YOUR MONEY-Will U.S. healthcare premium guessing game continue in 2014?

By Beth Pinsker

NEW YORK, Oct 17 (Reuters) - Benefits consultant Aon Hewitt predicted that healthcare premium costs for large U.S. employers would rise about 6 percent in 2013, but when it tallied up its numbers for the year, the increase was only about 3.3 percent.

A similar shift happened in 2012. The forecast was 7 percent, and the actual rise in premiums turned out to be 4.9 percent.

The projection for 2014 costs is again in the 6-percent-to-7-percent range, Aon Hewitt said on Thursday. Based on actual tallies of healthcare usage, the forecast is on track, while the last two years are anomalies, the company says.

Companies use Aon Hewitt's forecasts to determine how much comes out of employees' paychecks each month for health insurance. When healthcare costs are 3 percent lower than expected, there is money left over - for somebody.

"If your employer expected that you'd pay 20 percent of the premium, and it turns out that the costs aren't as much, they're not going to give that back to you," says Gary Claxton, a vice president at the nonpartisan Kaiser Family Foundation, which studies healthcare.

In 2013, the average employee contribution to health insurance was $2,303, about 20 percent of the overall premium of $10,472.

Fewer-than-expected medical procedures and visits to doctors are the main reason why previous forecasts were off base, says Aon Hewitt chief healthcare actuary Tim Nimmer. The company predicted that people would start using more services as the economy rebounded, but they simply did not, he says.

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Employers may be saving money on healthcare costs. Yet chief financial officers are not popping bottle of champagnes over a big sack of cash, says Helen Darling, president of industry trade group National Business Group on Health. "It's all on paper," she says.

In the "self-funded" model where a big company covers its employee's healthcare costs directly, planners look at the projections from companies like Aon Hewitt and budget accordingly. At the end of the year, if the expenses were not as high as expected, there is still money in the account. (If the expenses were higher, they would have to add money.)

Clients have been asking what they should do with their reserves and how they should plan for the future, says Aon Hewitt's Nimmer. It is unlikely that much of the cost savings will be passed along directly employees, he notes.

"Employers are very cautious about releasing those reserves," he says. "If the scenario plays out where costs go up and they've already made plan designs, they are protected financially."

Most are still tweaking plan designs to get costs lower, which often means shifting more of the financial burden to employees. Many are raising deductibles or their workers' share of costs.

Companies with a combined 1 million employees have made the switch to private health insurance exchanges, the largest of which is run by Aon Hewitt.

United Parcel Service Inc and other companies are dropping coverage for working spouses, and many more are raising deductibles or switching to high-deductible health plans. Many companies are focused on wellness plans and on adding surcharges for undesirable behavior like smoking.

The California Public Employees' Retirement System, which administers retirement and healthcare benefits for public employees, said this summer that its annual premium for members would only go up 3 percent in 2014, the smallest increase since 1998. This came after the organization made plan design changes that opened up their offerings to more providers.

"The lower rates most members will see next year are the result of successful rate negotiations with existing and new health plan providers," the organization said in a statement.