title: Financial protection afforded by employer-sponsored health insurance: current plan designs and high-deductible health plans.
abstract: This article provides the first national estimates of actuarial values and out-of-pocket spending from the era of nonrestrictive managed care that began in the late 1990s. Employer plans paid about 84 percent of total medical expense for those with employer-sponsored coverage in 2004, about 1 percent less than in 2000, and high users faced potential out of pocket spending in the thousands of dollars when they received a portion of their care out of network. Since 2004, more employers have offered plans with higher deductibles coupled with employer-funded personal accounts. These arrangements can result in low out of pocket costs for many employees, but high users will face substantially higher costs. Many employers adopting high-deductible plans are not contributing to personal accounts. Those who are concerned about higher out-of-pockets might consider income-related cost sharing, educational efforts to communicate the savings that can result from using in-network providers, and continued availability of managed care options that limit out-of-pocket spending.
authors.affiliation: Watson Wyatt Worldwide, Arlington, Virginia, USA.
authors.forename: Roland
authors.initials: R
authors.lastname: McDevitt
authors.forename: Jon
authors.initials: J
authors.lastname: Gabel
authors.forename: Laura
authors.initials: L
authors.lastname: Gandolfo
authors.forename: Ryan
authors.initials: R
authors.lastname: Lore
authors.forename: Jeremy
authors.initials: J
authors.lastname: Pickreign
mesh_terms: D000206:Actuarial Analysis; D003625:Data Collection; D003669:Deductibles and Coinsurance; D006264:Health Benefit Plans, Employee / Q000458:organization & administration* / Q000639:trends; D014481:United States