Continuing with our review of the annual Kaiser Family Foundation survey on employment-related health benefits (link in yesterday’s post), we start with more employee pain–service cost sharing. 83% of workers are in a plan with a general deductible for single coverage. The average annual deductible is $1478 compared to $1318 in 2015, a sizable jump of almost 12%. Deductibles were larger in small firms, $2069, than in large ones, $1238. However, 65% of employees in small companies have a deductible of at least $1000 or more, and 45% of those employed by large companies do. Only a small percent of workers have an HSA or HRA contribution that is equal to or greater than the deductible. In addition to deductibles, copayments for specific services are widespread; 65% of workers are in plans with a copayment and 25% in one with primary care coinsurance. While 56% of all companies offer at least some employees health insurance, this is misleading. Small firms, 3 to 49 workers, make up the vast majority of companies and only 53% of them offer coverage, but the medium-sized, 50 to 99 workers, and large employers, are at 89% and 96% offer rates, respectively. And most importantly, 89% of all workers are at companies that offer at least some employees health benefits. These rates are consistent with prior years.
Very few firms report taking actions to reduce the number of employees eligible for coverage, although many already did so shortly after the ACA was passed. Most firms offer coverage to spouses. Some limit coverage when the spouse has access to insurance where he or she works, and many have decreased the amount they contribute for spousal coverage. Retiree coverage is now offered by only 24% of firms, and it is reasonable to believe that is largely due to union contracts. Large companies, those with 200 or more workers for this purpose, frequently offer various wellness programs. 59% of workers have a health risk assessment available and of these, 32% have incentives to complete it. 53% have access to biometric screening, with 31% incenting the screening and 8% rewarding or penalizing specific measures. 74% of firms offer smoking cessation, 68% weight control and 73% coaching programs.
39% of firms cover telemedicine in some form and of these, 33% provide a financial incentive to get care this way. 73% of firms cover retail clinics, and 10% provide cost incentives for their use. For companies with over 50 employees, 5% have an onsite clinic and for firms with 1000 or more workers, 25% have such clinics. 14% of companies have a high-performance network option, down rather significantly from 24% in 2015. 61% of employees are in a self-funded plan. Companies report little use of exchange technologies and approaches, although more firms are expressing an interest in them.