After 21 years of benchmarking the state of employer health benefits, there should be few surprises in the latest edition of Kaiser Family Foundation’s Employer Health Benefits Survey. Health insurance premiums are going up for both employers and employees (to the tune of $20,576 for family coverage); PPOs are still the most popular plan option (44 percent of enrollees), though high-deductible health plans are becoming more common; and employers are continuing to look for other ways to bring costs down.
But a deeper look at the survey paints a much more complicated picture, especially compared with the talking points popular among politicians.
“In the political debates, the private insurance system has been treated mostly as a monolith: good or bad,” said KFF president and CEO Drew Altman in a call with media. “What we see in this survey is that it’s really not that simple. It’s a spectrum of coverage from good to lousy.”
Specifically, there are notable differences between the health insurance benefits at large and small employers, as well as low-wage employers.
Workers at low-wage employers (where at least 35 percent of employees make less than $25,000 a year) are less likely to be offered health benefits (66 percent compared to 81 percent). If they are offered insurance, they’re more likely to pay more for them, shouldering a family contribution of $7,047, compared to $5,968 for non-low-wage workers. As a result, just one in three low-wage employees are covered by employer-sponsored health insurance.
Meanwhile, benefits at small employers are also running the gamut. Some are more generous: small employers will pay the entire individual premium for 31 percent of covered workers, compared to only 5 percent of covered workers in large firms. That generosity doesn’t extend toward their families: 35 percent of covered workers in small firms contribute more than half of the premium for family coverage, compared to 6 percent of their large-employer counterparts.
Still, there’s one thing everyone has in common: health insurance costs are rising significantly faster than wages. Employees this year have an average contribution of $6,015 toward the cost of family coverage, and $1,242 for single coverage.
“I don’t think you can look at what’s happening with health care costs without also looking at what’s happening with wages,” Altman said. “Over the past 10 years, just workers contributions to health care premiums grew 71 percent while wages grew 26 percent. That’s why people are so upset about their health care costs.”
Employers are still working to keep costs in check, though cost-sharing strategies are falling out of favor. According to this year’s numbers, 28 percent of workers now pay at least $2,000 in deductibles, a four-fold increase since 2009.
Employers are also still keen on health and wellness tools: 41 percent of small firms and 65 percent of large firms offer health risk assessments. Biometric screenings are offered at 26 percent and 52 percent, respectively, and health and wellness promotion programs and 50 percent and 84 percent of small and large firms.
The survey results don’t suggest any significant disruption in employer-sponsored health care anytime soon. The expanding economy, though not as beneficial to workers’ financial health as it could be, has dampened appetites for change. And, according to Altman, the results of this survey are important because they show “what most employers are doing, not just pacesetters who get a lot of attention.”