Kaiser Health Insurance Survey II

Our second installment on the new Kaiser employer-based health benefits survey begins with employee premium contributions.  (Kaiser Report II) The amount of premium contributed by employees in 2011 did not change much from 2010.  Workers paid 18%, or $77 per month, of the single coverage premium and 28%, or $344 per month, of the family premium.  The employer contributions went up substantially, as companies picked up almost all of the growth in premiums in 2011.  Workers covered by a high-deductible plan pay the least in premium contributions.  Workers in small firms tend to pay the least for single coverage but the largest percent of family premiums.  Workers in low-wage companies pay more of the premium on average, while those in self-funded firms contribute less of the coverage costs.

In terms of cost-sharing–deductibles, copays, and coinsurance–over 80% of workers in a PPO have a general annual deductible, while only about 30% of those in HMO coverage do.  Even when there is no general annual deductible, most employees have some form of cost-sharing for a hospital admission.  The average annual deductible for single coverage is $911 in an HMO plan, $675 for PPOs and $1908 for high-deductible plans.  Deductibles have increased about 50% in five years.  Generally deductibles are higher for workers in small firms.  The number of workers with deductibles over $1000 tripled from 10% in 2006 to 31% in 2011.  In addition to hospital inpatient cost sharing, almost all employees have hospital outpatient cost-sharing and over 90% of workers have either copayments or coinsurance even for in-network physician visits, but often times preventive care is exempted.

The use of high-deductible plans with some kind of savings account attached to the coverage has been one of the major trends in employer health coverage over the last few years.  According to the survey, 23% of companies offer either an HRA or HSA high-deductible plans, with large firms much more likely to offer such plans, but employees in those large companies are less likely to enroll, probably because they have other choices.   Overall enrollment in such plans increased from 13% in 2010 to 17% in 2011.  The workers in these high-deductible plans have average single deductibles of $1,763 for an HRA and $2,033 for an HSA plan.  The premiums for these plans are significantly lower than for other plans, and the employer contribution, including contribution to the savings account is often more than the contribution toward the costs of other health plan types.