Consumer-Driven Health Plans (CDHP)

Consumer-driven health plans (CDHPs) are a type of health insurance that places more financial responsibility on the individual. These plans generally have lower monthly premiums than traditional health insurance plans, but require individuals to pay higher out-of-pocket costs when receiving medical care.

Here are some key features of consumer-driven health plans:

  • Health savings account (HSA): CDHPs typically include an HSA, which is a tax-advantaged account that allows individuals to save money for medical expenses.

  • High deductible health plan (HDHP): CDHPs typically have a high deductible health plan, which is a plan with a higher out-of-pocket cost before insurance coverage kicks in.

  • Preventative care: CDHPs typically cover preventative care, such as routine physical exams and screenings, at no cost to the individual.

  • Flexibility: CDHPs may allow individuals to choose the medical services they receive, as well as the providers they see.

  • Cost-sharing: CDHPs require individuals to pay a larger share of the cost of medical care, which can encourage them to be more mindful of the cost of medical services.

Example:

An example of a consumer-driven health plan is a plan that has a high deductible, but a lower monthly premium. The plan includes an HSA, which the individual can use to save money for medical expenses. The plan covers preventative care, such as routine physical exams and screenings, at no cost to the individual. The individual is responsible for paying the full cost of medical services until they reach their deductible, at which point the plan begins to cover a portion of the cost. The individual can choose the medical services they receive and the providers they see. The plan also requires cost-sharing, which can encourage the individual to be more mindful of the cost of medical services. Consumer-driven health plans are often offered by employers as part of a benefits package or can be purchased directly by individuals.

Next Up

Vision is the most commonly offered ancillary benefit in employer-sponsored plans — 89% of employers offer it nationally, higher than dental, higher than life insurance, and higher than any voluntary benefit. And yet vision is also one of the most underfunded benefits in the market.
Dental benefits are not your largest cost center. For most employers, dental represents a fraction of what medical costs per covered employee annually. But dental is one of the highest visibility benefits in your package: employees use it, notice it, and talk about it. When it’s good, it builds goodwill. When it’s inadequate (low maximums, no orthodontia, zero employer contribution) it registers as a signal that the employer isn’t invested in the total package.
How an employer funds its health plan sits quietly in the background of every benefits decision. Most CHROs and CFOs know their premium cost. Fewer understand the mechanics of how their plan is actually structured: who holds the risk, who administers the claims, how costs flow, and what flexibility, if any, they have to change any of it.