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Lavish health plans begin to fade in face of upcoming tax

Large employers are increasingly putting an end to their most generous health-care coverage as a tax on “Cadillac” insurance plans looms closer under federal health insurance laws.

Employees including bankers at JPMorgan Chase and college professors at Harvard University are seeing a range of moves to shift more costs to workers. Companies are introducing higher deductibles and co-payments, rising premiums and the imposition of wellness programs that carry penalties for people who don’t comply.

Requiring employees to shoulder more of the cost burden could undermine public support for the health-care law just as Congress, now firmly under Republican control, considers new ways to gut it.

The “Cadillac” tax takes effect in 2018, and employers are already laying the groundwork to make sure they don’t have to pay the 40 percent surcharge on health-insurance spending that exceeds $27,500 for a family or $10,200 for an individual. Once envisioned as a tool to slow the nation’s growing health-care tab, the tax has in practice meant higher out-of-pocket health-care costs for workers.

“I don’t think there’s any employer that’s planning on paying that tax,” Steve Wojcik, vice president of public policy for the National Business Group on Health, which represents large employers, said in a phone interview.

“It doesn’t help the company, it doesn’t help the employees, it doesn’t help the shareholders,” he said. “It doesn’t really help anybody except the federal government.”

The tax on Cadillac plans – named after the luxury vehicle to denote their lavishness – is one reason the growth in health-care premiums has slowed since the Patient Protection and Affordable Care Act took effect in 2010.

Last year, average family premiums rose 3 percent to $16,834, while single premiums held steady at $6,025, according to the Kaiser Family Foundation. Companies with a large percentage of high-wage workers paid more, with an average of $6,244 for single coverage.

Among employers with 200 or more workers, 51 percent had employees paying one-quarter or more of their premiums for family coverage last year, according to Kaiser’s report in September. That portion has been gradually increasing since 2011, when it was 42 percent.

Employers who have traditionally offered generous benefits to lure top professional talent, or who have conceded to demands from labor unions for better health benefits, are most susceptible to the tax, Wojcik said. Many are responding by imposing new requirements on workers and reducing their health benefits.

The tax “is having the effect that was intended, which is the cost of these plans are being reduced,” Christopher Condeluci, a former Senate Republican aide who helped design it, said in a phone interview. “Sadly, the way in which they’re being reduced is they’re shifting more costs onto the employees.”

George Washington University in Washington eliminated its most generous health plan this year because it would have been subject to the tax, the school told employees in a benefits guide.

“Primarily as a result of this significant future tax liability, GW will no longer be offering this plan after 2014,” the university said. Employees can select from three health plans, including a new one that carries a deductible of at least $1,500, almost twice as much as the next-highest plan.

The high-deductible plan, which employees at the school can pair with a savings account for medical expenses, covers less of workers’ health costs – 70 percent on average, compared with at least 79 percent for the other two plans.

“GW, like all employers, has the challenge of maintaining competitive benefits plans while balancing increases in the cost of medical care,” the university’s executive vice president and treasurer, Lou Katz, said in a September blog post. A spokeswoman, Maralee Csellar, didn’t immediately provide answers to emailed questions about the benefit changes.

The number of employers offering only a high-deductible plan was expected to increase by 50 percent for 2015, according to an August study from the National Business Group on Health. Thirty-two percent planned to offer such “consumer-directed health plans,” up from 22 percent in 2014.

Harvard is requiring employees to pay in-network deductibles for the first time this year, sharing in the cost of care, which will help the university reduce the premiums workers pay. That led to protests from faculty who called the change a pay cut.

The school has been scrutinizing employee benefits since at least 2012, when the college said the annual expense had doubled to $476 million over the previous 10 fiscal years. Harvard gives general guidelines on spending to the University Benefits Committee, a group of faculty and staff who advise the provost on health benefits.

It’s unclear how much of a role the Cadillac tax played in Harvard’s decision, said Michael Chernew, the chairman of the committee and a professor of health-care policy at Harvard Medical School in Boston. The tax’s debut in 2018 is still a long way away, and Harvard probably wouldn’t have been affected by it for the first few years, depending on how quickly health-care spending climbs, he said.

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