Watson Wyatt benefit consultants have identified trends that employees can expect to see in their benefit packages during open enrollment:

• Higher out-of-pocket costs. More than four in 10 employers in a recent Watson Wyatt survey said they will raise deductibles, copayments and out-of-pocket maximums due to the economic crisis. Some employers might raise doctor visit copayments by $5. Others might no longer provide 100 percent coverage for in-network services, opting instead to introduce some level of coinsurance to encourage workers to be more aware of the cost of services. Deductibles for individual and family coverage are expected to increase by $50 to $100 or more among some employers.
• Greater use of incentives to stay healthy. Employers are continuing their push to improve the health of employees and their families. In addition to continuing the focus on wellness communication, employers are offering workers (and, in some cases, spouses) more incentives like gift cards, cash and discounted premiums for undergoing a health risk assessment or participating in smoking cessation, weight management or fitness programs. They are also giving workers access to onsite health coaching as well as using health service providers to deliver Web-based and telephonic coaching.
• Consumer-directed health plans. More employers will offer CDHPs next year as they are increasingly viewed as an effective way to control rising costs. Those employers adopting new plans are generally adding a high-deductible plan, often with a health savings account. Most employers adding these plans will offer them as an option to workers rather than replacing their traditional health plans.
• Consolidation of health plan offerings. Some employers plan to reduce the number of health plan options they offer to workers. As more employers consolidate and change their health plans and networks for 2010, some employees might have to change physicians or pay higher out-of-network costs.
• Prescription drug benefits. Some workers will see changes to their prescription drug benefits in 2010. As part of an overall movement to CDHPs, a number of employers are introducing a CDHP prescription drug benefit option that typically offers workers 100 percent coverage on a list of preventive medications. Other companies are introducing value-based designs that include zero copays on certain prescription drug therapies that are known to help lower health costs and reduce hospitalizations.
• Closer eye on spousal and dependent coverage. Employers are increasingly revisiting spousal and dependent coverage in their efforts to control rising costs. Some employers are requiring spouses to complete health risk assessments, while others are charging higher premiums for working spouses who have access to other health care coverage. More employers are also expected to audit their workers to eliminate dependents who are not eligible for coverage.