Employer Health Benefit Survey 2015
Release Slides
September 22, 2015
Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Family Coverage, 1999‐2015
1999
$1,543
2000
$1,619
2001
$1,787*
2002
2003
$7,061*
$5,274*
Employer Contribution
$8,003*
$5,866*
$2,137*
Worker Contribution
$6,438*
$4,819*
$9,068*
$6,657*
$2,412*
2004
$2,661*
2005
$2,713
2006
$2,973*
$9,950*
$7,289*
$10,880*
$8,167*
2007
$3,281*
2008
$3,354
2009
$3,515
2010
$3,997*
2011
$4,129
2012
$4,316
2013
$5,791
$4,247
$11,480*
$8,508*
$12,106*
$8,824
$12,680*
$9,325*
$13,375*
$9,860*
$4,823
2015
$4,955
$15,073*
$10,944*
$11,429*
$4,565
2014
$13,770*
$9,773
* Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 1999‐2015.
$11,786
$12,011
$12,591*
$15,745*
$16,351*
$16,834*
$17,545*
Average Annual Premium Increases for Family Coverage, 1999‐2015
50%
45%
40%
35%
30%
25%
20%
15%
11%
10%
5%
5%
5%
2005 to 2010
2010 to 2015
0%
1999 to 2005
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 1999‐2015
Cumulative Increases in Health Insurance Premiums, Workers’ Contributions to Premiums, Inflation, and Workers’ Earnings, 1999‐2015
250%
Health Insurance Premiums
Workers' Contribution to Premiums
Workers' Earnings
Overall Inflation
200%
221%
203%
158%
150%
138%
100%
88%
75%
56%
42%
50%
20%
42%
31%
17%
0%
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 1999‐2015. Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 1999‐2015; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1999‐2015 (April to April). 2013
2014
2015
Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single and Family Coverage, by Firm Size, 2015
Single Coverage
Family Coverage
$17,983*
$17,545
$13,390*
$12,591
$4,549*
$4,955
Large Firms
(200 or More
Workers)
All Firms
$16,625*
Employer Contribution
Worker Contribution
$10,720*
$6,163
$6,289
$6,251
$5,264
$5,142
$5,179
$899*
$1,146*
$1,071
Small Firms
(3 to 199
Workers)
Large Firms
(200 or More
Workers)
All Firms
$5,904*
Small Firms
(3 to 199
Workers)
* Estimate is statistically different between All Large Firms and All Small Firms estimate (p<.05). SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015.
Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single and Family Coverage, by Firm Wage Level, 2015
Single Coverage
Family Coverage
$17,665*
$17,545
$16,182*
Employer Contribution
Worker Contribution
$12,835*
$6,307*
$5,238*
$5,606*
$4,507*
$1,099
Less Than 35% 35% or More are
are Lower‐Wage Lower‐Wage
Level
Level
$12,591
$6,251
$5,179
$4,829*
$1,069
$9,801*
$6,382*
$4,955
$1,071
All Firms
Less Than 35% 35% or More are
are Lower‐Wage Lower‐Wage
Level
Level
* Estimate is statistically different between All Large Firms and All Small Firms estimate (p<.05). NOTE: Lower‐wage level is $23,000 annually or less, the 25th percentile for workers earnings nationally.
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015.
All Firms
Percentage of Covered Workers With a General Annual Deductible for Single Coverage, 2006‐2015
90%
78%*
80%
74%
70%*
80%
81%
2014
2015
72%
70%
63%
60%
59%*
59%
2007
2008
55%
50%
40%
30%
20%
10%
0%
2006
2009
2010
2011
* Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2006‐2015.
2012
2013
Average General Annual Deductible for Covered Workers Enrolled in Single Coverage, 2006‐2015
$1,318 $1,275
$1,217 $1,135 $1,175
$1,097*
$1,075
$991 $975
$989*
$917*
$875
$883 $826*
$802 $735*
$775
$675
$584 $747*
$616 $646*
Average Deductible Among Covered
Workers With a Deductible
$575
$533*
Average Deductible Among All Covered
Workers
$475
$433*
$375
$1,077 $343 $303 $275
2006
2007
2008
2009
2010
2011
2012
2013
* Estimate is statistically different from estimate for the previous year shown (p<.05). NOTES: Average general annual deductible is among all covered workers. Workers in plans without a general annual deductible for in‐network services are assigned a value of zero. SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2006‐2015.
