Employer Health Benefit Survey
Release Slides
Tuesday, August 20, 2013
Cumulative Increases in Health Insurance Premiums,
Workers’ Contributions to Premiums, Inflation, and
Workers’ Earnings, 1999-2013
250%
Health Insurance Premiums
Workers' Contribution to Premiums
Workers' Earnings
200%
196%
Overall Inflation
182%
150%
117%
119%
100%
56%
57%
50%
50%
34%
40%
14%
29%
11%
0%
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013. Bureau of Labor Statistics, Consumer Price Index, U.S. City
Average of Annual Inflation (April to April), 1999-2013; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment
Statistics Survey, 1999-2013 (April to April).
2013
Average Annual Premiums for Single and Family Coverage,
1999-2013
$2,196
1999
$5,791
$2,471*
2000
$2,689*
2001
Family Coverage
$7,061*
$3,083*
2002
Single Coverage
$6,438*
$8,003*
$3,383*
2003
$9,068*
$3,695*
2004
$9,950*
$4,024*
2005
$10,880*
$4,242*
2006
$11,480*
$4,479*
2007
$12,106*
2008
$4,704*
2009
$4,824
$12,680*
$13,375*
$5,049*
2010
$13,770*
$5,429*
2011
$15,073*
$5,615*
2012
$15,745*
$5,884*
2013
$0
$2,000
$4,000
$6,000
$16,351*
$8,000
$10,000
* Estimate is statistically different from estimate for the previous year shown (p<.05).
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013.
$12,000
$14,000
$16,000
$18,000
Average Annual Worker Premium Contributions and
Total Premiums for Covered Workers, Single and Family
Coverage, by Firm Size, 2013
$18,000
$16,000
All Small Firms (3-199 Workers)
All Large Firms (200 or More Workers)
$16,715
$15,581
$14,000
$12,000
$10,000
$8,000
$6,000
$5,711
$5,967
$5,284
$4,226
$4,000
$2,000
$862
$1,065
$0
Premium
Worker Contribution*
Single Coverage
* Estimates are statistically different between All Small Firms and All Large Firms (p<.05).
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.
Premium*
Worker Contribution*
Family Coverage
Average Worker and Employer Premium Contributions For Covered
Workers at Higher- and Lower-Wage Firms, 2013
$16,989
$18,000
$16,000
$7,000
$6,025*
$15,225
$6,000
$5,450 *
$14,000
$5,000
$12,000
$10,000
$9,407 *
$12,959 *
$8,000
$4,000
$3,000
$6,000
$4,216 *
$5,071*
$1,234 *
$954 *
Many Workers are LowerWage
Many Workers are HigherWage
$2,000
$4,000
$2,000
$5,818*
$4,030 *
$1,000
$0
$0
Many Workers are LowerWage
Many Workers are HigherWage
Family Coverage
Employer Premium Contribution
Single 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 $56,000 or more. Wage cutoffs are the inflation adjusted- 25th and 75th percentile of national wages according to
Bureau of Labor Statistics using data from the Occupational Employment Statistics (OES) (2011). 1% of covered workers are in firms which are both high
income and low income, excluding these firms does not change the estimates or significance testing.
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013. National Compensation Survey: Occupational Earnings in the
United States, 2010. http://www.bls.gov/ncs/ocs/sp/nctb1489.pdf.
Percentage of All Firms Offering Health Benefits, 1999-2013
100%
90%
80%
70%
66%
68%
68%
66%
66%
69%*
63%
60%
61%
60%
50%
55%
57%
58%
58%
55%
63%
59%
60%*
59%
61%
57%
59%*
52%
47%
40%
50%
49%
45%
48%*
47%
50%
45%
30%
All Firms
20%
Firms with 3-9 Workers
10%
0%
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
*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 2010. 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, 1999-2013.
2013
Among Firms with 50 or More Workers,
Percent of Firms Offering Health Benefits, 2013
Percent of Firms that Do Not
Offer Health Benefits
7%
Percent of Firms Offering
Health Benefits
93%
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.
Percentage of Firms Offering Health Benefits, by Firm Characteristics,
2013
Less Than 35% Earn $23,000 a Year or Less *
Low Wage Level
35% or More Earn $23,000 a Year or Less *
60%
23%
Less Than 35% Earn $56,000 a Year or More *
High Wage Level
49%
35% or More Earn $56,000 a Year or More *
69%
Less Than 35% of Workers Are Age 26 or Younger *
Younger Workers
35% or More Workers Are Age 26 or Younger *
Less Than 35% of Workers Are Age 50 or Older
Older Workers
35% or More Workers Are Age 50 or Older
* Estimates are statistically different from each other within category (p<.05).
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.
