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 savings account (HSA) to help employees pay for eligible medical expenses. You, your employee, or both of you can contribute money to the employee’s health savings account each year. The account is the employee’s to keep, even if he or she 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 deductible, but members 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, your employee, or both of you contribute money to a health savings account every year. Your employee uses the money in the account to pay for eligible medical expenses. When the account is used up, the employee is responsible for the remaining amount of the deductible and out-of-pocket maximum. Unused funds in the account at the end of the year are “rolled over” and added to the next year’s balance.
The account is the employee’s to keep, even if that person leaves the company or retires. The employee can invest a portion of his or her unused account dollars in a variety of stocks, bonds and mutual funds.
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 doctor 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 because 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 and employees.
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.