PPO Plans Dominate Employer Health Plan Offerings

According to the survey results, 22.06% of all employers offer a Health Maintenance Organization (HMO) plan, 11.09% offer a Point of Services (POS) plan, 8.8% offer a Consumer Directed Health Plan (CDHP) tied to a health savings account or health reimbursement account, .9% offer an Exclusive Provider Organization (EPO) plan, and .8% offer an indemnity fee for service (FFS) plan. Sixty-one percent of employees are covered by a PPO, 16.6% by an HMO, 12.8% by a POS, and 6% by a CDHP. UBA found that 19.3% of active employees waive health plan coverage by their employer.

For 65.6% of employers, only one medical plan is offered to employees, while 24.1% offer two, 7.89% offer three, and 2.5% offer four or more medical plan choices. Among all employers in the survey, 93.8% offer no retiree medical plan, while 4.09% offer one, 1.6% offer two, and .5% offer three or more medical plan choices to retirees.

As for health plan costs, the survey found the median PPO premium for single coverage is $336 and for family coverage is $817, of which employees pay $77 and $344, respectively. For HMOs the median premium for single coverage is $315 and for family coverage is $787. Employees are responsible for a median of $80 and $358, respectively, of HMO premiums.

The POS plan median premium for single coverage is $368, $924 for family, and the employee share is $94 and $370, respectively. Among CDHPs, the median premium for single coverage is $273 and for family coverage is $692, of which employees pay $65 and $274, respectively.

The survey found only 7.4% of all employers offer a wellness program, and those that do offer incentives for participation, including cash toward health plan premiums, a flexible spending account or 401k (35.3%), extra paid time off (5.3%), and gift certificates or health club dues (54.2%).

The purpose of the survey is to provide employers with a benchmark against which to compare their own health plan costs and designs. The study results are broken down by employer size, industry, and geographic location. The data includes information on active employee and retiree health plans, prescription plans, HSAs and HRAs, and Section 125 plans.

For more information, contact Carmen LoCascio at UBA at 317-705-2444 or Carmen@unitedbenefitadvisors.com .