Survey: Health plan premiums outpacing pay raises, inflation

MENLO PARK, Calif. — Annual premiums for employer-sponsored family health coverage reached $15,745 this year, up 4% from last year, with workers on average paying $4,316 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research and Educational Trust 2012 Employer Health Benefits Survey released Tuesday. 

This year’s premium increase is moderate by historical standards, but outpaced the growth in workers’ wages (1.7%) and general inflation (2.3%). Since 2002, premiums have increased 97%, three times as fast as wages (33%) and inflation (28%).

“In terms of employee insurance costs, this year’s 4% increase qualifies as a good year, but it still takes a growing bite out of middle-class workers’ wages, which have been flat or falling in real terms,” stated Drew Altman, Kaiser president and CEO.

The 14th annual Kaiser/HRET survey of more than 2,000 small and large employers provides a detailed picture of trends in employer-sponsored health insurance costs and coverage. The survey reveals significant differences in the benefits and worker contributions toward family premiums between firms with many lower-wage workers (at least 35% of workers earn $24,000 or less a year) and firms with many higher-wage workers (at least 35% of their workers earn $55,000 or more a year). 

Workers at lower-wage firms on average pay $1,000 more each year out of their paychecks for family coverage than workers at higher-wage firms ($4,977 and $3,968, respectively). This occurs even though the firms with many lower-wage workers on average pay less in total premiums for family coverage than firms with many higher-wage workers ($14,694 and $16,427, respectively).

In addition, workers at lower-wage firms are also more likely to face high deductibles than those at higher-wage firms. Specifically, 44% of covered workers at firms with many low-wage workers face an annual deductible of $1,000 or more, compared with 29% of those at firms with many high-wage workers. Across all employers, a third of covered workers (34%) face a deductible of that size, including 14% with deductibles of at least $2,000 annually.

“This year’s survey suggest that working families at the low end of the wage scale face significant out of pocket costs for coverage,” stated study lead author Gary Claxton, a Kaiser VP and director of the Foundation’s Health Care Marketplace Project. “Firms with many lower-wage workers ask employees to pay more out of pocket than firms with many higher-wage workers even though the coverage itself tends to be less comprehensive.”

The survey estimated that 2.9 million young adults are currently covered by employer plans this year as a result of a provision in the 2010 Affordable Care Act that allows young adults up to the age of 26 years without employer coverage of their own to be covered as dependents on their parents’ plan. That’s up from the 2.3 million in the 2011 survey. Young adults historically have been more likely to be uninsured than any other age group.

The survey also found that 48% of covered workers are in “grandfathered” plans as defined under health reform, down from 56% last year. Grandfathered plans are exempted from some health-reform requirements, including covering preventive benefits with no cost sharing and having an external appeals process. To retain this status, employers must not make significant changes to their plans to reduce benefits or increase employee costs.

In addition to the survey conducted in the spring, employers were asked in August whether they had information about the change in premiums (or total cost for self-funded plans) for their current health plan with the largest enrollment. The average increase reported by employers who had received information for their current plan is 7%.

These early reports may not match what employers and workers ultimately end up paying next year, as firms can raise deductibles or otherwise change the health benefits and plans they offer to lower premiums. This year, for example, more than half (54%) of employers who offer health benefits reported that they had shopped around for new coverage. Of that group, significant shares switched carriers (18%) or changed the type of plans they offer (27%).

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