In our continuation of coverage of the KFF employer health plan survey, we look at some attributes of health benefits offered. In addition to core health benefits, a number of employers provide an option for dental coverage, 67% of small companies and 97% of large ones; vision benefits, 47% of small employers and 82% of large ones; long-term care insurance, 16% and 25%, respectively; critical illness insurance (picks up cost-sharing for cancer, etc.), 23% and 46%; and hospital indemnity insurance (picks up cost-sharing), 16% and 28%. With the exception of dental coverage, most firms make no contribution toward the cost of these ancillary coverages. Wellness activities continue to be popular. 38% of small companies and 62% of large ones offer a health risk assessment, with 52% of large firms offering an incentive attached to the HRA. Incentives include gift cards and other financial incentives, lower premium contributions or copays and having to complete an HRA to be eligible for other wellness incentives. 21% of small companies and 52% of large firms offer biometric screening, and 53% of large firms have an incentive, similar to HRAs. 14% of large companies tie incentives to actual biometric levels, like cholesterol or blood pressure. 58% of small employers and 85% of large ones offer at least one health improvement program, such as smoking cessation, weight control, or nutrition. 32% of large employers combine these with an incentive for completion. 8% of small firms and 14% of large ones will collect data through a wearable.
63% of large employers cover telemedicine use and 33% of these give an incentive, such as lower copay, to use telemedicine. 73% of large firms include use of retail clinics in their covered providers and 17% of those who do so provide an incentive for such use. 79% of large firms have a nurse line available to covered persons. 155 of large employers are using tiered or high-performance networks and almost all provide an incentive for use of these. 9% of these large companies say they offer a narrow network, but only 35 say they have eliminated a hospital or health system from their network in the last year. Only 4% of firms with over 50 employees are using a private exchange for health benefits, although 10% say they are considering doing so. It appears that companies are slowly adopting various approaches to lower costs, although still primarily relying on greater premium contributions and cost-sharing to shift higher spending to employees. I think the market is ripe for a more radical approach that would really lower costs for both employees and the firms they work for–get rid of comprehensive health insurance, give everybody some money every year to cover basic needs and design and separate system to cover expensive acute health conditions.