While U.S. workers may be expecting a major overhaul to their benefits plans because of the new health care reform law, most may be surprised to see few differences in what’s offered during this year’s open enrollment season, according to Hewitt Associates, a global human resources consulting and outsourcing company. However, some changes employees will see—including cost increases, changes to dependent coverage requirements and stricter federal rules around flexible spending account (FSA) reimbursements—will make it more important than ever for workers to take an active role in choosing their health benefits this enrollment season.

The good news is that an increasing number of workers seem to be getting the message. According to Hewitt, nearly half (45 percent) of employees actively chose their benefits for 2010 instead of defaulting into the coverage they had in the previous year - which is the highest number of active enrollees since Hewitt began tracking the data in 2003. But with health care costs projected to jump significantly next year, it’s critical that more employees follow that approach. Hewitt’s data shows that overall health care costs are expected to rise 8.8 percent in 2011, from $9,028 per employee in 2010 to $9,821 per employee in 2011. Workers will be expected to contribute 22.5 percent of the total health care premium, or $2,209. This is up 12.4 percent from 2010, when employees contributed $1,966, or 21.8 percent of the total health care premium. In total, workers are projected to spend an average of $4,386 in out-of-pocket costs and premiums in 2011, up from $3,900 in 2010.

“While health care benefits aren’t going to change drastically next year, it doesn’t mean workers have a ‘free pass’ to not participate in this open enrollment season,” explained Sara Taylor, Health & Welfare Solutions leader at Hewitt Associates. “Health care cost increases continue to outpace inflation and salary increases. Employees who take time to do their homework, weigh their choices and make smart trade-off decisions will be in the best position to make their benefits dollars stretch further this year, without having to sacrifice the quality of those benefits.”

Changes Stemming from Health Care Reform

While most of the significant health care reform provisions won’t go into effect until 2014, a few changes will affect workers in the next plan year:

- Most U.S. workers will be able to cover their adult children up to age 26.

- Over-the-counter medications, such as aspirin, pain relievers and allergy medications, will no longer be reimbursable from a FSA unless employees have a prescription from a doctor.

- For health plans that are new or for existing plans that are not “grandfathered,” preventive care (e.g., immunizations and certain check-ups and recommended screenings) will be 100 percent covered. While many employer-provided health plans already provide this level of coverage, this provision will improve the scope of benefits for some workers.

Tips for Open Enrollment Season

To help workers maximize their dollars during open enrollment, Hewitt offers the following tips:

Assess Your Needs: As you go through the benefits selection process, start by reviewing what worked for you last year and what didn’t. Consider how much you spent on co-pays and out-of-pockets costs; whether your doctors are still covered under your plan; and if you put aside enough money in your FSA to cover all out-of-pocket costs. Based on this analysis, you may find there are different plan options that will better suit your needs.

Read the Fine Print: You may not see big changes to your benefits this year, but employers are continuing to tweak the designs of their existing plans. You may see these changes in a number of ways:

- A growing number of companies are starting to charge premiums on a per-participant basis, rather than through a “lump sum” premium traditionally found within the “individual” and “family” pricing models.

- Companies may require you to pay more to cover your spouse, or they may apply surcharges to encourage your spouse to enroll in his or her own employer’s plans.

- Employers are increasingly shifting plan designs from fixed dollar copayments to coinsurance models, where you pay a percentage of the out-of-pocket costs for each health care service.

Know the Plan Rules: Dependent eligibility rules are changing for 2011, so now is an ideal time to review your plan rules for covering dependents. An increasing number of companies are conducting periodic dependent eligibility audits aimed at removing ineligible dependents from a health plan. Conducting these audits can reduce an employer’s overall health care costs by millions of dollars each year.

Take Advantage of Cost-Saving Opportunities: Most employers provide you with a number of ways to shave off hundreds of dollars each year in benefits costs. Often, employees pass up these opportunities during open enrollment simply because they don’t realize they are available.

Almost all companies offer FSAs, which enable you to set aside pre-tax money for health care expenses. Be sure to do an assessment of how much you think you’ll be spending in the coming year and evaluate whether the medications you need will now require a prescription for reimbursement. By effectively planning, you may be able to select less costly medical plan options while using the FSA to offset increased out-of-pocket costs.

You can also keep costs down by taking advantage of the health and wellness programs offered by your employer. Some companies provide incentives for completing health risk questionnaires (HRQs) or biometric screenings, often in the form of reduced premiums. According to Hewitt’s annual health care trends survey, 37 percent of companies now provide cash incentives for participating in health improvement and wellness programs such as weight management and smoking cessation programs.

Get Help: Nearly all employers (90 percent) offer online modeling and health care cost estimators that help you compare and make trade-off decisions among your benefits options. An increasing number of companies also provide quality data on providers, giving you the opportunity to plan ahead and see ratings and read reviews of various aspects of your benefits package before you enroll.