Employer Health Benefits Survey. Release Slides September 10, 2014

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1 Employer Health Benefits Survey Release Slides September 10, 2014

2 Cumulative Increases in Health Insurance Premiums, Workers Contributions to Premiums, Inflation, and Workers Earnings, Health Insurance Premiums Workers' Contribution to Premiums Workers' Earnings Overall Inflation 212% 191% % 127% % 38% 54% 17% 43% 28% 13% SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), ; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, (April to April).

3 Average Annual Premiums for Single and Family Coverage, $2,196 $2,471* $2,689* $3,083* $3,383* $3,695* $4,024* $4,242* $4,479* $4,704* $4,824 $5,049* $5,429* $5,615* $5,884* $6,025 $5,791 Single Coverage $6,438* Family Coverage $7,061* $8,003* $9,068* $9,950* $10,880* $11,480* $12,106* $12,680* $13,375* $13,770* $15,073* $15,745* $16,351* $16,834* $0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000 $18,000 * Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

4 Average Annual Worker Premium Contributions and Total Premiums for Covered Workers, Single and Family Coverage, by Firm Size, 2014 $20,000 All Small Firms (3-199 Workers) $18,000 All Large Firms (200 or More Workers) $17,265 $16,000 $15,849 $14,000 $12,000 $10,000 $8,000 $6,000 $4,000 $5,788 $6,130 $5,508 $4,523 $2,000 $902 $1,160 $0 Premium* Worker Contribution* Premium* Worker Contribution* Single Coverage Family Coverage * Estimates are statistically different between All Small Firms and All Large Firms (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

5 Average Worker and Employer Premium Contributions For Covered Workers at Higher- and Lower-Wage Firms, 2014 $7,000 $6,000 $5,000 $5,175* $6,244* $20,000 $18,000 $16,000 $14,000 $14,177* $17,582* $4,000 $3,000 $3,871* $5,137* $12,000 $10,000 $8,000 $7,706* $13,084* $2,000 $1,000 $0 $1,304 $1,106 Many Workers are Lower-Wage Many Workers are Higher-Wage $6,000 $4,000 $2,000 $0 $6,472* Many Workers are Lower-Wage $4,497* Many Workers are Higher-Wage Single Coverage Employer Premium Contribution Family Coverage Worker Premium Contribution *Estimate for many workers are lower-wage is statistically different from estimate for many workers are higher-wage, within coverage type (p<.05). NOTE: Firms with many lower-wage workers are ones where 35% or more of employees earn $23,000 or less. Firms with many higher-wage workers are ones where 35% or more of employees earn $57,000 or more. Wage cutoffs are the inflation adjusted- 25 th and 75 th percentile of national wages according to Bureau of Labor Statistics using data from the Occupational Employment Statistics (OES) (2012). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, National Compensation Survey: Occupational Earnings in the United States,

6 Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, % 4 Single Coverage Family Coverage 35% 3 27% 26% 26% 28% 27% 28% 26% 27% 28% 27% 27% 3* 28% 28% 29% 29% 25% 15% 14% 14% 14% 16% 16% 16% 16% 16% 16% 16% 17% 19%* 18% 18% 18% 18% 1 5% * Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

7 Distribution of Percentage of Premium Paid by Covered Workers for Family Coverage, by Firm Size, 2014 All Small Firms (3-199 Workers) 14% 27% 28% 31% All Large Firms (200 or More Workers) 2% 48% 42% 9% Greater Than, Less Than Or Equal To 25% Greater Than 25%, Less Than Or Equal To 5 Greater Than 5 * Distribution is statistically different within firm size from distribution for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

8 Percentage of All Firms Offering Health Benefits, % 68% 68% 66% 66% 63% 6 61% 59% 63% 59% 69%* 6* 61% 57% 55% % 57% 58% 58% 55% 52% 47% 49% 45% 5 47% 59%* 48%* 5 45% 44% 3 1 All Firms Firms with 3-9 Workers *Estimate is statistically different from estimate for the previous year shown (p<.05). NOTE: Estimates presented in this exhibit are based on the sample of both firms that completed the entire survey and those that answered just one question about whether they offer health benefits. The percentage of firms offering health benefits is largely driven by small firms. The large increase in 2010 was primarily driven by a 12 percentage point increase in offering among firms with 3 to 9 workers. In 2011, 48% of firms with 3 to 9 employees offer health benefits, a level more consistent with levels from recent years other than The overall 2011 offer rate is consistent with the long term trend, indicating that the high 2010 offer rate may be an aberration. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

9 Percentage of Firms Offering Health Benefits to At Least Some of their Workers, by Firm Size, % % to 49 Workers 50 to 99 Workers 100 or More Workers NOTE: Estimates presented in this exhibit are based on the sample of both firms that completed the entire survey and those that answered just one question about whether they offer health benefits. Sixty-two percent of workers at firms offering health benefits with 50 or more workers are covered by the health benefits offered by their firm. Firm size categories are determined by the number of workers at a firm, which may include full-time and part-time employees. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

