While the word “change” was frequently used throughout 2013 to characterize health care in America, recently released studies of the year almost gone by paint a relatively static picture. Following is a snapshot of U.S. health-coverage trends over the last 12 months.
Health Insurance Premiums and Employee Contributions
This year brought with it modest increases in premiums for both single coverage and family coverage. Specifically, the average annual premiums for employer-sponsored health insurance were:
• $5,884 for single coverage – a 5% increase from 2012;
• $16,351 for family coverage – which is 4% higher than the previous year.
Workers’ premium contributions and cost-sharing requirements held steady from 2012 to 2013, with covered employees contributing – on average – 18% of the premium for single coverage and 29% of the premium for family coverage.
This year did, however, bring with it a change in the percentage of covered workers enrolled in plans with a general annual deductible, with that total now standing at 78%. At small firms – those with from three to 199 employees – more than half of covered employees now have a deductible of $1,000 or more.
Type of Plans
The 2013 statistical breakdown of plan types looks like this:
• PPO plans again took the top spot, enrolling 57% of covered employees;
• 20% of covered workers opted for High-Deductible Health Plans with Savings Option;
• 14% selected an HMO;
• 9% chose a Point of Service plan;
• Less than 1% of covered employees selected a conventional, fee-for-service plan.
Availability of Employer-Sponsored Coverage
The percentage of businesses that offer health benefits remained statistically unchanged, with 57% of companies providing coverage in 2013, compared to 61% last year.
Health coverage availability does differ significantly, however, based on company size – a fact that was consistent from 2012 to 2013. Specifically, this year saw only 45% of small employers offering coverage; by contrast, virtually all employers with 1,000 or more workers provided coverage to at least some of their employees.
For retirees, health-benefit availability also remained statistically unchanged year to year. In 2013, 28% of firms with 200 or more employees offered health benefits to retirees; in 2012, the figure was 25%.
Focus on Wellness
A trend that continued in 2013 is company health coverage that includes wellness and health-promotion programs:
• 77% of businesses offered at least one wellness program;
• 24% of companies provided health-risk assessments;
• 57% covered at least one disease-management program.
The most common wellness offerings focused on: weight loss; gym memberships; biometric screenings; smoking cessation; personal-health coaching; web-based resources for healthy living; flu shots; and Employee Assistance Programs.
The 2013 studies additionally found that most employers offer at least one disease-management program focusing on chronic conditions such as diabetes, depression, and hypertension.
While all was relatively quiet on the health-coverage front in 2013, the coming years – starting with 2014 – are forecast to bring far-reaching changes associated with the Affordable Care Act. These include new benefits, cost-sharing tiers, and premium-rating rules that will impact plans for companies with 50 or fewer employees.
Benefits experts also are projecting:
• Higher costs for covering your spouse and children;
• Increased prevalence of “consumer-driven” plans featuring high deductibles;
• More companies incentivizing employees to improve their health.