According to a 2016 employer health benefits survey conducted by the Kaiser Family Foundation and the Health Research & Educational Trust (HRET), the majority of workers are required to pay a share of the cost for their health care services.
Workers’ average contributions toward their premiums were similar to last year, with employees contributing 18 percent for single coverage and 30 percent for family coverage. However, there is considerable variation between how much workers contribute, as with total premiums. Workers’ contributions have risen significantly over the past decade. Premiums for family coverage increased 28 percent since 2011 and 78 percent since 2006. Workers’ average annual contributions in 2016 were $1,129 and $5,277, for single and family coverage, respectively.
Eighty-three percent of workers enrolled in single coverage must pay an annual deductible before services are paid by the plan. Workers who don’t have a deductible are still often required to pay fees like copayments or coinsurance; although, this is often the case regardless of having a deductible. Among those who pay an annual deductible, the average deductible amount for single coverage was over $150 higher than last year—jumping to $1,478 from $1,318.
Premiums rose slightly for employer-sponsored health insurance in 2016. Family coverage rose 3 percent over the 2015 average, bringing the average premium to $18,142. Single coverage essentially remained the same, with an average premium of $6,435. In the same period, workers’ wages increased 2.5 percent and inflation increased 1.1 percent.
Plan Enrollment
The most common plan types in 2016 were: preferred provider organizations (PPOs) for 48 percent of workers covered, HDHPs/SO for 29 percent; Health maintenance organizations (HMOs) for 15 percent; point of service (POS) plans for 9 percent; and Indemnity plans for less than 1 percent of workers covered.
Self-funding
Sixty-one percent of covered workers are enrolled under a plan that is either partially or completely self-funded. Eighty-two percent of workers in large firms and 13 percent in small firms are covered under some sort of self-funded (partially or fully) plan.
Private Exchanges
Of the firms offering health coverage with 50 or more employees, 2 percent offer health benefits through a private exchange. Firms who do not currently offer benefits through a private exchange report they have considered it. Of those firms, 18 percent have at least 50 employees and 28 percent have at least 5,000.
As this survey indicates, health plan costs have increased similarly over the past few years. HSAs and similar mechanisms are becoming more popular as a way to bring those costs down. The new administration will greatly affect these future trends and should continue to be monitored moving forward in 2017.
