5 Questions to Ask About Your 2012 Health Benefits

Many U.S. employers will drop a bunch of health-care options in their workers' laps in the next few weeks, if they haven't already.

If you're one of those workers, unless you change jobs or lose your job, the choices you make will stick with you and possibly your family for all of 2012, so it's important to scrutinize and compare health-plan options.

You may be tempted to automatically re-enroll in the same plan you have now, but that could cost you. Many plans are shifting costs and benefits around and some employers have introduced new ways for workers to save money, experts say.

"If an employee blows off open-enrollment communications, the employee could pay more because they're missing incentives to pay less that are tied to participation in wellness activities," said Eric Parmenter, vice president of consulting for High Roads, a benefit consulting firm in Nashville, Tenn.

For next year, employers generally aren't as interested as they've been in recent years in raising workers' premium contributions, but they're finding other ways to pass on higher health-care costs, said Michael Thompson, principle in human-resource services at PricewaterhouseCoopers in New York.

"There's not as much focus on increasing premiums for workers as much as there is on increasing the amount of cost-sharing workers have at the point of service," he said.

People who use their health plan might feel more of a squeeze than those who don't, said John Asencio, senior vice president of Sibson Consulting, a human-resource consulting firm in New York.

"If you had a $15 copay, you'll probably see those go up to $20, $25 for physician office visits," he said.

The good news is underlying benefit-cost increases are expected to be moderate, compared with earlier in the 2000s when double-digit premium spikes whipsawed employers and employees alike.

Though they still far outpace general inflation and workers' wage gains, health-benefit costs are on track to rise 5.4% on average next year, the lowest rate of increase in 15 years, according to preliminary survey data from Mercer, a consulting firm in New York. If employers did nothing to manage the cost increase through plan-design changes, the increase would be 7.1%. The overall trend of the past five years has been about 9%, according to Mercer's findings.

Use of health-care services declined last year as people were left with less disposable income in a struggling economy and more workers faced higher out-of-pocket medical costs, said Beth Umland, director of research for health and benefits for Mercer in New York.

"If money is tight and you've got a $1,000 deductible, you might think twice about going to the doctor if you also think you could put it off," she said, noting the average deductible has doubled in the past five years.

Here are five bottom-line questions to consider as you compare your 2012 options:

1. What's new this year? As part of the health-reform law that kicks in more comprehensively in 2014, most employers already extend coverage to workers' adult children up to age 26 even if they're married or in school. And they have to offer free preventive care for a number of services such as colonoscopies and mammograms. For 2012, many employers are offering what are called consumer-driven health plans, which have high deductibles and often attached savings accounts. They're trying to control costs before 2014, when they have to extend coverage to part-time workers putting in at least 30 hours a week, among other anticipated costs, Umland said.

For 2012, the minimum annual deductible required for high-deductible health plans to be coupled with health savings accounts (HSAs) is unchanged at $1,200 for self-only coverage and $2,400 for family coverage. But the annual maximum for workers' out-of-pocket expenses is going up $100 to $6,050 for single coverage and rising $200 to $12,100 for family coverage next year, according to the Internal Revenue Service. Out-of-pocket expenses include deductibles and copays but exclude premiums.

Workers with HSAs for themselves only can contribute up to $3,100 to their accounts in 2012 compared with up to $6,250 for workers with family coverage in a high-deductible health plan. Those limits are slightly higher than for 2011.

2. What would the plan cost me? If your plan is shifting to coinsurance, where you pay a percentage of the total instead of a flat fee, you may have to think differently. "If you had a $10 or $20 copay, it was easy to understand what it was going to cost you when you went to the doctor," Thompson said. "If the plan now has coinsurance and a deductible, that visit may cost over $100 if you haven't met your deductible."

In making a total estimate of what a plan might cost you, first take stock of the premiums, the amount you contribute each month out of your paycheck, which will likely be higher for more a comprehensive benefit plan than for a bare-bones one. The second part relates to your out of pocket costs. For this, consider your recent history of health services. If you see a doctor or need blood work drawn frequently, for example, your copay or coinsurance amounts could make a big difference in your overall spending projections.