59%
23%
51%
58%
Distribution of Health Plan Enrollment for Covered Workers, by Plan
Type, 1988-2013
Conventional
1988
PPO
POS
HDHP/SO
73%
1993
16%
46%
1996
27%
1999
8%
2001
7%
21%
31%
10%
2000
2002
HMO
17%
5%
25%
2007
3%
55%
1%
20%
2010
1%
19%
2011
1%
2012
<1%
2013
<1%
17%
16%
14%
15%
60%
13%
57%
20%
2009
15%
61%
21%
2008 2%
23%
54%
2004
20%
46%
18%
24%
3%
21%
52%
5%
2006
24%
27%
2003
21%
14%
42%
24%
3%
7%
39%
29%
2005
26%
28%
28%
4%
11%
13%
58%
57%
8%
10%
58%
56%
5%
12%
60%
55%
4%
8%
8%
10%
9%
9%
13%
17%
19%
20%
NOTE: Information was not obtained for POS plans in 1988. A portion of the change in plan type enrollment for 2005 is likely attributable to
incorporating more recent Census Bureau estimates of the number of state and local government workers and removing federal workers from
the weights. See the Survey Design and Methods section from the 2005 Kaiser/HRET Survey of Employer-Sponsored Health Benefits for
additional information.
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013; KPMG Survey of Employer-Sponsored Health Benefits, 1993,
1996; The Health Insurance Association of America (HIAA), 1988.
Percent of Covered Workers Enrolled in a Plan That Includes a General
Annual Deductible, 2006-2013
100%
90%
78%*
80%
74%
69%*
70%
72%
62%
60%
56%
57%
2007
2008
52%
50%
40%
30%
20%
2006
2009
2010
2011
2012
2013
* 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. Between 2012 and 2013 we did not collect information on the
attributes of conventional plans, to be conservative, we assumed conventional plans did not have a deductible. Because of the low enrollment in
conventional plans, the impact of this assumption is minimal. 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, 2006-2013.
Average General Annual Deductible Among Covered Workers Enrolled
in a Plan with a Deductible for Single Coverage, by Firm Size,
2006-2013
$2,000
All Small Firms
All Large Firms
$1,800
$1,715
All Firms
$1,537
$1,600
$1,596
$1,391
$1,400
$1,254
$1,124*
$1,200
$1,000
$800
$600
$400
$775
$584
$917*
$852
$1,097*
$1,135
$875*
$884
2012
2013
$991
$826*
$735*
$616
$640*
$496
$519
$553
2006
2007
2008
$686
$757
$200
$0
2009
* Estimate is statistically different from estimate for the previous year shown (p<.05).
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2006-2013.
2010
2011
Percentage of Covered Workers Enrolled in a Plan with a General
Annual Deductible of $1,000 or More for Single Coverage, By Firm Size,
2006-2013
All Small Firms (3-199 Workers)
60%
58%*
All Large Firms (200 or More Workers)
50%
All Firms
50%
49%
46%
40%
40%
38%
35%*
34%
31%
27%*
30%
22%*
21%*
20%
18%*
16%
10%
28%
22%*
12%*
17%
10%
0%
26%
13%*
6%
2006
8%
9%
2007
2008
2009
2010
2011
2012
* 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, 2006-2013.
2013
Among All Large Firms (200 or More Workers) Offering Health Benefits
to Active Workers, Percentage of Firms Offering Retiree Health
Benefits, 1988-2013
100%
90%
80%
70%
66%
60%
50%
40%
30%
46%
40% 40% 40%
36%
34%
37%
35% 36% 35%
32%
34%
32%
29% 28%
26% 26% 25%
28%
20%
10%
0%
1988 1991 1993 1995 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
NOTE: Tests found no statistical difference from estimate for the previous year shown (p<.05). No statistical tests are conducted for years prior to
1999.
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013; KPMG Survey of Employer-Sponsored Health Benefits, 1991,
1993, 1995, 1998; The Health Insurance Association of America (HIAA), 1988.
Percentage of Covered Workers in Partially or Completely
Self-Funded Plans, by Firm Size, 1999-2013
100%
All Small Firms (3-199 Workers)
All Large Firms (200 or more)
90%
83%*
80%
72%
67%*
70%
60%
66%
73%
75%
78%
77%
77%
82%
81%
83%
77%
66%
60%
50%
40%
30%
20%
13%
15%
17%
13%
10%
10%
10%
13%
13%
12%
12%
15%
16%
13%
15%
16%
0%
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
* 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 2013. Due to a change in the survey
questionnaire, funding status was not asked of firms with conventional plans in 2006. Therefore, conventional plan funding status is not included
in the averages in this exhibit for 2006. For definitions of Self-Funded and Fully Insured plans, see the introduction to Section 10.
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013.
2013
Grandfathering Under the Affordable Care Act (ACA),
by Firm Size, 2011-2013
Percentage of Covered Workers
in a Grandfathered Health Plan
2011
2012
2013
All Small Firms (3-199 Workers)
63%
54%*
49%
All Large Firms (200 or More Workers)
53%
46%
30%*
56%
48%*
36%*
2011
2012
2013
All Small Firms (3-199 Workers)
72%
58%*
54%
All Large Firms (200 or More Workers)
61%
57%
43%*
72%
58%*
54%
ALL FIRMS
Percentage of Firms
with At Least One Grandfathered Plan
ALL FIRMS
* 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, 2011-2013.
