United States: Kaiser Releases Comprehensive Survey Of Employer-Sponsored Health Benefits

The Kaiser Family Foundation and the Health Research & Educational Trust (Kaiser/HRET) have released their annual survey of employer-sponsored health benefits. In the survey, Kaiser/HRET analyzes the responses provided by 2,067 public and private employers with three or more employees during the first five months of 2013. According to the survey results, while health plan premiums increased in 2013 by an amount consistent with prior year increases, coverage and offer rates did not vary significantly.

The survey also provides some insight into the types of plans employers are offering their employees, as well as which employers are offering wellness and disease management programs and incentives. Highlights of the survey are as follows:

Plan Premiums

The average annual premiums for employer-sponsored health insurance in 2013 are $5,884 for single coverage plans and $16,351 for family coverage plans. This is a modest increase in premiums for both single coverage (5%) and family coverage (4%). With respect to the employee's portion of those amounts, the average contribution was $999 for single coverage and $4,565 for family coverage. Contribution is up slightly – but not in a statistically significant way – from 2012 ($951 and $4,316, respectively).

Deductibles

The percentage of covered workers enrolled in a plan with a general annual deductible (78%) increased in 2013. More than half (58%) of covered workers at small employers (3-199 workers) now have a deductible of a $1,000 dollars or more.

Offers of Coverage

Fifty-seven percent of employers responding to the survey claimed that they offer health benefits to their employees, a percentage that is virtually unchanged from last year's reported numbers (61%). The number of employers that offered their employees benefits remained steady for both small and large companies. Once again, the larger the employer, the more likely it is to offer health insurance.

A small percentage (28%) of large employers that offer health insurance benefits also offered retiree health benefits.

Grandfathered Plans

Fewer workers (36%) were enrolled in grandfathered health plans this year. In 2012, 48% were enrolled in grandfathered plans; in 2011 that number was 56%. Fifty-four percent of employers reported that they offered health benefits through at least one grandfathered health plan. This percentage was unchanged from 2012.

Types of Coverage

The most common type of plan coverage remains Preferred Provider Organization (PPO) plans. Approximately 57% of employees were enrolled in PPOs in 2013. The survey reports that 20% of covered workers are enrolled in a High-Deductible Health Plan with Savings Option (HDHP/SO), 14% in a Health Maintenance Organization (HMO), 9% in a Point of Service (POS) plan, and less than 1% in a conventional health plan. PPOs are more popular for covered workers at large employers (200 or more workers) than smaller employers (62% compared to 47%), while POS plans are slightly more popular among smaller employers than large employers (16% compared to 5%).

Private Exchanges

With respect to private health insurance exchanges, 9% of large employers (200 or more employees) and 29% of very large employers (5,000 or more employees) reported that they are considering offering health benefits through a private health exchange in the future. According to the survey, several consulting firms have announced that they are creating private exchanges for employers. Private insurance exchanges would allow employees to receive coverage while relieving employers of some of insurance plan design and management responsibilities.

Wellness and Disease Management Programs

The majority of firms (77%) offer their employees at least one type of wellness program, including weight loss programs, gym membership discounts or on-site exercise facilities, biometric screening, smoking cessation programs, personal health coaching, classes in nutrition or healthy living, web-based resources for healthy living, flu shots or vaccinations, Employee Assistance Programs (EAP), or wellness newsletters. Approximately one quarter (24%) offer health risk assessments, and 57% offer at least one disease management program. The larger the employer, the more likely it is to offer a wellness program.

A smaller percentage (36%) of large employers (those with 200 or more employees) and 8% of smaller employers offer financial incentives to participate in the programs. Incentives include smaller premium contributions, smaller deductibles, higher HSA/HRA contributions or gift cards, travel, merchandise or cash.

While many employers offer wellness programs, new Affordable Care Act wellness regulations along with a recent Equal Employment Opportunity Commission (EEOC) interpretation letter may make it more difficult for employers to implement effective programs. For more information, see Littler's Insight, Double Whammy, Part II: EEOC Stance and ACA Final Regulations Impose New Burdens on Wellness Programs, by Russell Chapman.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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