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Employer health plan costs and employee cost sharing both rising

(Lisa F. Young /

(Lisa F. Young /

The cost of employer-sponsored health insurance has continued its steady rise, but there also has been a steady increase in worker cost-sharing, including through greater adaptation of deductibles, the 20th annual Kaiser Family Foundation Employer Health Benefits Survey found.

The employer market covers around 152 million people, by far the largest group of covered people in the United States. It covers more people than Medicaid and Medicare combined.

“My main takeaway from all this … is that rising health care costs absolutely remain a problem for employers, but they remain a bigger problem for workers as their cost sharing rises much faster than their wages over recent years,” Drew Altman, president and CEO of the Kaiser Family Foundation, said.

The average premium for a family on an employer-sponsored plan for 2018 was more than $19,600. Most of those premium costs are covered by employers, while families paid an average of nearly $5,550 in premiums.

The overall premium costs rose about 5 percent from 2017, within the general range of premium increases over the past 10 years. The family share of premiums actually fell slightly, but Kasier Family Foundation analysts warned it was small enough to not be statistically significant.

At the same time, workers have been paying a greater share through cost-sharing methods like deductibles. This year, the average worker will pay a deductible of $1,350, a figure that includes workers without a deductible.

Of the now 85 percent of workers in 2018 whose insurance plan includes a deductible, that deductible averages $1,573.

The number of workers with a deductible has risen significantly over the past decade, from 59 percent in 2008 to 85 percent this year. At the same time, the amount of that deductible has also steadily risen while wages have remained relatively flat. Over the same period, deductibles have grown 212 percent while wages have grown 26 percent.

While cost-sharing measures have increased some of the burden for workers, employers have also taken more steps to reduce costs overall but with uncertain results.

Telemedicine has rapidly grown as a way to save money, with video conferencing replacing in-person doctor visits in some cases. Nearly three-quarters of large firms cover telemedicine visits in their health plan with the highest enrollment. That represents a significant increase over a relatively short amount of time. In 2015, 27 percent of these plans covered telemedicine.

But workers may not be taking advantage of these programs to the extent employers would like. A second survey released by Kaiser Wednesday showed that in 2016, the most recent year it could survey, less than 1 percent of employees with access to telemedicine in their health plan took advantage of it.

Employers have also looked to retail clinics, like those found in pharmacies, grocery stores and department stores, to help cut costs over more expensive doctor and hospital visits. Fourteen percent of firms in the survey said they offered incentives to employees to use these clinics.

Firms could also be turning to big data to help reduce their health care costs. The survey found 70 percent of large companies offer a health assessment and/or biometric screening, and 38 percent of those firms offered employees incentives to complete the program.

Employers also are collecting data from their workers. Twenty-one percent of large companies and 5 percent of small employers said they are collecting data from their employees using mobile apps or wearable technology.

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