Household premiums for employer-sponsored medical health insurance rose 7% this yr to succeed in a median of $25,572 yearly, KFF’s 2024 benchmark Employer Health Survey finds. On common, staff contribute $6,296 yearly to the price of household protection.
This marks the second yr in a row that premiums are up 7%. Over the previous 5 years—a interval of excessive inflation (23%) and wage development (28%)—the cumulative enhance in premiums has been comparable (24%).
Whereas employers are seeing whole premiums for household protection rise steadily, the quantity that staff, on common, pay towards their annual premiums is little modified over the previous 5 years—up lower than $300 since 2019, or a complete of 5% over 5 years. This can be because of a decent labor market.
Amongst staff who face an annual deductible for single protection, the typical this yr stands at $1,787, just like final yr’s $1,735 and up a modest 8% since 2019 when the typical was $1,655.
On common, staff with a deductible at small companies (below 200 staff) face a lot bigger deductibles than staff at bigger companies ($2,575 vs. $1,538). Amongst all lined staff, practically a 3rd (32%) of lined staff at smaller companies face a median single deductible of a minimum of $3,000.
“Employers are shelling out the equal of shopping for an financial system automotive for each employee yearly to pay for household protection,” KFF President and CEO Drew Altman mentioned. “Within the tight labor market lately, they haven’t been capable of proceed offloading prices onto staff who’re already battling well being care payments.”
About 154 million non-elderly People depend on employer-sponsored protection, and the twenty sixth annual survey of greater than 2,100 massive and small employers supplies an in depth image of the traits affecting it. Along with the full report and summary of findings launched at present, Well being Affairs is publishing an article with choose findings on-line. The article can even seem in its November situation.
The survey finds that a number of the nation’s largest employers (a minimum of 5,000 staff) are taking steps to protect lower-wage staff from the total impression of rising well being care prices. Of those jumbo companies, 29% say they’ve a program to scale back lower-wage staff’ premiums, and 19% say they provide a reduced-benefit plan with extra reasonably priced protection.
Employer Protection of GLP-1 Medication for Weight Loss is Restricted and Restricted
Amid a growth in curiosity in pricey GLP-1 medicine corresponding to Wegovy to deal with weight reduction, this yr’s survey additionally gauges how extensively obtainable such protection is in employer plans.
Fewer than 1-in-5 massive employers with a minimum of 200 staff providing well being advantages (18%) say that they cowl GLP-1 medicine for weight reduction, whereas half (52%) say they don’t cowl them, and the others (31%) are uncertain. Among the many largest companies with a minimum of 5,000 staff, greater than 1 / 4 (28%) say they cowl GLP-1 medicine, and practically two thirds (64%) say they don’t.
Amongst massive companies that supply the medicine, about half (53%) have situations or necessities related to their protection. These situations might current obstacles to accessing the medicine, corresponding to first requiring a gathering with a dietician, psychologist, or different skilled (24%); requiring participation in a way of life or weight-loss program both earlier than (8%) or whereas (10%) taking the medicine; or one other sort of situation or requirement (26%).
Protection for these weight-loss medicine has important price implications for employers, as a earlier KFF evaluation estimated that nearly 50 million adults in employer plans meet the scientific standards for taking such medicine, which might price hundreds of {dollars} yearly per particular person.
Amongst massive companies protecting GLP-1 medicine for weight reduction, a 3rd (33%) say it can have a “important impression” on their plan’s prescription drug spending. Amongst all massive companies, practically half (44%) say it will likely be “essential” or “necessary” to cowl GLP-1 medicine for his or her workers’ satisfaction with their well being plan.
Amongst massive companies that don’t presently cowl GLP-1 medicine for weight reduction, few (3%) say they’re “very possible” to take action within the subsequent yr. 1 / 4 (23%) say they’re considerably possible to take action.
“Employers face the problem of integrating these doubtlessly necessary therapies into their already pricey profit plans,” KFF Vice President and research writer Gary Claxton mentioned.
Different findings embrace:
- IVF and different family-building advantages. Amongst massive employers with a minimum of 200 staff, a few quarter (27%) say they cowl in-vitro fertilization (IVF), and an analogous share (26%) say they cowl synthetic insemination. Extra say they cowl fertility medicines (37%), whereas fewer say they cowl egg or sperm freezing (12%). Roughly a 3rd of companies are uncertain if their plans cowl every merchandise.
- Rebates from pharmacy profit managers (PBMs). PBMs handle prescription drug advantages on behalf of payers, together with employers, and usually negotiate rebates with drug producers in alternate for favorable placement of their medicine on formularies. Among the many largest companies with a minimum of 5,000 staff, 34% say they obtain “most” of the rebates negotiated by their PBM or well being plan; 34% say they obtain “some,” and eight% say they obtain “little or no.” The remainder are uncertain how a lot of the rebates they obtain.
- Abortion. Amongst massive employers with a minimum of 200 staff, 8% say that their plan doesn’t cowl legally offered abortions below any circumstances, and one other 18% say that they cowl such abortions below restricted circumstances, corresponding to rape, incest, or the life or well being of the pregnant enrollee. Most (45%) different massive employers say they weren’t certain whether or not and the way their plans lined abortion. These numbers are little modified from 2023.
- Psychological well being and substance abuse. A few quarter of providing employers say their plan’s community for psychological well being and substance abuse companies is “considerably” or “very” slim, in comparison with 10% who say the identical about their networks usually. About half (48%) of huge companies with a minimum of 200 staff say they’ve elevated the psychological well being counseling assets obtainable to their staff via an worker help program or third-party distributors corresponding to Headspace or Lyra Well being.
- Spousal protection and incentives to not enroll. Amongst massive companies with a minimum of 200 staff that supply well being advantages to spouses of staff, 1 / 4 (24%) both require increased premiums or prohibit protection when spouses have been supplied medical health insurance from one other supply. As well as, 12% of huge companies providing well being advantages present additional compensation or advantages to workers who enroll in a partner’s plan, and 13% present additional compensation or advantages to workers if they don’t take part within the agency’s well being advantages.