Next, if you're considering a health plan with a savings account such as an HSA, factor in what, if anything, your employer contributes to that account that may offset your costs. Your monthly premiums will likely be lower, but don't forget unpredictable and intangible costs. "How much am I saving for sure vs. how much might I lose if I actually use the plan?," Umland suggested asking. Plus, are you OK with managing another financial account? Try to find out how many extra administrative tasks you may need to do to use the HSA funds. Some offer debit cards you can swipe, but others may force you to submit and track claims for reimbursement.

3. What happens if I get really sick or injured? Try to run a worst-case health scenario under each of the plan options to see how financially exposed you would be among them should you or one of your covered dependents have a grave accident or illness. Know what expenses are counted in the out of pocket maximums. "How much would I be out of pocket in this option vs. this option if I suddenly need $50,000 worth of care?" Asencio said.

4. Are my meds covered? If you're on maintenance medication for a chronic illness, check to see if any plans will waive your copay or coinsurance on certain prescription drugs, making them effectively free to encourage you to keep taking them, Thompson said. You may have to talk to a health coach or participate in a disease-management program to get the free meds, but more employers are trying this option to get a handle on their long-term health costs. Some plans also offer a separate out of pocket maximum for prescription drugs, he said.

5. Am I leaving money on the table by failing to participate in wellness programs aimed at making or keeping me healthy? Whether it's a game-oriented workplace exercise competition, private dietary counseling, talking to a health coach or taking classes to help you quit smoking, you may not be able to afford to ignore your employer's 2012 wellness offerings. "While these programs have been around for a while, employers are really taking them seriously now as a way to manage costs," Umland said.

You may not have to do much work to score a break on your health-care costs. In fact, some employees may end up paying $25 to $50 more in premiums per month or hundreds of dollars more in deductibles if they don't complete a health risk assessment or other activities meant to gauge their general health status, Asencio said. "Companies are getting more aggressive around these issues."

[Credited] - Original source: http://finance.yahoo.com/news/5-questions-ask-2012-health-070000424.html

Kristen Gerencher is a reporter for MarketWatch in San Francisco.

The Rising Price of Retirement

As more people work part-time rather than hit the greens, the formula for how much they need to live on is changing. Their tax rate may not fall, and expenses may be higher than planned.

Mention the word "retirement," and most people shudder. The term seems synonymous these days with the phrase, "you can't afford it." More than half of workers in the 2011 Retirement Confidence Survey by the Employee Benefits Research Institute say the total value of their household's savings and investments, excluding the value of their home and any defined benefit plans, is less than $25,000. Housing wealth has vaporized for many households. More than 27 percent of all residential properties with a mortgage—13.4 million homeowners—had negative-equity or near-negative-equity mortgages at the end of 2010, according to CoreLogic, an information and analytics firm.

Times remain tough even though the stock market is up 97 percent from its March 2009 low and the economy is gathering steam. The government's broadest measure of unemployment, and underemployment, is at 15.7 percent, and household budgets are being squeezed by rising food and oil prices—not to mention miniscule yields on savings. It all reinforces the fact that one must confront huge areas of uncertainty when planning for the last stage of life. The answer to the question "how much will you need?" depends on a series of imponderables, from the timing of your death to your health in old age.

Nevertheless, the pervasive gloom about retirement is overdone. Fact is, people are quite creative at coming up with solutions. Case in point: An aging generation isn't really retiring, at least not in the traditional sense of the word. (Think golf.) They may say goodbye to their employer and colleagues for the last time, but they're continuing to work, usually part-time. (Think consulting.) Call it the partial retirement or the job-tirement. It allows savings to compound longer. Delaying taking Social Security benefits locks in a more generous payout. "People aren't slowing down in their 60s and 70s," says Ross Levin, a certified financial planner (CFP) and president of Accredited Investors in Edina, Minn. Adds Joel Larsen, a CFP with Navion Financial Advisors in Davis, Calif.: "If you really like what you're doing, why retire?"