2014
2015
Cumulative Increases in Health Insurance Premiums, General Annual Deductibles, Inflation, and Workers’ Earnings, 2010‐2015
80%
Overall Inflation
Workers Earnings
70%
67%
Single Coverage Deductibles, all Workers
60%
Single Coverage Premiums
50%
40%
30%
24%
20%
10%
9%
10%
0%
2010
2011
2012
2013
2014
NOTE: Average general annual deductible is among all covered workers. Workers in plans without a general annual deductible for in‐network services are assigned a value of zero. SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2010‐2015. Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 2010‐2015; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 2010‐2015 (April to April). 2015
Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $1,000 or More for Single Coverage, By Firm Size, 2006‐2015
All Small Firms (3‐199 Workers)
70%
All Large Firms (200 or More Workers)
58%*
All Firms
60%
50%
46%
50%
49%
40%
40%
31%
21%*
20%
16%
10%
34%
39%*
32%
22%*
18%*
26%
28%
22%*
12%*
17%
10%
0%
41%
27%*
30%
63%
46%
38%
35%*
61%
13%*
6%
2006
8%
9%
2007
2008
2009
2010
2011
2012
2013
* Estimate is statistically different from estimate for the previous year shown (p<.05). NOTE: These estimates include workers enrolled in HDHP/SOs and other plan types. Average general annual health plan deductibles for PPOs, POS plans, and HDHP/SOs are for in‐network services. SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2006‐2015.
2014
2015
Distribution of Health Plan Enrollment for Covered Workers, by Plan Type, 1988‐2015
Conventional
1988
1993
46%
1996
27%
1999
10%
28%
2000
8%
29%
2001
7%
24%
2002 4%
27%
2003
5%
24%
2004
5%
25%
2005 3%
21%
2006 3%
20%
2007 3%
21%
2008 2%
20%
2009 1%
20%
2010 1%
19%
2011 1%
17%
2012 1%
16%
2013 1%
14%
2014 <1%
13%
2015 1%
14%
HMO
PPO
POS
HDHP/SO
73%
16%
26%
21%
31%
28%
39%
42%
46%
52%
54%
55%
61%
60%
57%
58%
60%
58%
55%
56%
57%
58%
52%
10%
9%
9%
8%
10%
NOTE: Information was not obtained for POS plans in 1988. A portion of the change in plan type enrollment for 2005 is likely attributable to incorporating more recent Census Bureau estimates of the number of state and local government workers and removing federal workers from the weights. See the Survey Design and Methods section from the 2005 Kaiser/HRET Survey of Employer‐Sponsored Health Benefits for additional information.
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 1999‐2015; KPMG Survey of Employer‐Sponsored Health Benefits, 1993, 1996; The Health Insurance Association of America (HIAA), 1988.
11%
7%
14%
24%
21%
23%
18%
17%
15%
15%
13%
4%
13%
5%
12%
8%
10%
8%
8%
13%
17%
19%
20%
20%
24%
Percentage of Firms Offering Health Benefits, by Firm Size, 1999‐2015
100%
98% 99%*
96%
98%
98%
97%
98%
97%
97%
99%
98%
99%
96%
96%*
96%
97%
95%
94%
96%
94%*
90%
94%
93%
91%
91%
91%
92%
93%
92%
93%
91%
90%
88%
87%
80%
89%
3 to 49 Workers
50 to 99 Workers
70%
68%
66%
66%
60%
68%
66%
63%
100 or more
69%*
ALL FIRMS
66%
63%
66%
64%
63%
60%
63%
61%
59%
61%
59%
66%*
60%*
57%
60%
57%
58%
56%
61%
59%
57%
57%
55%
57%*
55%
50%
54%
52%
40%
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
*Estimate is statistically different from estimate for the previous year shown (p<.05). NOTE: Estimates presented in this exhibit are based on the sample of both firms that completed the entire survey and those that answered just one question. For more information, see the Survey Methods Section.
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 1999‐2015.
Eligibility, Take‐Up Rate, and Coverage for Workers in Firms Offering Health Benefits, 1999‐2015
100%
Percentage Eligible
Percentage of Eligible That Take Up
Percentage Covered
90%
85%
84%
84%
85%
84%
83%
83%
83%
82%
82%
81%
83%
80%
81%
81%*
81%
79%
80%
80%
78%
79%
80%
79%
80%
79%
81%
81%
80%
80%
79%
79%
79%
77%
77%
77%
62%
62%
62%
2012
2013
2014
70%
70%
68%
68%
68%
66%
67%
66%
65%
65%
65%
65%
65%
63%
63%
60%
50%
1999
2000
2001
2002
2003
2004
2005
2006
2007
* Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 1999‐2014.
