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Employer-based Health Insurance

By March 28, 2014Commentary

With reform in full swing, everyone wants to know what is up with employer-based health insurance.  Of course, that mandate was delayed and other reform provisions have been eviscerated by the Administration, as the rolling disaster known as the PPACA unfolds, but there are impacts.  An Agency for Healthcare Research & Quality Statistical Brief details private sector group coverage in 2012, based on survey data.  (Stat. Brief)   The Brief divides employer-based coverage into three types:  single, single plus one and family.  Companies are roughly divided into small, under 50 employees, and large, over 50 employees.  About 55.4 million employees were enrolled in employer insurance coverage in 2012.  About 51% had single coverage, 18% had employee plus one and 31% enrolled in family coverage.  The primary difference between large and small employers was that employees in small firms had a higher percent of employees in single-only coverage, likely a result of higher premium sharing for single plus one and family coverage in those firms.  Average premium costs were $5384 for single coverage, $10,621 for employee plus one and $15,473 for family coverage.  The only significant difference in premium between large and small firms was that family coverage cost 7% less in small firms, a somewhat surprising result.  Almost all employees must share some part of the premium, although 17% with single coverage did not have to do so, compared with about 8% for the other coverage types.  Again, it is surprising to see that in small firms, employees were less likely to have to pay part of the premium.  This was true for 45% of employees in small firms with single coverage, compared to 10% in large firms.  And for the other coverage types, the comparable percents with no premium were around 30% for small companies and 4% in large ones.  The average contribution to single coverage was $1118 and it was $4,236 for family coverage; and again employees in small firms tended to pay a lower percent of the premium for single coverage than did those in large firms; but for the other coverage types, employees in large firms paid a slightly lower percent of total premium.  Health benefits have a high cost to companies, and a large percent of that burden, especially for families, is borne by the employee.

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