Among Firms Offering Health Benefits, Distribution of Firms’ Opinions
on the Effectiveness of the Following Strategies to Contain Health
Insurance Costs, 2013
Don’t Know
Not At All Effective
Not Too Effective
Somewhat Effective
100%
20%
80%
22%
17%
Very Effective
8%
35%
37%
60%
32%
41%
33%
32%
40%
26%
29%
21%
20%
0%
27%
24%
9%
1%
Wellness Programs
14%
15%
4%
2%
Disease Management
Programs
Consumer-Driven
Health Plans
(Ex: High-Deductible
Plan Combined with a
Health Savings Account)
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.
20%
24%
4%
4%
Higher Employee Cost Tighter Managed Care
Sharing
Restrictions
Among Firms Offering Health Benefits, Percentage Offering a Particular
Wellness Program to Their Employees, by Firm Size, 2013
Other Wellness Program*
26%
10%
Offer at Least One
Specified Wellness Program*
99%
76%
Class in Nutrition/Healthy Living*
50%
20%
Flu Shot or Vaccinations*
87%
53%
Employee Assistance Program (EAP)*
79%
22%
Weight Loss Programs*
Biometric Screening*
55%
26%
Lifestyle or Behavioral Coaching*
Wellness Newsletter*
47%
Web-based Resources for Healthy
Living*
47%
60%
78%
71%
39%
Gym Membership Discounts or
On-Site Exercise Facilities*
69%
21%
0%
20%
40%
60%
* Estimate is statistically different between All Small Firms and All Large Firms within category (p<.05).
NOTE: Biometric screening is a health examination that measures an employee's risk factors
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.
All Small Firms
(3-199
Workers)
57%
33%
Smoking Cessation Program*
All Large Firms
(200 or More
Workers)
58%
31%
80%
100%
Among Firms Offering Health Benefits, The Use of Financial Incentives
for Participating in Various Health Programs, by Firm Size, 2013
100%
80%
99%
76% 77%
Large Firms (200 or more Workers)
Small Firms (3-199 Workers)
All Firms
77%
57% 57%
60%
55%
55%
36%
40%
26% 27%
20%
0%
54%
8% 10%
Percentage of
Offering Firms
Offers Incentive to
Employees who
Participate*^
Offers at least one Wellness
Program~
8%
Percentage of
Offering Firms
23% 24%
11%
2% 2%
Offers Incentives
to employees who
participate*
Offers at least one Disease
Management Program
Percentage of
Offering Firms
Offers reward or
penalties for
employees who meet
biometric outcome*
Biometric Screening``
Percentage of
Offering Firms
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, 2013.
Offers
Incentive to
complete*
Percentage of Firms whose Largest Plan Covers Care Received at
Retail Clinics, and Percentage of Firms who Offer a Financial Incentive
to do so, by Firm Size, 2013
100%
Among Firms Offering Health Benefits:
Among Firms whose Largest Plan Includes
Coverage at a Retail Clinic:
80%
61%
60%
56%
56%
40%
17%
20%
13%
17%
0%
Largest Plan Covers Care Received at a Retail Clinic
All Small Firms (3-199 Workers)
Offers Financial Incentives for Choosing a Retail Clinic
Instead of a Traditional Physician's Office
All Large Firms (200 or More Workers)
ALL FIRMS
NOTE: Tests found no statistical difference between All Small Firms and All Large Firms within category. A retail clinic is a health care clinic
located in retail stores, supermarkets and pharmacies that treats minor illnesses and provide preventive health care services, such as flu shots.
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.
Among Large Firms (200 or More Employees) Offering Health Benefits,
the Percentage of Firms Considering Offering Benefits Through a
Private Exchange, by Firm Size, 2013
100%
2%
2%
2%
2%
80%
69%
60%
91%
85%
89%
40%
20%
29%
0%
7%
200-999 Workers
13%
9%
1,000-4,999 Workers
Yes
No
5,000 or More Workers
ALL LARGE FIRMS (200 or
More Workers)
Don't Know
NOTE: A private exchange is created by a private company or consulting company where the employer offers a defined contribution for their
employees and the employees choose among different health plan options from different health insurers selected by the exchange. The
employees pays the difference between the defined contribution and the cost of the health insurance option that they choose.
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.
Among Firms Offering Health Benefits, Percentage of Firms Whose
Largest Plan Includes a High-Performance Provider Network, 2007,
2010, 2011, and 2013
100%
80%
60%
40%
20%
15%
16%
2007
2010
20%
23%
0%
2011
2013
Note: The overall percentage of firms whose largest plan includes a high performance provider network is not significantly different between
2013 and previous years the question was included in the survey (2007, 2010, 2011) (p<.05). A high performance network is one that groups
providers within the network based on quality, cost, and/or efficiency of care they deliver.
SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.