10 Eligibility, Take-Up Rate, and Coverage for Workers in Firms Offering Health Benefits, Percentage Eligible Percentage of Eligible That Take Up 9 Percentage Covered 8 85% 79% 84% 84% 81% 83% 85% 84% 81%* 81% 83% 83% 83% % 82% 82% 79% 8 81% 8 81% 81% % 79% 79% 77% 77% 77% 7 66% 68% 7 68% 68% 67% 66% 65% 65% 65% 65% 63% 65% 62% 62% 62% *Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

11 Among Firms Offering Benefits, Percent of Firms Which Offer Coverage to Spouses, Dependents and Partners, 2014 Firm Only Offers Single Coverage All Small Firms (3 to 199 workers) All Large Firms ( 200 or More Workers) 4% 96% 10 Firm Offers Coverage to Spouses All Small Firms (3 to 199 workers) All Large Firms ( 200 or More Workers) 96% 99% 4% 1% Yes No Firm Offers Coverage to Other Dependents, such as Children All Small Firms (3 to 199 workers) All Large Firms ( 200 or More Workers) 92% 99% 8% 1% Not Encountered Firm Offers Coverage to Same-Sex Domestic Partners All Small Firms (3 to 199 workers) All Large Firms ( 200 or More Workers) 39% 49% 19% 45% 42% 5% Firm Offers Coverage to Opposite-Sex Domestic Partners All Small Firms (3 to 199 workers) All Large Firms ( 200 or More Workers) NOTE: Not encountered refers to firms where no workers requested domestic partner benefits and there is no corporate policy on coverage for that classification of domestic partners. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, % 39% 26% 58% 35% 3%

12 Among Firms Offering Health Benefits, Eligibility and Incentives for Enrolling in Coverage, By Firm Size, % Firm Provides Additional Compensation If 18% If Spouses Are Offered Coverage from Another Source 15% 14% 1 9% 9% 7% 7% 9% 8% 9% 9% 5% 5% 5% Employees Elect Not to Participate in Health Benefits* Employees Enroll on Spouses' Plan* They are Not Allowed to Enroll in the Firm's Plan They are Charged More in the Form of Higher Premiums or Cost Sharing* All Small Firms (3 to 199 Workers) All Large Firms (200 or More Workers) All Firms * Estimates are statistically different between All Small Firms and All Large Firms (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

13 Among Firms with a Waiting Period the Percentage of Firms who Changed the Length of their Waiting Period During the Last Year, No, Did Not Change the Waiting Period 8 7 Yes, Decreased the Length of the Waiting Period 6 87% 76% Yes, Increased the Length of the Waiting Period % 1 2% 1% All Small Firms (3-199 Workers) All Large Firms (200 or More Workers) SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

14 Percentage of Covered Workers Enrolled in Either a HDHP/HRA or HSA-Qualified HDHP, % 19% 17%* 15% 13%* 1 8%* 8% 5% 4% 5% * Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

15 Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $2,000 or More for Single Coverage, By Firm Size, All Small Firms (3-199 Workers) 4 3 All Large Firms (200 or More Workers) All Firms 28%* 27% 31% 34% 1 18% 16% 15% 14% 12%* 12%* 1 7% 7%* 5%* 11%* 6% 3% 8% 7% 3% 1% 1% 2% 3%* 4% 5% * Estimate is statistically different from estimate for the previous year shown (p<.05). Note: These estimates include workers enrolled in HDHP/SO and other plan types. Average general annual health plan deductibles for PPOs, POS plans, and HDHP/SOs are for in-network services. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

16 Percent of Covered Workers Enrolled in a Plan with an Out-Pocket- Maximum Above $6,350 or in a Plan without an Out-of-Pocket Limit, % 3 29%* 25% 22% * 19% 19% 19% 15% 15%* 14% 1 7%* 5% * Estimate is statistically different from estimate for the previous year shown (p<.05). SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

17 Percentage of Covered Workers Enrolled in Plans Grandfathered Under the Affordable Care Act (ACA), by Firm Size, % All Small Firms (3-199 Workers) All Large Firms (200 or More Workers) 6 53% 56% 54%* ALL FIRMS 5 46% 48%* 49% 4 36%* 35%* 3 3* 26%* 22%* * Estimate is statistically different from estimate for the previous year shown (p<.05). NOTE: For definitions of Grandfathered health plans, see the introduction to Section 13. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

18 Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers, Percentage of Firms Offering Retiree Health Benefits, % % % % 37% 35% 36% 35% 32% 34% 32% 29% 28% 26% 26% 25% 28% 25% NOTE: Tests found no statistical difference from estimate for the previous year shown (p<.05). No statistical tests are conducted for years prior to SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, ; KPMG Survey of Employer-Sponsored Health Benefits, 1991, 1993, 1995, 1998; The Health Insurance Association of America (HIAA), 1988.

