NBGH Survey of Employers

The National Business Group on Health and Towers Watson have released results from their survey of employers regarding health benefits.  (Employer Survey)   The respondents were 595 companies with over 1000 employees.  Ninety-five percent of these firms say subsidizing health benefits will continue to be important to them but 94% expect there will be modest or major changes in those benefits in the next five years, and only 25% are confident they will offer health benefits in ten years.  Despite lower growth rates, 4.1% for 2013, most companies are very concerned about costs and are taking steps to mitigate spending growth.  Spending increases are estimated at 4.4% for 2014, but this is after benefit and employee contribution changes.  Before those, the increase is 7%.  And the cost per employee is $12,535, a very high burden on employers.  The explicit employee share of the cost for health benefits continues to rise and is now at 37%.  In economic realty, employees bear all the cost in foregone wages.  Cost-sharing for dependents is increasing faster than for employees and companies are showing decreased interest in covering dependents, particularly working spouses.  Health-savings account plans are also seeing a steady rise in enrollment, with 75% of employers offering one, and more employers are beginning to offer them as the sole option.  Retiree medical benefits are steadily declining.  New provider reimbursement approaches, including value-based benefit designs and reimbursement, are gaining favor, and there is high interest in telemedicine as a method to increase convenience and lower costs.  Two-thirds of companies use incentive to encourage wellness participation, not just for employees but also for covered dependents, and incentive and penalty amounts are increasing.  Private exchanges are growing rapidly, but a number of companies are still in wait and see mode.