The consulting firm Watson Wyatt Worldwide has identified six healthcare benefits trends that workers should expect to see during this year's open enrollment season.

"Open enrollment is a much more active process than it was just a few years ago," says Ted Nussbaum, North America director of group and healthcare consulting at Watson Wyatt. "With some employers making significant changes to their benefit offerings, employees will need to pay closer attention to their options than ever before. And that will require time to ensure they receive the benefits they want for next year."

The six trends are:

• Incentives/penalties for healthy/unhealthy behaviors. More companies are offering financial incentives to employees who have healthy lifestyle habits or who participate in wellness and fitness programs. A forthcoming survey by Watson Wyatt and the National Business Group on Health (NBGH) shows that 46 percent of employers currently offer economic incentives and another 26 percent plan to do so in 2008. A few companies take the opposite approach and penalize workers for unhealthy choices, such as smoking, by charging them higher premiums.
• Full coverage for preventive care benefits. More employers are covering preventive medical care and even preventive drugs at 100 percent and not subjecting these to a deductible. Often included in these fully paid benefits are vaccinations, exams and screenings for early diagnosis of and intervention in breast, colon, and cervical cancer.
• Health coaches/onsite health centers. A growing number of employers offer workers access to health coaches and advocates. These experts provide individualized advice to workers on personal health care needs and can educate workers about best care and what questions to ask their health care providers.
• More choice to meet individual needs. Employers are offering workers a variety of benefit options to help meet personal and family needs. Some of these options are voluntary benefits, such as homeowners, automobile, and group life insurance and discounts on vision and dental care, massage therapy, chiropractic care, weight-management programs and fitness club memberships.
• More communication/more tools. Employers are enhancing their communication with workers and providing online tools to help them evaluate and estimate their health care expenses and needs and manage their personal health care.
• More health savings accounts/fewer plan options. Employer interest in consumer-directed health plans (CDHPs) with health savings accounts (HSA) continues to grow. Watson Wyatt research shows that 40 percent of companies will offer workers an HSA next year. At the same time, to reduce administrative costs, employers are cutting back on the number of health plan options they will offer workers. More employers plan to offer a consumer-directed health plan as their only option.