Smart Benefits: Survey Reveals Employees and Taxpayers Hit Hardest
Monday, October 28, 2013
Highlights of the most recent survey results follow.
Employees with Families Pay More
Employers are increasing their share for single plan coverage, but decreasing their contribution towards family coverage. Employers covered 18% more of a single plan in 2013, increasing their contribution from $5,184 in 2012 to $6,118 in 2013. For family coverage, employees paid 3% more, paying $1,110 in 2012 versus $1,151 in 2013.
Plan Designs Changes Hold Premiums Flat
In exchange for employers holding premium costs flat, employees are absorbing higher deductibles, increased out-of-pocket expenses and more coinsurance. For example, nationally, coinsurance dropped from 90% coverage to 80%. However, in Rhode Island and Massachusetts, employers are still offering better coverage with coinsurance levels at 100%.
Four-Tier Rx Coverage Now the Norm
Another way employers are adjusting their coverage is with prescription copays, most notably, with four-tier drug plans. In 2013, there was a 27.9% increase in employers adding a fourth tier copay, up 13% since 2012. This plan design enables employers to pass on the cost of the most expensive drugs, mostly used to manage long-term chronic illness, by segmenting them into the highest cost category.
Taxpayers Pay More for Municipal Employees
At a time when employees are absorbing more costs for their own healthcare, they are also bearing more as taxpayers by assuming a higher percentage of costs for employees who work in the public sector. The survey revealed that the portion of the costs of an employer-sponsored health plan covered by a government/education sector employee decreased nearly 30%, or $1,025 since 2012, for a single employee, while taxpayers assumed an additional cost of more than 24% for those workers.
Employers not Ready to Send Employees to Exchanges
Despite employers asking employees to pay more, most employers don't seem ready to eliminate coverage and send employees to the public health exchanges. The survey showed that only 3.5 percent of employers offered payment in exchange for opting out of coverage in 2013, compared to 3 percent in 2012. And employees didn’t appear eager to leave, either. The average monthly waiver bonus amount in 2013 was $127 per month for single coverage and $154 for a family plan. To those employees it was offered to, only 23% accepted the payment in 2013, compared to 20% in 2012.
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