Annual premiums for employer-sponsored family health coverage held to the recent moderate trend, climbing to $16,351 this year, or 4 percent more than last year, according to the Employer Health Benefits Survey released Tuesday by the Kaiser Family Foundation.
Workers paid $4,565 on average toward the cost of their family's health coverage, but their wages did not keep up with even the modest rise in premiums. During the same period, wages rose just 1.8 percent and general inflation was up 1.1 percent, the survey noted.
Since 2003, premiums have increased 80 percent, nearly three times as fast as wages (31 percent) and inflation (27 percent).
Still, 93 percent of employers with 50 or more employees offered their workers coverage this year, only slightly less than 94 percent last year, said Gary Claxton, the study's lead investigator and director of Kaiser's Health Care Marketplace Project, on a briefing call with reporters.
He doesn't think that the Affordable Care Act will have an impact on premiums, especially with the employer mandate delayed until 2015. "Most of the coverage expansions would be in the non-group market. I don't know if there is a reason to think that it will have a big effect on the employer market," Claxton said.
The annual survey, for 15 years a joint project of Kaiser and the Health Research & Educational Trust, polled more than 2,000 companies between January and May about trends in employer-sponsored health insurance costs and coverage.
The rise in premiums has been held in check by historical standards mostly because of the weak economy, "which causes people to use less health care. But other factors are cost-sharing and changes in the health system," said Drew Altman, Kaiser president and CEO, on the call.
Among the findings, cost-sharing by employees continues to expand and take a bigger bite out of their finances. Businesses with many lower-wage workers (at least 35 percent earning $23,000 or less annually) require workers to pay $1,363 more on average toward family premiums than employees at firms with fewer lower-wage workers ($5,818 vs. $4,455 annually).
This year, 78 percent of all covered employees face an annual deductible, up from 72 percent in 2012. Workers typically must pay this deductible before most services are covered by their health plan.
The survey also finds that large deductibles of at least $1,000 or more are common in employer-sponsored plans, especially among workers of smaller firms. This year, 38 percent of all covered workers face such a deductible. At small firms, 58 percent of covered workers now face deductibles of at least $1,000, including nearly a third (31 percent) who face deductibles of at least $2,000, up from 12 percent in 2008.
Wellness programs are also growing in popularity, especially among large employers and targeted at certain conditions, to control costs. More than one third, or 36 percent, of employers with at least 200 workers and who offer wellness programs, also link them to some form of financial incentive for their workers to participate, including lower premiums or lower deductible, receiving larger contributions to a health savings account, gift cards and cash.
However, the effectiveness of wellness programs is still more anecdotal than evidence-based. "You can find differences of opinion whether the amount of cost savings is very large," Claxton said. "You can find examples of firms that lower premiums right away, and some of those cases are because they increased cost-sharing quite a bit at the same time that they instituted a wellness program."
However, over the long term, all companies want to make employees healthier. "If you look beyond health benefits in terms of getting people to stay at work and reducing time off, there is probably more room for finding cost effectiveness," he said.