Today we continue our summary of the findings of the annual Kaiser survey of companies in regard to their health benefits. (link available in yesterday’s post) It is hard as yet to tell the overall effect of the reform law on benefit offerings from private companies, since the employer mandate and other features have been delayed. The survey finds that 55% of companies offer health benefits, but this is misleading as most of the firms that don’t are quite small. For example, only 44% of companies with 3 to 9 employees offer health benefits but almost 100% of firms over 1000 employees do. A much larger 90% of employees has a health plan available for enrollment at their workplace. Employers with more older employees are more likely to be offering a health plan. Not all employees at a company that has a health plan are eligible for it; in fact on average only 77% are, largely due to part-time work restrictions. Out of this 77% of workers who are eligible, about 80% tend to actually enroll. Overall, across companies that do and don’t offer health coverage, 55% of employees have health coverage. Retiree coverage continues to decline, with only 25% of larger firms that offer health benefits to active employees also offering them to retirees. Most firms continue to offer dependent coverage, although some are restricting spouse eligibility when the spouse has coverage available at a workplace. It is unclear how much the full implementation of the reform law will affect some of these offer rates–will the implementation of the mandate increase them, will employers begin to encourage use of the exchanges?
Wellness, broadly defined, continues to gain in popularity among employers. A third of employers who offer a health plan ask employees to complete a health risk assessment and 51% of large firms which have a health risk assessment give employees an incentive to complete it and some of these incentives are quite large. 51% of large firms and 26% of smaller ones also offer a biometric assessment, which includes testing of various types, for example, weight, blood pressure, sugar levels and lipid levels. A small number of large firms require such testing to enroll and others offer incentives or penalties for meeting certain biometric goals. 74% of all employers, and a 98% of large ones, offer at least one wellness program to employees; with weight loss, gym membership discounts, smoking cessation, nutrition, education and stress reduction being among the popular offerings. A minority of firms have incentives for participation or completion of wellness programs. High-performance or tiered provider networks are gaining in use, with 19% of companies having such a network in their health offering with the highest enrollment. And another set of firms are utilizing narrow networks to reduce spending growth. About 57% of employers cover receipt of services at retail health clinics, which are often less costly that use of physician offices. Overall the survey suggests moderate premium growth for now and a general continuation of trends that were in place.