Towers-Perrin has issued another study of "high- performing" versus "low-performing" employers when it comes to health benefits. On average, the employers surveyed spent $9,660 per employee on benefits. However, this amount varied by 20 percent depending on the practices followed by the employer. The study finds that employees as well as employers in high-performing companies save money, so it isn't just a matter of cost-shifting.

The study notes, "High performers also show success in holding down costs across all plan types. Notably, high performers offering account-based health plans (ABHPs) with a health savings account (HSA) feature are keeping the total per-employee cost under $6,700 -- a figure well below the low-performer cost ($7,584), as well as overall costs for other plans." These employers do not rely solely on plan design for results but also a lot of employee engagement, wellness programs, clear communications, and performance metrics. The high-performing plans also tend to prefer HSAs over HRAs because they want to encourage employee wealth accumulation in preparation for retirement.