The median in-network deductible on an employer-sponsored PPO health plan increased 50% from $1,000 to $1,500 in 2016, according to the latest Health Plan Survey released by United Benefit Advisors (UBA), an independent employee-benefits advisory organization.
The survey also found that average health plan costs for employers decreased from $9,736 in 2015 to $9,727 in 2016. However, the employees’ share increased. Of the $9,727, employees contributed an average of $3,378 and employers contributed on average $6,350. In 2015, employers paid $6,403 of the $9,736 average overall cost, while employees paid $3,333.
“Overall, employer costs remained consistent because they are passing more and more of their increases on to employees – a trend we expect to see more of in the future,” says Les McPhearson, CEO of UBA. “Employers simply cannot continue to absorb unsustainable increases in health care costs. Unfortunately, neither can employees.”
According to the survey, monthly premiums for all types of plans combined stayed at a flat $509 for a single employee.
However, the employees’ share of monthly premiums increased slightly from $140 in 2015 to $144, and family portions increased from $540 in 2015 to $552 in 2016. The survey indicated that for an employee electing single coverage, the employer covers 71% of the monthly premium, and only 54% percent of a family premium.
UBA also found that median out-of-network deductibles rose from $3,000 to $3,400 this year seeing a 13.3% increase from 2015. Median emergency room copays increased from $250 to $300 representing a 20% boost from last year.
“The deductible increases are mostly due to two factors: First, by raising the deductible $500, you avoid a premium increase of roughly 3% to 6%,” explains Carol Taylor, director of compliance and health plan collaborative with D&S Agency. “The second factor is the result of insurance carriers being forced to comply with ‘metal’ levels (platinum, gold, silver and bronze) in the Affordable Care Act (ACA) small group market. As long as insurance carriers are required to meet the ACA metal levels, we can expect to see plan changes in this same direction.”
UBA’s 2016 Health Plan Survey Executive Summary will be available to the public in late September. It can pre-ordered online here.
The 2016 UBA Health Plan Survey contains the validated responses of 19,557 health plans and 11,524 employers, that cumulatively employ more than two and a half million employees and insure more than five million total people, according to UBA.