Large employers may not change health benefits all that much in 2012, but bigger changes could be coming in 2013 or 2014.

Towers Watson & Company, New York (NYSE:TW), covers the large-employer health benefits market in a summary of results from a recent survey of 368 large U.S. employers.

The employers’ average annual cost of medical and pharmacy benefits is about $11,200 per active employee.

Participants said they expect the cost of health care for active employees to increase an average of just 5.9% in 2012, down from 7.6% this year. Back in 2010, large employers told Towers Watson they thought their health benefits costs were going to increase 8.2% in 2011.

Few of the employers are talking about drastic changes in health benefits in 2012 as a result of the federal Patient Protection and Affordable Care Act of 2010 (PPACA).

But 53% of the employers said they expect to see PPACA take effect roughly as written, without being repealed, and 88% said their companies will try to keep health benefits packages from triggering the PPACA “Cadillac plan” excise test.

If PPACA does take effect as written and works as expected, then, starting in 2018, the federal government will impose the 40% tax on insurers of group health plans with a total value of more than $10,200 for individual coverage and $27,500 for family coverage.

About 56% of the employers surveyed told Towers Watson they expect their plans to trigger the Cadillac plan tax in 2018.

The employers that are implementing concrete changes in 2012 will be taking steps such as shifting to high-deductible, account-based health plans, cutting coverage subsidies and updating wellness incentives and other incentives.

Towers Watson found, for example, that 57% of employers are thinking about rewarding or penalizing employees based on the results of biometric tests, such as blood pressure tests, up from 8% that do so today.

- Allison Bell

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