19 Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers and Retirees, Percentage of Firms Considering Changing the way they Offer Retiree Coverage Because of Healthcare Exchanges, by Firm Size, % 2% 6% 3% 8 48% Yes, Considering Changing 6 72% 79% 6 No, Not Considering Changing 4 Don't Know 25% 34% 49% ALL LARGE FIRMS Workers 1,000-4,999 Workers 5,000 or More Workers SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

20 Percentage of Covered Workers in Partially or Completely Self-Funded Plans, by Firm Size, All Small Firms (3-199 Workers) All Large Firms (200 or more) %* 66% 66% 72% 73% 75% 78% 77% 77% 77% 83%* 82% 81% 83% 81% % 15% 17% 13% % 13% 12% 12% 15% 16% 13% 15% 16% 15% * Estimate is statistically different from estimate for the previous year shown (p<.05). NOTE: Sixty-one percent of covered workers are in a partially or completely self-funded plan in Due to a change in the survey questionnaire, funding status was not asked of firms with conventional plans in Therefore, conventional plan funding status is not included in the averages in this exhibit for For definitions of Self-Funded and Fully Insured plans, see the introduction to Section 10. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits,

21 Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, 2014 Offer at Least One Specified Wellness Program* 73% 98% Class in Nutrition/Healthy Living* 19% 47% Flu Shot* 52% 87% Employee Assistance Program* 27% 79% Weight Loss Programs* 18% 48% Biometric Screening* 26% 51% Lifestyle or Behavioral Coaching* 22% 58% Wellness Newsletter* Web-based Resources for Healthy Living* Smoking Cessation Program* Gym Membership Discounts or On-Site Exercise Facilities* Other Wellness Program* 4% 15% 26% 26% 33% 38% 6 64% 64% 77% All Large Firms (200 or More Workers) All Small Firms (3-199 Workers) * Estimate is statistically different between All Small Firms and All Large Firms within category (p<.05). ^ Biometric screening is a health examination that measures an employee's risk factors such as cholesterol, blood pressure, stress, and nutrition. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

22 Among Large Firms (200 or More Workers) Offering Health Benefits, The Use of Financial Incentives for Participating in Various Health Programs, by Firm Size, % Of Firms Offering Wellness Programs Of Firms Offering Biometric Screening 51% 51% Of Firms Offering Workers the Opportunity for a health risk assessments 51% 4 36% Offering Firms Offers Incentive to Employees who Participate*^ 12% Offers Incentive to Employees who Complete Offering Firms 1% Employees required to complete biometric screenings 8% 7% Employees rewarded or penalized for meeting biometric outcomes Offering Firms Financial Incentive For Employees Who Complete Employees with Risk Factor Must Complete Wellness Program~ Offers at least one Wellness Program~ Biometric Screening`` Opportunity for Health Risk Assessment *Percent of firms offering incentives is among firms offering health benefits who also offer the specified health program or activity. ~ Includes the following wellness programs: weight loss programs, biometric screenings, gym membership discounts or on-site exercise facilities, smoking cessation program, lifestyle or behavioral coaching, classes in nutrition or healthy living, web-based resources for healthy living, flu shots or vaccinations, or employee assistance programs (EAP) or a wellness newsletter. ^Among Firms Offering Health and Wellness Benefits. Any financial incentive indicates firms that offer employees who participate in wellness programs one of the following incentives: smaller premium contributions, smaller deductibles, higher HRA or HSA contributions, or gift cards, travel, merchandise, or cash. ``Biometric screening is a health examination that measures an employee's risk factors such as cholesterol, blood pressure, stress, and nutrition. A health risk assessment includes questions about medical history, health status, and lifestyle and is designed to identify the health risks of the person being assessed. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

23 Among Offering Firms that Provide Incentives to Employees Who Participate in Wellness Programs, Firms Opinions on How Effective Incentives are for Employee Participation, by Firm Size, 2014 Very Effective Somewhat Effective Not At All Effective Don't Know All Small Firms (3-199 Workers) 12% 33% 3 25% All Large Firms (200 or More Workers) 33% 58% 6% 2% ALL FIRMS 14% 36% 27% 22% SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

24 Among Large (200 or More Employees), Offering Firms, Percentage of Firms whose Largest Plan has Various Features, % % 12% 8% Largest Plan Includes High Largest Plan Includes Reference Performance or Tiered Provider Pricing for ANY Service Network Offers a Plan Considered a Narrow Network Plan Largest Plan Covers Care at a Retail Clinc SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

25 Among Large (200 or More Employees) Offering Firms, Percentage of Firms Considering Offering Benefits Through a Private Exchange and the Percentage of Covered Workers Currently in a Private Exchange, by Firm Size, % 18% 23% 24% 25% 23% Workers 1,000-4,999 Workers 5,000 or More Workers ALL LARGE FIRMS (200 or More Workers) 15% 1 12% 13% 5% 2% 3% 3% 3% Firm Considering Offering Benefits through a Private Exchange Firm Considering a Defined Contribution Approach Covered Workers Enrolled at a Firm Offering Benefits Through a Private or Corporate Exchange NOTES: 2% of large firms did not know if they were considering a private exchange and 3% did not know if they were considering a defined contribution approach. A private exchange is one created by a consulting company, not by either a federal or state government. Private exchanges allow employees to choose from several health benefit options offered on the exchange. SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2014.

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