The recent debate regarding health care reform has highlighted for the public what employers have known for years - health care is expensive. Employers have for years looked for creative ways to alleviate double digit annual increases in the cost of health coverage provided to its employees. Employers have toggled deductibles and co-payments, and they have implemented wellness programs and consumer driven health care programs. While many of the measures taken by employers have operated to reduce costs, the cost to provide health care is still high. An often overlooked method to reduce cost is to implement an opt out incentive. It is not uncommon for employees and dependents to be “over covered”. But what if you gave employees with access to other coverage money to opt out of your coverage?