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Is it realistic for an employee to influence an employer, and the HR department, to add a high-deductible health plan to the medical benefits offered by the company?

In this case, the employee believes it would be beneficial to multiple employees, given the differential in cost to the employees (vs PPO) and their current health situation, to have an HSA and high deductible health plan option.

However, how would an employee go about encouraging, possibly even suggesting plans or other examples to the employer? What plans or steps can be taken towards implementing such a thing?

From the perspective of an engineer who is used to proposing new things with a proof of concept in hand.

  • Presumably this is in the U.S., but a country tag would help a lot. – Upper_Case Feb 19 at 18:20
  • Thank you, it's been added. – user3.1415927 Feb 19 at 18:33
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Is it realistic for an employee to influence an employer, and the HR department, to add a high-deductible health plan to the medical benefits offered by the company?

A single employee? Probably not. Many employees? Perhaps.

Make your preferences known to HR and encourage others to do the same. The more employees join in, the more likely HR is to consider their opinion.

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  • Is there any more tangible steps, more than just voicing an idea? Sure, several employees could get together and ask the employer, but that doesn't seem as persuasive as presenting some sort of evidence that it would be a helpful thing, or worth the effort to change on the employer's part. – user3.1415927 Feb 18 at 22:05
  • Perhaps they could even gather together - in a sort of union - to represent their needs – Azor Ahai Feb 19 at 19:34
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Talk to the person in charge of benefits in your workplace about what you want

There isn't a whole lot you can do, individually, to set a benefit package for all employees. Indicating your interest to the company is a good step to get them to start considering the different insurance (assuming they haven't considered it already), and will be a stronger step as more employees join in. But, crucially, you almost certainly lack relevant information on this matter that would guide a decision, and so cannot provide meaningful evidence.

Companies typically cannot simply "add" an insurance benefit of their own volition. Coverage in the U.S. is nearly always provided directly by an insurer or underwritten by an insurer in the case of a company self-insuring. The insurer reviews information about the employer and its employees, does some modeling and actuarial analysis, and then comes back with a benefit package (what the insurance policy covers, and in what ways) along with a bid for premium pricing (what the employer will pay per covered life-year to obtain that insurance coverage).

This is not a trivial amount of work, particularly if the employer is self-insuring. An insurer will be able to provide estimates more easily, assuming they offer such a plan. Most importantly, the term "high deductible health plan" is not specific enough to point to an actual policy that might be offered. There exist a huge number of options which would go along with an HDHP, including network restrictions, availability of family deductibles, pricing for dependents, service exclusions, and a huge number of others.

This is information which will only be available from an insurer and will reflect what options they currently offer. It's very easy for the benefits of a HDHP to be overwhelmed by negative impacts from those other elements, and it is very unlikely that those benefits and problems will fall evenly across employees. And even if direct benefits and harms are fairly evenly distributed, the degree of risk tolerance may differ a lot between different employees, leading them to value the outcomes very differently.

Your best bet for persuading your company that this might be worth pursuing is to show that there is demand among employees for such a benefit package. Something that is less expensive, month to month, for the employer and specifically requested by many employees is a much better pitch than anything an individual worker is going to be able to offer.


A benefit for you from this change may not be a benefit to the company

The attraction of HDHPs is typically that the premiums are lower, meaning for people that do not utilize many medical services they save money each month on that expense. The other side of that coin is that people that do use medical services have to bear a lot more financial risk personally, while also (typically) being forced to use a narrower network of medical service providers and more byzantine service restrictions and carve-outs.

The split between people that will find the HDHP attractive and the people that will not presents more problems, from an insurance perspective: it tends to split the risk pools between higher- and lower-risk individuals and families. Depending on the number of employees, that may or may not matter in practical terms. But it could easily cause the effective price the non-HDHP plans to go up by a substantial amount, which impacts both the employees and the employer. It may or may not add to the regulatory and reporting burdens the employer already has to deal with as well. It will definitely add to the administrative burden the insurer has to deal with, which is unlikely to be free.

Relatedly, it may cut against the employer's goals to pursue a policy like this. Many employers are focused on cutting direct costs as much as is possible, which would favor HDHPs. Others are more focused on caring for their employees' needs, or providing more generous benefits to attract and retain workers. Saving money on premium costs for a few younger, healthier workers at the direct expense of other workers may not be appealing.

Finally, insurance benefits are a part of overall compensation packages in the U.S., largely for arbitrary tax reasons. But when moving from a more generous insurance package to a less generous one individual compensation for workers almost never increases. The company will pocket the savings, your salary will not change, but the insurance you have will be "worth" less, and the additional medical cost risk that results will be borne exclusively by the employees.

That may still be a net gain for you, with respect to the out-of-pocket costs you pay in premiums (and premiums only, as your risk increases). But depending on your specific employer's current insurance setup, such a change may well be equivalent to asking for coworkers' pay to be cut solely to increase it for others. That could happen, but is awkward for one of the proposed beneficiaries to argue for as it requires harms to others be discounted.

If your employer ultimately declines to offer HDHPs, you could potentially ask for a voucher to use to purchase your own HDHP off of the state or federal insurance exchange (whichever is relevant to the state you live in). You may not find this option attractive relative to what your employer offers, so I recommend researching available plans before asking about this.


tl;dr:

You cannot provide any sort of reasonable proof of concept for this, because you don't (and almost certainly legally cannot) possess the relevant information to do so. You can ask your employer to look into such a plan, but there is a strong chance that the benefits to you would be balanced (or more than offset) by harms to others and the company as a whole. Indicate your interest, especially if you can present this as a request from many employees, then let the employer and potential insurers determine whether or not it's a suitable approach for them.

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I've been part of a company team trying to sort out health care benefits. It's an incredible pain in the neck. It takes a long time and a lot of negotiation with the benefits provider. Among painful time-drains for executives, health insurance is near the top of the list.

And, typically the issue of what plan options will be available gets settled many months before the open-enrollment period starts. Adding a new plan on the fly at the request one person, or even many people? Not going to happen. Too hard.

If your company uses an employment service (like ADP) it may be easier for them to add another option.

I suspect if you write a well-reasoned email message to an executive in HR, your request will get due consideration for inclusion in the next open-enrollment cycle. I suggest you try to pitch it as good for the company as well as the employees.

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  • Definitely not talking about a mid-cycle change, but trying to learn about influencing future options. I'm interested to hear about the "well-reasoned message" though. Aside from good for all parties, what are other good things to include, or good ways to phrase things? – user3.1415927 Feb 18 at 23:10
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    If you know of another company with a plan that's a good model for what you suggest, you could mention it. If you know the benefits manager at that other company, you could even introduce them to your exec, with permission of course. If you have a summary plan description for a plan like that, you could include it with your suggestion letter. Those are evidence of your respect for the time and effort they put in to negotiating the plan. "Thanks for all your hard work on this" won't hurt either. – O. Jones Feb 19 at 1:17

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