Another data point on employers’ intentions in the wake of health reform was released by Willis, the large insurance broker. The 2014 Health Care Reform Survey collected responses from 1033 companies in early 2014. (Willis Survey) Employers remain committed to offering health benefits; 77% said they were either very or somewhat unlikely to stop offering health coverage. Seventy-nine percent offer a PPO plan, 36% offer a high deductible plan and only 16% offer retiree coverage. Most employers have high levels of participation, with 62% of respondents saying at least 80% of workers have enrolled. Sixty-four percent say they have a well-developed strategy for health benefits, but very small percentage have a strategy for either public or private exchanges. Most employers feel that they will need to do some adjusting to the total mix of compensation to account for higher health care spending. The highest priorities in regard to reform are to control costs and to engage employees more in their health. About a third are considering defined contribution models and a fifth are looking at disengaging in health benefits. In regard to the employer mandate, 62% say they will continue to offer coverage higher than the minimum but adjust contributions and benefits to manage the cost. Almost none say they will drop coverage altogether and pay the penalty. Most employers will continue to keep large numbers of employees in the part-time category to avoid paying for their health care coverage. Right now, few employers are considering moving workers to the exchanges to get coverage.
In terms of cost control, the most common anticipated change was to increase dependent contributions or even eliminate coverage for spouses who have another option, and for those who were providing it, to now eliminate part-time coverage. Over 60% say they will increase their commitment to wellness programs and associated incentives. Among those who have tracked costs associated with reform, over 50% say it was between zero and 5%. About 75% experienced an increase in health plan costs in 2014, with the average being 10.6%. Interestingly, 9% had a decrease. Most employers are planning to absorb most of that cost increase themselves. Most organizations say they have increased communications about health care coverage in light of reform. Most companies rely on brokers and other advisors to help them understand the reform law and develop strategies. The overall sense one gets from this survey is that employers intend to keep muddling along pretty much as they have in the past when it comes to health plans.