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NAVIGATION PNHP RESOURCES
Posted on November 15, 2007

Renew it or lose it

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Making the Most of Benefits

By Terri Cullen
The Wall Street Journal
November 15, 2007

It’s that time of year again: open-enrollment season.

The biggest decision for most workers is choosing a health-insurance plan. Ironically, this year the biggest mistake workers may make with health-plan choices is to not make a choice, says Sara Taylor, annual enrollment leader at human-resources company Hewitt Associates. In the past, if workers made no changes to their current health-care plan, they’d remain in the same plan the following year. But this year more companies are asking workers to re-enroll if they want to remain in their current plans.

“If they don’t enroll they may be assigned no coverage at all and employees will be stuck with that decision for a year,” unless they have a change in status, such as a marriage or new child, Ms. Taylor warns. “People need to understand what can happen if they do nothing.”

Why the switch? Health-plan options are changing, with many employers shifting to high-deductible health-insurance plans that include health savings accounts. With workers having to pay more of their own health-care costs, employers and plan providers are pushing them to better understand their plan options.

Indeed, a Hewitt survey estimates employees will contribute an average of $1,859 toward insurance premiums in 2008, compared with $1,690 this year. Out-of-pocket expenses are also expected to climb, thanks to higher co-pays and deductibles. According to Hewitt, employees can expect to pay an average $3,597 out of pocket in 2008, or about 10% more than last year.

http://online.wsj.com/article/SB119505443236192843.html.html

Comment:

By Don McCanne, MD

One crucial feature of a health care program that covers everyone is that enrollment must be automatic and permanent. Obviously we fall far short of that now, but disenrolling an employee because of passive inaction is certainly a further step backwards.

But is it really passive inaction? When an employee has to pay an average of $5456 for premiums plus out-of-pocket expenses, many simply cannot afford that. With a median household income of $48,000 it is understandable why so many forgo their coverage simply because the money is not there. It was spent on food, housing and transportation.

Well, we do keep going backwards. All numbers are worse. That’s too bad when all we really need is one single step forward to a comprehensive health care program that is automatic, permanent, affordable and includes everyone. Why do we continue to resist the obvious?