Sharing the cost-shifting

Small businesses and their employees pay more for health insurance than larger ones, and after many years of relentless price increases, many of them are tapped out. While the ACA has not so far caused those yearly price increases to spike, it's added new costs and new pressures.

I have an article up at SHRM.org examining how some small businesses are coping and options they're examining -- including sending workers to the ACA exchanges. One interesting part concerns the various ways employers can, so to speak, share the cost-shifting to employees by partially funding tax-favored savings accounts dedicated to out-of-pocket medical costs:

[Broker Roger] Howell, in Wilkes-Barr...has helped establish a variety of cost-sharing arrangements between employers and employees:

• Some make employees self-fund a portion of the deductible and then cover all costs (co-pays or co-insurance) beyond it.

• Some split costs 50-50 or 80-20.

• Some have a kind of reverse doughnut hole: The employee may be responsible for the first $500, the employer for the next $1,500, and the employee for expenses beyond that.

“We’ve gotten very creative,” Howell said.

Hope you'll take a look.