Employer-Health Insurance Benefits: 2018 Survey Results

Written by Joanna Morrow

Joanna Morrow, Principal and Founder of Employer Benefits & Advice, is an employer consultant and advocate who has worked in the employee benefits industry for over two decades. She works diligently to help employers overcome obstacles in their business by sharing her expertise in Human Resources, Benefits & Compensation, Process Mapping, Risk Management and ERISA/DOL/IRS compliance. She is a licensed life and health insurance professional in the State of Arizona and is an active member of the National Association of Health Underwriters (NAHU).

Employer-Health Insurance Benefits: 2018 Survey Results

Employer-sponsored health insurance covers over half of the non-elderly population in the United States or approximately 152 million non-elderly people in total. Each year, the Kaiser Family Foundation and the Health Research & Educational Trust conduct a survey to examine this coverage and identify trends.

The following 7 categories briefly summarize the main points of the 2018 Employer Health Benefits survey. The size segment of “small” and “large” employers referenced throughout this summary is defined as follows:

  • Small Companies (3 – 199 workers)
  • Large Companies (200 or more workers)

Health Insurance Premiums

In 2018 the average employer-sponsored health insurance premium rose:

  • 3% for single coverage, averaging $6,896 annually for an individual
  • 5% for family coverage, averaging $19,616 annually for family coverage

However, high deductible health plans (HDHP) paired with a health savings account (H.S.A.) option were noticeably lower than the average premiums, averaging:

  • $6,495 annually for individual coverage and
  • $18,602 annually for family coverage

The premium for family coverage tends to be lower at smaller companies when compared to larger ones:

  • $18,739 annually compared to $19,972 on average. 

Worker Contributions

In 2018 the average employee contribution across companies surveyed was:

  • 18% for single coverage and
  • 29% for family coverage

The survey identifies that low wage workers (workers earning $25,000 or less annually) make above average contributions at approximately:

  • 24% for single coverage and
  • 42% for family coverage
  • As well, 27% of covered workers in small companies are enrolled in a plan where the employer pays 100% of the single coverage premium, compared to 6% of covered workers in large companies.
  • However, 34% of covered workers in small companies are in a medical plan where they must contribute more than 50% of the premium for family coverage, compared to 8% of covered workers in large companies.

In terms of dollar amounts, in 2018 workers contributed on average:

  • $1,186 annually for single coverage
  • $5,711 annually for family coverage

For those enrolled in H.S.A plans the numbers are lower:

  • $1,074 annually for single coverage
  • $4,631 annually for family coverage

Plan Enrollment

In 2018, workers enrolled in plan options as follows:

  • 49% of workers enrolled in Preferred Provider Organization (PPO) plans, also commonly identified as traditional copay plans
  • 29% of workers enrolled in High Deductible Health Plans (HDHP) paired with Health Savings Accounts (HSA)
  • 16% of workers enrolled in Health Management Organizations (HMO)
  • Less than 1% enrolled in Indemnity Plans

Since 2013 PPO plan enrollment has decreased by 8% while HSA plan enrollment has risen by 9%, indicating a growing trend amongst workers toward improved consumerism when it comes to healthcare.

Plan Design

Over the past five years, the average annual deductible among all covered workers has increased 53%.*

  • 42% of covered workers in small firms and 20% of covered workers in large firms are in a plan with a deductible of at least $2,000 for single coverage.
  • 8% of covered workers in an HDHP with a Health Reimbursement Arrangement (HRA) and 2% of covered workers in a Health Savings Account (HSA)-qualified HDHP receive an employer contribution for single coverage at least equal to their deductible.
  • The average copayments are $25 for primary care and $40 for specialty care.

*Deductibles have increased in recent years due to higher deductibles within plan types but also higher enrollment in HSA qualified plans.

While growing deductibles in PPOs and other plan types generally increase enrollee out-of-pocket liability, the shift in enrollment to HSA plans does not necessarily do so because the majority of enrollees receive an account contribution from the employer that helps reduce the deductible.

Health & Wellness Promotion Programs

Wellness programs help workers improve their lifestyles and avoid unhealthy habits. Offering at least some type of wellness program are:

  • 53% of small employers
  • 82% of large employers

Of the large employers 35% offer participation incentives like gift cards or merchandise.

Programs vary in topic but include subjects like smoking cessation, weight management and lifestyle coaching.

  • 37% of small companies and 62% of large companies provide workers with the opportunity to complete a health risk assessment
  • 21% of small companies and 50% of large companies provide workers the opportunity to complete a biometric screening
  • 15% reward or penalize workers based on achieving specified biometric outcomes (such as meeting target BMI)

Telemedicine

  • 74% of large employers offer telemedicine services through the company health plan. Of those,Telemedicine

    74% of large employers offer telemedicine services through the company health plan. Of those,

  • 39% offer financial incentives to receive health care services via this method as opposed to an in-person physician office visit
    39% offer financial incentives to receive health care services via this method as opposed to an in-person physician office visitc

Self-Funding

  • 61% of workers, including 13% of covered workers in small companies and 81% in large companies are enrolled in plans that are either partially or completely self-funded.

To interpret the following charts illustrating trends in self-funding by region and industry, it’s important to first define the various geographic regions from which employers responded to the survey:

If you have questions regarding the 2018 survey results, or would like to order your free copy of the survey and corresponding charts in their entirety call us at 602-903-4047 or email us at jmorrow@employerbenefitsandadvice.com.