- The average premium for employer-sponsored health insurance in 2019 rose 5% to $20,576 for family coverage and 4% to $7,188 for single coverage, according to the latest annual Kaiser Family Foundation Employer Health Benefits Survey.
- Employees pay a significant share of those premiums: 30% for family coverage ($6,015) and 18% ($1,242) for single coverage, KFF found.
- And employee share of the costs for coverage have grown faster than wages. Over the past five years, employee contribution to insurance premiums increased 15% for single coverage and 25% for family coverage, and the average deductible increased 36%. Meanwhile, wages increased 14% over the same period, researchers said.
Employers dominate the health insurance market, providing coverage to 153 million Americans — or more than half of the population younger than 65 years old. In 2019, 90% of people were employed by companies —primarily large organizations — that offer health insurance benefits.
Despite access to benefits for many Americans, Drew Altman, KFF president and CEO, emphasized the impact of premiums, deductibles and other out-of-pocket costs on employees' family finances.
"This survey underscores for me why for most Americans the issue is affordability much more than it is expanding coverage. And it really is just math," Altman said Wednesday at a press briefing to release the results of the survey of 2,012 randomly selected employers.
For example, at companies with many low-wage workers, employees paid $1,168 in premium costs for single coverage and $7,047 for family coverage. Not surprisingly, only slightly more than half (51%) of eligible workers at those companies signed up for benefits, KFF found. "That to me is the definition of unaffordable for these low wage workers who are making $25,000 or less a year," Altman said.
At companies with fewer low-wage workers, employees paid $1,245 in premiums for single coverage and $5,968 for family coverage, and 78% of them signed up, the report found.
Even with employers' often-iterated concerns about healthcare costs, they've been reluctant to steer employees to providers who meet metrics for cost and/or quality, KFF found.
Slightly more than half, or 55%, describe the network for the plan with the largest enrollment as "very broad," 37% say it is "somewhat broad" and 7% say it is "somewhat narrow." Similarly, only 14% of companies with 50 or more employees with health benefits have a high-performance network in the health plan with the largest enrollment.
The foundation also asked large employers whether they've modified employee benefits in the past five years in response to the opioid crisis.
Some have. Specifically, 40% of large employers launched or revised employee assistance programs, 24% added utilization management or step therapy to their coverage of opioid prescriptions, 21% asked their insurer or pharmacy benefit manager to increase monitoring of opioid use, 8% limited employees with high opioid use to prescriptions from only one provider and 2% increased the number of in-network substance abuse providers.
In addition to health insurance, the survey also asked employers about wellness programs.
For example, 41% of small firms and 65% of large firms offer health risk assessments, which ask employees questions about their health history and lifestyle. And 50% of employers offer employees an incentive to complete the assessments.
Fewer employers (26% of small companies and 52% of large companies) offer biometric screenings, which include such measures as body mass index (BMI), cholesterol levels and blood pressure readings.
Some large employers (14%) reward or penalize their employees based on whether they reach biometric goals, such as a specific BMI. The size of the rewards varied from a maximum of $150 (17% of companies) to more than $1,000 (11% of companies).