With 2012 nearing, the latest benefits landscape is on the horizon, and much of it focuses on costs.

As many employers are still looking for ways to tighten their budgets, the shift toward shared accountability is projected to continue, says Lenny Sanicola, senior benefits practice leader for WorldatWork, a nonprofit organization that specializes in global human resources issues. More employees are expected to partner with their respective employer to manage health care costs, meaning employees will continue to take on a larger share of those expenses than in the past. Thus, consumer-driven health plans are expected to be strong in 2012.

"Although employee selections of these options has been slow, I expect more and more employees to choose CDHP options due to generally lower premiums coupled with more education from organizations on how these plans work and can save individuals and families money," Sanicola says. "In addition, more employers are beginning to only offer CDHP options, totally replacing more traditional options, so eligible employees who want coverage must select such options."

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When looking at CDHP enrollment figures from 2006 to 2011, these plans appear to be a largely growing trend, according to a recent benefits trend survey by WorldatWork. In 2006 the survey shows that 73 percent of employers did not offer CDHPs, but by 2011 that figure fell to only 53 percent. Of the respondents with CDHPs, 26 percent offer health savings accounts in conjunction with CDHPs in 2011, as opposed to 11 percent in 2006, and 11 percent offer health reimbursement accounts with CDHPs in 2011, compared to 9 percent in 2006. Another 6 percent of respondents offered both HSAs and HRAs in 2011 when no respondents offered the combination in 2006.

Sanicola also expects wellness programs, which tie into cost sharing, to continue their surge in popularity. With wellness programs, employees have a greater sense of consumerism and accountability, causing more employers to rely on them as a way to manage costs. The increase in wellness programs can be seen in the WorldatWork survey that shows 75 percent of respondents offered wellness programs and promoted better health in 2011 while only 65 percent did so in 2004.

Critical illness is another benefit that is expected to see growth in 2012. In fact, just from 2009 to 2010, critical illness grew 24 percent, reports Colonial Life, a supplementary insurance provider. Medical conditions such as cancer, heart attacks and strokes are expensive to care for, but critical illness insurance provides out-of-pocket protection to handle the expenses after treatment, says Randy Finn, assistant vice president of supplemental health product at Colonial Life. While critical illness is a newer product on the market, updated versions are available to include benefits for multiple occurrences of a critical illness.

Regarding the Patient Protection and Affordable Care Act, there are not many compliance issues that employers should have to address in 2012, Sanicola says, but employers should take some time to focus on developing a long-term health care strategy and analyzing how PPACA can impact business over time. The new year may only be 2012, but 2014 is just around the corner.

"There is much uncertainty and anxiety of where reform will land, but for 2012, most employers will stay the course, manage their short-term expenses with a shared accountability with employees, be aggressive with their health and wellness strategies, and continue to look for the best value for the return on their investment in benefits," Sanicola says.

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