2008
2009
2010
2011
2015
Among Firms with More Than 50 Employees and Who Offer Health Benefits, The Percentage of Firms Considering Offering Benefits Through a Private Exchange, 2015
100%
7%
7%
80%
60%
Yes
76%
No
68%
Don't Know
40%
20%
17%
26%
2%
3%
0%
Considering Offering Benefits Through a Private Exchangeǂ
ǂ
Considering a Defined Contributionǂ
Percentage of Covered
Percentage of Firms
Workers Enrolled at a offering Health Benefits
Firm That Offers Benefits Which Offer Coverage
Through a Private or
Through a Private or
Corporate Exchange
Corporate Exchange
These questions were not asked of firms that already offer health benefits through a private exchange.
NOTE: A private exchange is one created by a consulting company, not by a state or federal government. Private exchanges allow employees to choose from several health benefit options offered on the exchange. A defined premium contribution is a set dollar amount offered to the employee. Employees may then select one of several plans and the employee pays the difference between the defined contribution and the cost of the health insurance option they choose. SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015. Among Large Firms (200 or More Workers) Offering Health Benefits, Percentage of Firms Offering Incentives for Various Wellness and Health Promotion Activities, 2015
100%
Health Risk Assessments
Biometric Screening
Wellness Programs
90%
81%
80%
70%
60%
50%
40%
50%
50%
31%
31%
28%
30%
20%
10%
0%
Also has an
Offers or
Incentive to
Requires Health
Risk Assessment Complete Health
Risk Assessment
Offers or Asks
Employees to
Complete
Biometeric
Screening
ǂ
Also has an
Incentive To
Complete
Biometric
Screening
Offers Specific Wellness Programǂ
Firms which offer either “Programs to Help Employees Stop Smoking”, “Programs to Help Employees Lose Weight”, or “Other Lifestyle or Behavioral Coaching“.
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015.
Also has an
Incentive or
Penalty to
Participate in
Wellness
Programs
Among Firms Offering Health Benefits, Percentage of Firms Offering Specific Wellness Program to Their Employees, by Firm Size, 2015
100%
90%
All Small Firms (3‐199 Workers)
All Large Firms (200 or More Workers)
81%*
80%
71%*
68%*
70%
61%*
60%
49%*
50%
41%*
40%
39%*
39%*
30%
20%
10%
0%
Programs to Help Employees
Stop Smoking
Programs to Help Employees
Lose Weight
Other Lifestyle or Behavioral
Coaching
* Estimate is statistically different between All Small Firms and All Large Firms (p<.05). NOTE: “Other Lifestyle or Behavioral Coaching” can include health education classes, stress management, or substance abuse counseling. SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015.
At Least One
of These Programs
Among Large Firms Offering Incentives for Workers Who Participate In or Complete Wellness Programs, Maximum Annual Value of the Reward for Wellness and Health Promotion Programs, Including Incentives for Health Risk Assessment and Biometric Screening, 2015
100%
Maximum Annual Value of the Reward for Wellness and Health Promotion Programs Altogether (All Large Firms‐200 or More Workers)
80%
60%
41%
40%
22%
21%
20%
11%
5%
0%
$150 or Less
>$150 to $500
>$500 to $1,000
>$1,000 to $2,000
NOTE: Firms with at least one of the listed wellness programs were asked to report the maximum reward or penalty an employee could earn for all of the firm's health promotion activities combined. For some employers, the maximum incentive may include rewards or penalties for activities related to health risk assessments and biometric screening. Listed programs include: “Programs to Help Employees Stop Smoking”, “Programs to Help Employees Lose Weight”, or “Other Lifestyle or Behavioral Coaching”.
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015. Greater than $2,000
Among Firms Offering Health Benefits, Percentage of Firms Who Have Incorporated Various Features into Their Provider Networks, by Firm Size, 2015
30%
All Small Firms (3‐199 Workers)
All Large Firms (200 or More Workers)
24%
20%
17%
10%
9%
8%
6%
5%
0%
Largest Plan Includes a High‐Performance or Firm/Insurer Eliminated Hospitals or Health
Tiered Provider Network
Systems from Network to Reduce Cost
Firm Offers a Plan Considered a Narrow
Network Plan
Note: A high performance network is one that groups providers within the network based on quality, cost, and/or efficiency of care they deliver.
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015.
Among Firms Whose Plan with the Largest Enrollment Covers Specialty Drugs, Percentage of Firms Which Use the Following Strategies to Contain Specialty Drug Cost, by Firm Size, 2015
100%
All Small Firms (3‐199 Workers)
All Large Firms (200 or More Workers)
90%
80%
70%
60%
50%
40%
30%
25%
20%
20%
10%
31%
30%
14%*
8%
7%
14%
7%
4%
6%
10%
7%
2%
0%
Separate Cost Sharing Specialty Drug Carve
Tier
Out
Specialty Pharmacy
Dispensing Program
Step Therapies
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015.
