This consumer-directed health plan is an innovative way to help you manage costs and the health of your employees. It’s a high deductible health plan coupled with a health reimbursement account (HRA) to help employees pay for eligible medical expenses. You contribute money to the employee’s health reimbursement account each year. The account remains with you if the employee leaves the company or retires.
See the tabs above to find out more about how consumer-directed plans work and learn about programs and services that Blue Cross offers to help keep employees healthy.
What is a consumer-directed benefit solution?
A consumer-directed benefit solution combines the protection of a high-deductible health plan with a financial account to help pay for medical and other eligible expenses. There are several variations of how the account is funded to offset the high deductible, but employees decide where and when to spend the money in the account (based on the IRS list of Section 213(d) eligible expenses).
How does the account work?
You contribute money to an employee’s individual health reimbursement account (HRA). When an employee sees a doctor or goes to a hospital, money is withdrawn from the account to apply towards the deductible of the health plan. Employees can choose where and when to spend this money based on how you design the account. Once all of the money in the account has been used, the employee pays the remaining deductible amount until the health plan coverage takes over.
With an HRA, the account remains with you should the employee leave the company or retire. If the employee doesn’t use all of his or her account dollars in one year, the unused balance may be rolled over to be added to next year's balance.
How do employees manage their accounts?
Employees have access to myBlueCross, our online service center. There, they’ll find tools and health information to guide them when making decisions about health care. Questions about specific claims or account transactions can be answered by our dedicated account service representatives.
Online tools include:
Why is consumer-directed important and why is it growing so fast?
Everyone is aware of the rising costs of health care. Businesses are struggling to maintain a quality health plan at an affordable price. There’s no single solution to the problem, but there is agreement that putting more responsibility for health care into the hands of the people who actually use it is a good start. A consumer-directed plan not only gives people more say in their health care, it raises awareness of the actual cost of visits and procedures. That kind of attention will lead to a healthier, more informed consumer and, ultimately, to lower costs for everyone.
One reason for the growing popularity of consumer-directed plans is that it provides employers with an attractive alternative. Employers no longer have to raise an employee’s contribution to the premium, reduce benefits, or eliminate the health plan altogether. Consumer-directed plans also provide tax advantages for employers, members, self-employed people and families.
How will I communicate this concept to employees?
Because this may be a new way of thinking for employees, we’ve created a number of tools to educate, engage and encourage them. Your employees may receive:
Health Support works with your health plan to surround your employees with a rich network of services that can make a difference in their lives. See Why Blue Cross to learn more about Whole Person Health Support.
Stop-Smoking Support: BluePrint for Health Stop-Smoking Program Quarterly Quit rate and Satisfaction Report, Free & Clear 2007.
Healthy Start prenatal support: National rates reported by the National Center for Health Statistics. Based on 2007 Healthy Start program outcomes in comparison to 2006 national outcomes from the National Center for Health Statistics.
Employee Assistance Program: Client satisfaction survey, 2008.
Enhanced Stop-Smoking Support: Internal Blue Cross program evaluation study, 2004-2005.