Employers are putting the most focus on consumer-directed health plans, which come with high deductibles and are usually tied to a health savings account.
Almost one-third of the companies that responded to the survey plan to offer a consumer-directed plan as their only benefit plan option in 2015, compared with 22% in 2014.
Another 29% of those surveyed said they are planning to impose surcharges for covering spouses if they can obtain coverage through their own employer, and 3% said they intend to exclude spouses outright if they have other coverage options.
The charges, averaging $100 a month, may lead some spouses to drop out of a plan, but many will pay to keep the coverage. “If you're facing paying a surcharge versus potentially going to a network that's potentially more restrictive, you may just choose to pay the fee,” said Glen Mays, professor of health services and systems research at the University of Kentucky in Lexington.
Most of companies that responded to the survey cited specialty pharmaceutical drugs, such as Sovaldi and other new hepatitis C drugs that hit the market this year, among their top three reasons they are seeing their healthcare costs grow.
The vast majority of companies say they plan to rely on high-touch case management to help keep these expenditures down.
“This could mean having a qualified clinician that specializes in the particular disease state, walking them through what they need and ensuring compliance,” said Karen Marlo, vice president of the National Business Group on Health.
Self-insured employers, meanwhile, are getting aggressive with drug manufactures on price, said Steve Kelly CEO of ELAP Services LLC, a healthcare cost management and employee advocacy services firm. For instance they may insist on paying Medicare rates or the average price paid by wholesalers plus a premium. Paying the full retail price is largely out of the question, Kelly said.
Follow Virgil Dickson on Twitter: @MHvdickson