Tight Limits on the
Number of Units
Administered
at a Single Time
Utilization
Management
Programs
Other
Among Firms Offering Health Benefits with 50 or More Full‐Time‐
Equivalentsǂ, Percentage of Firms That Took Various Actions, by Firm Size, 2015
All Large Firms (200 or more Workers)ǂ
3%
Increased the waiting period before
new employees are eligible for health benefits
All Firms (50 or More FTEs)ǂ
2%
Reduced the number of full time employees
the firm intended to hire because of the cost
of providing health benefits
5%
4%
Changed some job classifications
from part time to full time so that
employees would be eligible
13%
10%
Changed some job classifications from
full time to part time so employees
would NOT be eligible
3%
4%
0%
10%
20%
30%
40%
50%
60%
70%
ǂ Firms were asked if they took the relevant action in response to the Employer‐Shared Responsibility Provisions. Firms with 50 or more full‐time equivalents were asked these questions. A significant number of employers, mostly large employers did not know how many FTEs they employed. In these cases, firms with 50 or more workers were asked these questions.
Source: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015. 80%
90%
100%
Among Firms Offering Health Benefits with 100 or More Full‐Time‐
Equivalentsǂ, Percentage of Firms That Took Various Actions, 2015
Extended Eligibility to Groups of Workers not Previously Eligible
because of the Employer Shared Responsibility Provisions
21%
Offered More Comprehensive Benefits to Some Workers who
Previously were only offered a Limited Benefit Plan
5%
Offers a Health Plan that Meets Minimum Standards for Value and
Affordability
96%
0%
10%
20%
30%
40%
50%
60%
ǂ Response are among firms with 100 or more full‐time equivalents. A significant number of employers, mostly large employers did not know how many FTEs they employed. In these cases, the responses for firms with 100 or more workers are included. Two percent of firms did not offer a health plan that meets minimum standards for value and affordability and three percent of firms did not know.
Source: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015. 70%
80%
90% 100%
Among Firms Offering Health Benefits, Percentage of Firms That Have Taken Various Actions in Anticipation of the Excise Tax on High‐
Cost Plans, by Firm Size, 2015
All Small Firms (3 to 199 More Workers)
100%
All Large Firms (200 or More Workers)
90%
80%
71%
70%
60%
53%
50%
38%
40%
30%
20%
10%
17%
13%
7%
8%
8%
6%
2%
0%
Conducted an analysis to Made changes to plan’s Switched to a lower cost
determine if plans will coverage or cost sharing plan
exceed limits
to avoid exceeding limits
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015.
Other
None of these
Among Large Firms (200 or More Workers) Offering Health Benefits Who Indicated That Have They Changed Their Plan or Switched Carriers In Anticipation of the Excise Tax on High‐Cost Health Plans, Percentage of Firms Which Have Taken Various Actions, 2015
100%
Actions Taken by Large Firms in Anticipation of the High Cost Plan Tax
90%
80%
70%
64%
60%
50%
40%
34%
30%
24%
18%
20%
16%
10%
10%
0%
Increased cost
sharing
Reduced the scope of Moved benefit Increase incentives to Considered offering
covered services
use less costly
health insurance
options to account‐
providers
through a private
based plans such as an HRA or HSA‡
exchange
‡ Among firms who offer either an HSA‐qualified plan or a high deductible plan paired with a health reimbursement arrangement.
Note: Sixteen percent of large firms offering health benefits report that they have changed their benefit plans or moved to lower cost plans in anticipation of the assessment
SOURCE: Kaiser/HRET Survey of Employer‐Sponsored Health Benefits, 2015. Other
U.S. health care spending per capita has risen at historically low rates recently, but is expected to pick up
Average annual growth rate of health spending per capita for 1970’s – 1990’s;
Annual change in actual health spending per capita 2000 – 2013 and projected health spending per capita (2014 – 2024) Actual
14%
12%
Projected
12.0%
9.9%
10%
8.6%
8%
7.6%
7.4%
6.2%
6.1%
6%
5.5%
5.8%
5.5% 5.3%
4.7%
3.8%
4%
4.4%
4.0%
4.5% 4.6%
5.2% 5.3% 5.3% 5.3% 5.2% 5.1%
3.2% 3.4%
2.9% 3.1%
2.9%
2%
SOURCE: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group.
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1990s
1980s
1970s
0%