The International Foundation of Employee Benefit Plans recently held its legislative conference in the nation's capital, where employers of all sizes buzzed about everything from the upcoming election to the war in Iraq.

But naturally, it was pending health care legislation on the forefront of everyone's minds. Karen Ignani, chief executive officer of America's Health Insurance Plans, provided audience members with an overview of 2009 policy conundrums that may come to affect employers.

Many measures are still in the planning stages, while others have reached talks on the House and Senate floors. Here's what employers should be aware of as we head into 2009 and beyond.

General health issues

►H.R. 493: The Genetic Nondiscrimination Act of 2008

• The law, which was recently signed by President Bush, prohibits health plans from adjusting premiums on the basis of predictive genetic information and establishes new confidentiality protections for genetic information.
• The measure does, however, maintain plans' ability to use genetic information in the aggregate for the purposes of disease management and prevention.
• It also prohibits employers and labor organizations from discriminating against employees on the basis of genetic information.

►S.334: Healthy Americans Act

• The Healthy Americans Act would eliminate employer-sponsored health insurance to guarantee universal health care coverage that is transportable, private and equal to the insurance that federal employees have today. It maintains a focus on prevention, wellness and disease management and encourages transparency across all health care offerings.
• The bill was introduced by Sen. Wyden (D-Or.) in January 2007 and is continuing to gain bipartisan momentum in the Senate.

Health technology

►S.1693: Wired for Health Care Quality Act

• Establishes a public-private partnership that would set guidelines for electronic health information exchanges.

►H.R.5442: TRUST in Health Information Act

• Creates a competitive grant program to encourage the implementation and use of health IT systems with a single organization to develop and enforce quality and performance measures.

►Quality and price transparency

• Transparency efforts are in places that aim to achieve greater quality of care at a lower cost to the consumer. Over two dozen states currently mandate that health care providers give report cards or other quality measures on their servicing organizations.

More women than men say paying for health care is a challenge, according to a survey by the Guardian Life Insurance Company of America, a provider of employee and voluntary benefits.

For example, 58% of women were more likely to find paying for health care premiums and out-of-pocket costs a struggle, compared to men (47%).

"As women continue to make strides in the workforce and gain earning parity with men, this may help to lessen the gender discrepancy we see with paying for health care," says Tim Bireley, vice president of group medical at Guardian.

In the survey, however, women (51%) are more likely, compared to men (42%), to have done some retirement health care planning.

Despite the findings, Bireley believes that the need and opportunity to educate consumers about health care transcends gender.

"We have to make sure that employees are fully absorbing information. We have to consistently surround the consumers and share information with them at several touch points until they have a solid understanding of their health care benefits, he adds.

Guardian, which surveyed 473 individuals employed either full-time or part-time, also found that two-thirds of workers admit that health care plans, coverage and benefits are difficult to understand.

Moreover, respondents believe that the rising costs of health care, in part, can be contributed to: profits of drug companies (28%), lawsuits against physicians (14%), physician fees and salaries (9%), poor health of the population (10%) and obesity (9%).

The Internal Revenue Service recently released the maximum contribution levels for health savings accounts and out-of-pocket spending limits for high deductible health plans connected to HSAs. 

The new amounts, which have been indexed for inflation, are for federal income tax purposes. For 2009, the agency reports that the maximum annual HSA contribution for an eligible individual with self-only coverage is $3,000.  For family coverage, the maximum annual HSA contribution is $5,950.

In addition, catch-up contributions for participants who are 55 or older will increase to $1,000 for 2009.

The new guidance also explains that eligible individuals are allowed the full annual contribution, including a catch-up contribution, if 55 or older by year end, regardless of the number of months the individual was an eligible individual in the year. 

"For individuals who are no longer eligible individuals on that date, both the HSA contribution and a catch-up contribution apply pro rata based on the number of months of the year a taxpayer is an eligible individual," the IRS explains.

For 2009, the maximum annual out-of-pocket amounts for HDHP self-coverage jumps to $5,800, and the maximum annual out-of-pocket amount for HDHP family coverage is twice that, $11,600. The minimum deductible for HDHPs increases to $1,150 for self-only coverage and $2,300 for family coverage.

Meanwhile, the House Ways and Means Health Subcommittee, which is chaired by Rep. Pete Stark (D-Calif.), launched a Web site to spotlight its recent hearing on HSAs and HDHPs.

Responding to workers' frustration with soaring prices at the gas plump, employers are beefing up commuter benefits as a way to offer some financial relief, reports the Society of Human Resource Management.

For example, 42% of companies increased their mileage reimbursement to the Internal Revenue Service maximum of 50.5 cents per mile. Last year, only 13% of employers raised mileage reimbursement to the IRS cap, SHRM found.  

Other tactics that employers are using to address the gas price blues include offering flexible work schedules (26%), telecommuting options (18%), public transportation discounts (14%) and a gas card for good performance (14%).

In addition, SHRM indicates that 12% of respondents help workers to organize carpools, and 7% offer priority parking to employees who do so.

"Rising gas prices are cutting into everyone's personal budgets, so employees are taking a closer look at benefits, such as compressed work [schedules] and public transportation discounts to reduce their costs," says Susan R. Meisinger, president and CEO of SHRM.  

Employers are offering extra help as a tool to retain employees and improve employee morale, she adds.

Growing trends around commuter benefits also entail providing new non-executive hires help in finding housing closer to the office (4%) and providing a monetary incentive for workers to buy hybrid cars (1%). Yet overall, SHRM found only 2% of surveyed employers offer a cost-of-living raise prompted by gas prices or stipends to employees with long commutes.