The luster of a high-deductible health plan quickly diminishes, however, if employees are not able to fund their deductible when a claim is incurred. They'll quickly forget their premium savings and focus instead on a perceived lack of coverage.

While it is not unusual for workers who change from a plan with a $1500 deductible to a high-deductible health plan with a $5,000 deducible to see an annual premium savings of $1500 or more, they are often raising their potential out-of-pocket exposure. When they're using the plan for commonplace occurrences such as physician visits and lab tests, it is easy to justify the trade-off of first-dollar coverage for the premium savings of an high-deductible health plan. However, when faced with a large bill, some will question their decision to move to an high-deductible health plan — or worse yet, question the company's decision to encourage an HDHP.

For some Americans — relatively low users of health care services — purchasing a high-deductible health plan may be a sensible method to manage health care costs.

However, when an employee experiences a year of acute health care expenditures and has not prepared for the potential financial repercussions, he or she might wind up in a precarious financial situation. Out-of-pocket costs and lost wages can quickly add up, especially if the insured was financially vulnerable before the claim. Much like an increase in monthly mortgage costs from an adjustable rate mortgage, an unfunded large claim can create a financial hole nearly impossible to escape.

Prepare your employees

There are several measures that brokers and benefits managers can take to prepare employees for a large claim. The first is to fully educate them on the trade-offs between a low deductible and a high deductible using data readily available on the internet. One great starting point is the Medical Expenditure Panel Survey database, available at www.meps.ahrq.gov/mepsweb. This government site provides information about average health care costs by various standards including age, sex and economic status.

Fully investigate the health savings account you offer in conjunction with a high-deductible health plan. Present an account with a low (or preferably, no) initial deposit requirement. An account must be open on the date a claim is incurred to allow payment from a health savings account. Clients who procrastinate in opening the account run the risk of incurring a claim prior to establishing the account and thus losing out on one of the fundamental tax advantages of an HSA.

Make sure the HSA allows online deposits from a checking or savings account. If it is convenient to deposit money into an account, the chances of that account being funded rise exponentially. Better yet, help employees set up direct deposit from paychecks or bank accounts to health savings accounts.

A third way to help plan in advance for a large claim is through critical illness coverage and accident benefits, which help offset large deductibles and increase client satisfaction. For a relatively small monthly premium, these products can provide protection from a large claim before patients have health savings account funds to meet a deductible.

Even after the employee has a fully funded health savings account, it may be a good idea to continue with CI coverage to help offset costs not covered under the health plan. Costs such as lost wages, home care and travel for medical care — which are not always covered under medical plans — might be paid with CI funds.

The financial similarities between the issues being faced by Americans with adjustable rate mortgages and high-deductible health plans are easy to see. Insurance professionals and benefits managers must help focus employees not just on the premium savings of high-deductible health plans, but also on what they need to make sure they are properly prepared in advance of a large claim.