NBGH Employer Survey

The National Business Group on Health works with very large employers to address issues of health care coverage and health costs.  Its members often represent the leading edge of employment-based health insurance design and tactics.  A new survey of 140 of its members gives a sense of these employers’ health plan intentions heading into 2016.  (NBGH Survey)   One major concern on these large companies’ minds is the “Cadillac” tax; in 2018 if a health plan is deemed to be too rich; i.e., it pays for too much of total health costs, it will be hit with a special excise tax.  About half of the firms surveyed currently expect at least one of their health care coverage offerings will be subject to the tax by 2018 and 72% by 2020, and they are working to avoid that.  This means their employees will pay more.

On average this group expects their health care costs to increase 6% in 2016 before benefit changes, or 5% after changes.  This increase is the same projected for 2015.  Companies say the biggest driver of rising spending is high-cost members, with specialty pharma and medical inflation also contributing.  76% of the large employers expect to have more usage of high-deductible plans in 2016.  70% are expanding their wellness offerings.  While more large employers are using private exchanges for their retirees, only 3% are using them in 2016 for active employees, although 24% are considering doing so in the future.  While employers think exchanges would offer a good choice of plans and support a defined contribution approach, they are considered about cost control in plans purchased through an exchange and whether the exchanges can effectively engage members.

The biggest changes employees will notice in 2016 include more spousal surcharges or outright coverage exclusions when the spouse has other coverage available; 74% of firms will offer telehealth options, up from 48% in 2015; around 70-80% will see greater availability of nurse coaching for care management or lifestyle changes and/or decision-support tools to help them become better health consumers; and of course, 83% will be faced with a choice of a high-deductible plan while 33% will find it is the only option at their company.