Every year the Kaiser Family Foundation does a survey of employers on their health plans. The 2015 survey covered 1,997 public and private employers of all sizes. (KFF Survey) Covering all the data presented may take more than one post; today we focus on basic cost issues. Across all employer types and sizes, 57% of firms offering health benefits to at least some of their employees and 63% of the workers at those firms have taken health plan coverage. Average annual premiums for this coverage in 2015 was $6251 for a single person and $17545 for family coverage; with both of these being up 4% over 2014. Premiums in small firms (less than 200 employees) are lower than in large firms. Premiums for high-deductible health plans tend to be lower and those for PPO plans higher than the average. Geographically, the northeast tends to have the highest and the south the lowest premiums. The retail industry has the lowest premiums and ironically, the health care industry has the highest. Firms with more young or more lower-paid employees tend to have lower premiums. Companies with a union presence also have higher premiums. There is obviously some interaction among these factors.
From 2005 to 2015 family premiums rose from $10880 to $17545, or 61%, at the same time the worker share of those premiums rose 81%. This is far larger than increases in average wages or household income in that time period, explaining, along with higher service cost-sharing, the ongoing angst regarding the impact of health care costs on the vast majority of the working population. Premium contributions by employees in 2015 averaged 18% of single coverage and 29% for family coverage. The raw numbers give a better feeling for the pain–$89 a month on average for a single plan and $413 a month for a family one. Workers in smaller companies contribute a lower percentage for single coverage than do employees in large firms but a higher percent for family plans. High-deductible plans tend to have the lowest dollar amount of employee contribution to premium cost both for single and family coverage. The averages conceal a wide range, with some workers contributing very little and some having very large contributions. More pain: firms with many low-wage workers tend to have the highest employee share of premiums.
Finally, for service cost-sharing we also see continued significant increases. This cost-sharing includes deductibles, copays and co-insurance. The Kaiser survey only captures information on in-network cost-sharing, so it likely understates the total burden; almost every plan has greater cost-sharing for using out-of-network providers. 81% of workers are in a plan with a with a general annual deductible for single coverage, about the same as the 80% in such a plan in 2014 but up from 70% in 2010. The percents are similar for large and small employers. HMO plans are less likely to have a general annual deductible. The average deductible across all plan types is $1318 for single coverage, but there is a wide range, with high-deductible plans obviously having the largest ones. Along with the number of plans using such deductibles, the size of the deductible is also rising, up almost 50% since 2010. Similar trends are seen in family coverage deductibles. 46% of covered workers are now in a plan with a general annual single deductible of over $1000 and 19% in one with a $2000 or more deductible. 65% of employees have a plan that includes coinsurance for hospital admissions and 14% have hospital copays. 68% have a copayment for general physician visits and 23% have a coinsurance requirement for such services. The average copayment is $24 for primary care visits and $37 for specialty care. You get the picture, employees continue to get hammered with health care costs.