The average premium was nearly $8,500 for single coverage and nearly $24,000 for family coverage this year, according to the study published in Health Affairs.

Published Oct. 18, 2023 by Emily Olsen

Dive Brief:

• The average annual premium for both employer-sponsored single and family health insurance coverage rose 7% in 2023, faster than last year but consistent with inflation and wage growth, according to a survey conducted by KFF and published in Health Affairs. 
• The average premium was $8,435 for single coverage and $23,968 for family coverage this year. On average, workers contributed 17% of the premium for single coverage and 29% of the premium for family coverage.
• Many employers surveyed raised concerns about their workers’ views of health plan performance. Fifty-eight percent said their employees had a high or moderate level of concern about the affordability of cost sharing. About half said their workers had a high or moderate level of concern about their ability to schedule timely appointments or the complexity of prior authorization requirements. 

Dive Insight: 

Employer-sponsored insurance is the largest source of health coverage in the country, covering almost 153 million nonelderly people this year, according to the survey.

Providing insurance is also increasingly pricey for employers, and many are disappointed with their plans when assessing their ability to provide high-quality care, according to a report from the Leapfrog Group published earlier this year.

The KFF survey on employer health benefits, which is conducted annually, noted that premiums have historically risen faster than inflation and wages, with the average family premium growing 47% over the past decade while inflation grew 30% and wages grew 42%.

However, during the past five years, these metrics have seen similar cumulative increases.

“This is in part due to the decline in use of health services during the COVID-19 pandemic, as well as the end of a prolonged period of very low inflation,” the study’s authors wrote. “There is no way to know whether this is a transient trend or a new pattern in the costs of care.”

People with employer-sponsored coverage generally have to pay for some portion of their care out of pocket. Ninety percent of workers were enrolled in a plan with a general annual deductible for single coverage this year, according to the survey. Nearly two-thirds of them had a deductible of $1,000 or more, while 31% were enrolled in a plan with a deductible of $2,000 or more. 

Eighty-three percent of employees faced some type of cost sharing for inpatient hospital services, while 68% had a copayment and 19% had a coinsurance payment when visiting a primary care doctor this year. 

Despite the increased premiums, employers report some challenges with their provider networks.

Though most said their largest plan had enough primary care providers to offer timely access to care for their workers, firms weren’t as satisfied with access to mental healthcare or substance use services. Only 68% of small companies, with three to 199 workers, and 59% of large firms, with 200 or more employees, felt there was a sufficient number of mental healthcare providers. 

Coverage for abortion care, facing upheaval in the wake of the Dobbs decision, is still up in the air for many firms. Among large employers, 32% said legally provided abortions are covered in most or all circumstances, 18% said they’re covered only under limited circumstances and 40% responded “don’t know.”

“The fairly large share of respondents (40 percent) who answered ‘don’t know’ to the abortion coverage question may reflect the complexity and fluidity of the issue as states continue to consider and pass abortion legislation and state courts continue to consider legal challenges seeking to block these abortion restrictions,” the study’s authors wrote.

Some companies have added travel benefits for workers who can’t access abortion services where they live. Seven percent of large companies either provided or planned to provide financial assistance for abortion travel expenses, while 19% of firms with 5,000 or more workers reported these benefits. 

Telehealth care, which experienced its own disruption as utilization increased during the COVID-19 pandemic, still remains a part of employer-sponsored coverage. Nearly all employers offered health benefits that covered services provided via telehealth in their largest health plan this year. 

Forty-one percent of firms with 50 or more workers said they believed telemedicine would have a “very important” role when it came to delivering behavioral healthcare going forward, compared with 27% for primary care and 16% for specialty care. 

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Source: HR Dive

https://www.hrdive.com/news/premiums-rise-7-percent-employer-sponsored-health-insurance-kff-health-affairs/697057/