WHEN INCOME REPLACES SAVINGS

Just ask Don Lambert, age 67. The engineering manager retired from Fisher Controls (now Emerson Process Management, a division of Emerson) in 2002. He spent 32 years with the company, half of it abroad, mostly working on projects in the Middle East and Africa. He lives in Ames, Iowa, and when he retired he set up a consulting firm with Fisher as a client. He spent two years on contract with Fisher in Saudi Arabia, where the only thing he had to pay for out of pocket was his "newspaper and haircuts." He still works about two days a week and spends the rest of his time doing community volunteer work with the Rotary International, Meals on Wheels, and the Iowa Council for International Understanding. Lambert has a defined benefit pension plan, Social Security, savings, and no debt. He takes out roughly 3 percent of his savings a year. "I don't need to draw on a lot of my savings yet," he says.

The twin benefit from a higher Social Security benefit and returns that have compounded longer is striking. The Social Security payout rises 8 percent a year for every year of delay after age 62 and before age 70. Laurence Kotlikoff, finance professor at Boston University and head of ESPlanner, an online financial planning website, ran a simulation. Among the key assumptions: A couple is 60 years old, each earns $100,000, and they have a total retirement portfolio worth $2 million. If they elect to take Social Security at age 62 in 2013, they draw on enough of their savings for a total income averaging around $140,000 for the next 38 years. That means they can maintain their standard of living at 70 percent of preretirement income.

Yet if the same couple shifts to part-time work in 2013, making $30,000 each for four years, draws on their 401(k)s, and waits until age 70 to file for Social Security, their discretionary spending jumps by 14 percent, to nearly $160,000 over the next four decades. "To get the same living-standard-hike, the couple would need to find $455,000 lying on the street," says Kotlikoff.

UNDERMINING OLD RULES OF THUMB

But (you knew the "but" was coming, didn't you?) working longer complicates everyday money management by upending a few critical and common assumptions. A traditional benchmark is that in order for households to maintain their standard of living in retirement, they need approximately 70 percent of preretirement income. The lower figure comes from the assumption that a retiree will drop into a lower tax bracket, have more time to shop for deals, and won't incur many expenses associated with work. For instance, economists Mark Aguir of the Federal Reserve Bank of Boston and Erik Hurst of the University of Chicago delved into household data on food gathered by the U.S. Agriculture Dept. from the late '80s and early-to-mid '90s. They found spending on food fell 17 percent among retired households while the time spent making meals rose by 53 percent. There was no real difference between eating out at table-service restaurants for those aged 60 to 62 (pre-peak retirement) and those 66 to 68 (post-peak retirement), except that the retired household spent 31 percent less on fast food and diners.

The old rule is obsolete for the partially retired. The retiree's tax bracket may not drop. The dry cleaning bill will probably stay the same. They're busy and just as likely to grab a burger before a meeting or stop for a takeout meal on the way home as they did before retirement. "I don't think the 70 percent rule applies," says Moshe Milesky, finance professor at York University in Canada and a wealth management and retirement expert. "It may be higher than that."

The other big change is that an aging, income-earning household needs to save from every paycheck, just like their younger co-workers. After all, the cost of goods and services used by the elderly is going up. True, over the past 12 months the consumer price index is up a mere 2.1 percent. Yet that average masks some critical differences. Fuel oil is up 27.1 percent and medical services 3 percent over the same period—a big blow to the budgets of the elderly—while the price of personal computers is down by 7.4 percent, which may be a boon to younger folks. Mutual fund giant Fidelity estimates a 65-year-old couple retiring in 2011 will need $230,000 to pay for medical expenses throughout retirement (and that does not include nursing-home care). "Every single one of our friends has had some serious financial surprise during retirement that was completely unseen," says Henry "Bud" Hebeler, the former president of Boeing Aerospace. His own "retirement" turned into a career offering retirement and financial-planning advice at his website, Analyzenow.com.

Hebeler has devised his own formula for how much to save in retirement while working. He recommends taking your monthly take-home pay, after all deductions and taxes; multiply it by the number of years you will still work, and divide that figure by the number of years it's possible you have to live. For example, say a 65-year-old plans on working another 10 years, expects to live to 95, and makes $2,100 a month after deductions for Social Security, Medicare, union dues, and the like. The monthly amount she can spend from that paycheck would be $700 (2,100 x 10/30 = $700). The remaining $1,400 should go right into savings. Clearly, this isn't our parent's retirement.