Employers have struggled for years with health care costs that climb faster than inflation and consume growing portions of their budgets each year. More are starting to veer from the decades-old practice of offering workers only a plan or two with benefits the employee might not want.
The alternative, called defined contribution health insurance, involves giving employees a set amount of money and then letting them pick their own coverage through a private marketplace or exchange that helps them sort out the choices.
The switch can make the employer's health care costs more predictable. But it also means workers who are used to having their coverage chosen for them could wind up with big medical bills and inadequate coverage if they don't pick wisely.
The exchanges are similar to the public exchanges or marketplaces that will debut next month for coverage that starts in 2014 as part of the health care overhaul, the massive federal law that aims to cover millions of uninsured people.
Sears Holdings Corp. and Darden Restaurants Inc., which operates the Red Lobster and Olive Garden chains, are among the companies that have already shifted to this approach with a private exchange run by benefits consultant Aon Hewitt.
Walgreen runs more than 8,100 drugstores nationwide and provides health coverage for about 180,000 employees and dependents. It also will use Aon Hewitt's exchange for coverage that starts next year.
Aon Hewitt started offering its private exchange last year, and has about 200,000 people covered through it in 2013. It expects that total to triple to more than 600,000 people for coverage that starts next year. The consultant said it has 18 companies, each with more than 5,000 employees, lined up for next year.
Employees using the Aon Hewitt exchange answer between 10 and 15 questions to figure out which plan may work best for them. One of the questions asks whether the employee could handle a $1,500 medical bill. That helps determine whether a high-deductible plan would work for an employee.
High-deductible plans come with a lower premium, or cost of coverage, than more traditional plans, but they require the employee to pay more upfront before most coverage kicks in.
The employer's contribution to coverage purchased on these exchanges may cover a greater or smaller portion of the insurance bill than the worker is accustomed. It depends on the plan selected.
The process is more complex than making trip plans on a travel website, said Ken Sperling, Aon Hewitt's national health exchange strategy leader.
"It's a little bit more involved than buying a plane ticket, but I don't think it's more involved than buying a TV," he said.
Workers who use these exchanges can wind up paying a bigger share of the insurance bill for their coverage over time if the contribution from their company doesn't climb to keep up with insurance costs or the worker doesn't chose a cheaper plan.
Sondergeld, the Walgreen executive, said his company will consider adjusting its contribution in the future if needed.