foundthat only 31 percent of Americans haggle with doctors over medicalbills but that 93 percent of those who did were successful, withmore than a third of those saving more than $100.

  • Stay educated: “Education” can be a tired termfor brokers and employers. Employees never seem to read the emailsand collateral materials that teams painstakingly curate each year.While disheartening, I think the focus on education is a long butultimately rewarding process. Consider the 401(k). These plansstruggled through the recessions in the early 2000s, but throughconstant behavioral reinforcement (helped largely by policies suchas The Pension Protection Act, which made it easier for companiesto automatically enroll their employees in 401(k) plans) andcontinued efforts by employers, 401(K)s bounced back and hold $4.8trillion in assets today.

    The same lesson can be applied to your education efforts as well.That is, eventually the education will stick. So help create a newecosystem for employees to navigate by getting timely informationand resources out there about maximizing HDHPs and utilizingHSAs.

3. Stay optimistic because change is coming.

This point is a bit more abstract. Worrying about health carecosts is exhausting, and things are likely to get worse before theyget better. However, there’s been a lot of news in the health carespace that should bring a glimmer of optimism.


For instance, we heard about the partnering of three industry powerhouses to create a newhealth care company for their employees. It’s been fascinating tosee how much chatter this announcement has already generated andwill likely keep traditional employer health care vendors on theirtoes.


While the trend of employers building coalitions to tacklehealth care costs is nothing new and it’s too early to tell howsuccessful this initiative will be, the bigger point is that thisis a strong signal that change is desperately needed. More and morecompanies — regardless of what industry they’re in — are startingto realize that they’re all in the business of health care. And aswe gain power in numbers, I believe we will build the momentum tocreate some serious change.


It’s tough to win in today’s health care world, and it’s likelygoing to get even more challenging over the next few years. But if brokers and employers can provide the right level ofguidance, education, and resources, they can help employees bettermentally and financially manage their high-deductiblefutures.

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