If relatively low cost and cost trend patterns were predictive of health plan category sponsorship, health maintenance organizations would be on the rise. That isn’t happening, however, as growth of high deductible health plans continues to outpace other medical plan types – even in the face of lower employer contributions to health savings accounts.

Enrollment in HDHPs rose to 20.6% last year, up from 15.6% in 2012. The average employer contribution to a single-coverage HSA was $515 last year, down 10.4% from the 2012 average of $575. The average employer contribution to a family-coverage HSA was $890 last year.

These are among the findings of the recently released United Benefit Advisors Benefit Plan Design and Cost benchmarking study. That annual study estimates the average total cost for all health benefit plans for 2014 was $9,504 – 66% ($6,276) of which was paid by employers, and the remaining 34% ($3,228) by employees.

Also see: Crafting high-flying HDHPs

Most economical plans

The lowest cost plan type, according to the study, was the CDHP, at $8,916, closely followed by HMOs at $9,072. The most costly plans were exclusive provider organizations, at $10,346, followed by $10,018 for point of service plans, and $9,828 for PPOs.

Premium rate increases were the lowest (4.5%) for EPOs, followed by HMOs (5.3%), CDHPs (5.6%), PPOs (5.8%) and POS plans (6.3%).

Average deductibles for in-network services, at $1,901, remained flat last year, but out-of-pocket maximums rose by 6% to an average of $3,500 for single coverage, and $8,000 for family coverage.

In 2012, 19% of health plans available to employees were HMOs. In 2014, that overall percentage dropped to 17%.

Regional HMO patterns

The prevalence of HMO options for employees is the largest (32.7%) in the Western states, exceeded only by PPOs (50.6%) in that region. HMOs also hold their own in Northeastern states, with a 21.4% share. But average HMO coverage in other parts of the country range from merely 6.5% in the middle of the country, to between 12% and 13% in the North Central and Southeastern states.

Actual HMO enrollment rates, however, vary by region from plan prevalence. For example, HMO enrollment in the West, where their prevalence is greatest, is only 13.1%, versus 16.5% in the Southeast, where their prevalence is considerably less, suggesting employers in the Southeast were more likely to give employees only one plan option.

A majority (55%) of surveyed employers give employees only one health plan choice, while 29% offer two options, and 16% offer three.

Despite considerable public discussion of the potential of wellness programs to improve employee health outcomes and ultimately slow health care cost increases, only 18.4% of survey respondents offer a “comprehensive” wellness plan, generally featuring health risk assessments, participation incentives and biometric screening.

Also see: Cadillac tax, wellness clarity top employer priorities

The survey incorporated responses from 9,950 employers sponsoring 16,467 health plans. Indianapolis-based United Benefit Advisors has more than 200 offices in the U.S., Canada and the UK.

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