What number should we show? One suggestion is the COBRA amount, or maybe a per capita amount? COBRA is an average for all individuals in that option. Wouldn't a more accurate number reflect more variables, age, location, etc.?
Obviously, the value received by any one individual does not equal the funding/premium - so, if improving understanding of the value of coverage is the goal, if we are trying to change behavior based on that information, perhaps we should show claims and administrative expenses - how about a rolling average over multiple years?
Cost varies dramatically based on age, location, vendor/insurer, gender, ... all of those variables, and more... If you have an HMO in 10 locations and the insured rate is blended across the country, do we show the same number for a 64 year old in New Jersey and a 24 year old in Oregon?
Let the feds show us how by starting with Medicare beneficiaries - a beneficiary with a $200/mo supplement gets you to $13,800 a year, per person. Of course that is a national average. Then, let the feds adjust for the value of the cost shift from RBRVS, DRG's, and Balance Billing limits, vary the amount by age, by location, by Medicare Advantage plan and PDP, etc. Gain some experience explaining the rate variations to those Americans who actually use the greatest amount of services... Once they have some success showing how behavior changes when you know the cost ...
They state they believe that once individuals know what something costs that they will try to control expense. Fact is, behavior is not likely to change until you must pay the costs directly, at point of purchase (this proposal is mostly focused on point of enrollment costs). But, few if any of the senate leaders pushing for W-2 reporting are interested in increasing point of purchase cost sharing.
If info is what they want to show, we already show associate deductions on the paycheck, why not simply mandate company financial support also be displayed? We've been doing that at my employer since 1997, and I can confirm, I know of no one who has changed their behavior just because we tell them 27 or 28 times a year what is paid for health coverage(each payday, and total rewards statement).
While some believe this may be a first step in taxing health coverage, that may not be first item on their agenda - other candidates:
(1) Change medical from pre-tax for FICA to post-tax (a la the change to 401(k) back in 1983),
(2) Impute as wages for highly compensated (similar to IRC 79 for life coverage), but, maybe it is needed for
(3) "Maintenance of effort" - some proposed "reform" efforts would require employer support be converted to wages; a la the 1988 Medicare Catastrophic Coverage Act.
Grassley's comment is on point - "... But once they realize they themselves are paying for it ..."
Finally, our Senators mistake averages as descriptive of the entire population - our associates are much more diverse. As a result, the number would understate the value for those using significant services. Those using few services might opt for less coverage or no coverage if they could get that value as compensation or other benefits (what the Senators state as the goal). However, employer spending would not necessarily decline because of the antiselection among those who continued coverage.
