Health Plan Offer Rates Hold Steady 

Fifty-six percent of employers offer health benefits, largely unchanged over the past five years, according to a Kaiser Family Foundation (KFF) Employer Health Benefits Survey. Fifty-three percent of firms with fewer than 50 workers and 99% of firms with at least 200 or more workers offer coverage.
 
Out-of-Pocket Maximums 
Virtually all covered workers are in plans with a limit on in-network cost-sharing (out-of-pocket maximum) for single coverage. Those limits vary widely, with 11% of covered workers in plans with maximums of less than $2,000 and 18% of covered workers in plans with maximums of at least $6,000.
 
Wellness Programs
Eighty-one percent of large firms offer at least one type of wellness or health promotion program. But only 11% of them view the programs as very effective at reducing their health care costs.
 
Premiums
Annual family premiums for employer-sponsored health insurance rose 4% to an average of $21,342 this year. On average, workers this year are contributing $5,588 toward the cost of family coverage, with employers paying the rest.

KFF President and CEO Drew Altman said, “Conducted partly before the pandemic, our survey shows the burden of health costs on workers remains high, though not getting dramatically worse. Things may look different moving forward as employers grapple with the economic and health upheaval sparked by the pandemic.”
 
The annual change in premiums is similar to the year-to-year rise in workers’ earnings (3.4%) and inflation (2.1%), though over time what employers and workers pay toward premiums continues to rise faster than wages and inflation. Since 2010, average family premiums have increased by 55%, at least twice as fast as wages (27%) and inflation (19%).

This year 83% of covered workers have a plan deductible, similar to last year and up from 70% a decade ago. The average single deductible is $1,644 for workers who have one, similar to last year’s $1,655 average, but up sharply from the $917 average of a decade ago. These two trends result in a 111% increase in the burden of deductibles across all covered workers.
 
A Look at Networks
Eighty-three percent of offering employers are satisfied with the choice of providers through their insurance plans, though only 67% say the same about their mental health and substance abuse networks. Nineteen percent describe their mental health networks as somewhat or very narrow.
 
“The coronavirus pandemic has increased the need for access to mental and behavioral health services, for which the provider networks are often more narrow than for other services. Some plans have been able to increase access by supporting telehealth, though it’s unclear whether such options will become a permanent feature,” said Gary Claxton, a KFF senior vice president.