America's Benefit Specialist December 2022

NOTEWORTHY

health services (55%) and serving enrollees in remote areas (54%). Smaller but still significant shares say telemedicine will be “very important” in providing primary care (35%) and specialty care (24%). Other findings include: Offer rate. Nearly all (99%) large employ ers offer health benefits to at least some of their workers, though smaller firms are in creasingly less likely to offer health benefits as they get smaller. For example, two thirds (67%) of firms with 10 to 199 employers offer health benefits to at least some of their workers, while just 39% of firms with three to nine workers do so. Spousal coverage restrictions. While most employers allow a worker’s spouse to enroll in coverage even if they are offered other coverage, 16% do not allow spouses to enroll in such circumstances, and another 14% place restrictions on the spouses’ enrollment. Some (five percent) charge spouses more for cover age if they have access to other coverage. Helping employees buy non-group coverage. The survey finds 11% of firms that offer health benefits to at least some workers and seven percent of those who don’t offer funds for some employers to purchase non-group coverage, such as that offered on the Affordable Care Act marketplaces. Such assistance can be provided in a tax-preferred way though Individual Coverage Health Reimbursement Arrangements. Coverage for insulin and statins. Most covered workers are in plans that cover the cost of at least some insulin products (70%) and statins for treating high cholesterol (71%) before they meet their general annual deductible. This follows a 2019 change in policies that allowed plans eligible for use with a Health Savings Account plans to cov er these expenses as preventive services. The Kaiser Family Foundation conducted the annual employer survey between Feb ruary and July. It included 2,188 randomly selected, non-federal public and private firms with three or more employees that responded to the full survey. An additional

The modest change in premiums this year is unusual in that it is less than the increase in inflation (eight percent) or workers’ wages (6.7%) during the same period. Even with this year’s minimal change, average premiums for family coverage have risen 43% since 2012, more than the shift in inflation (25%) and a little more than wages (38%) over the same period. Employer costs for this year were largely set last year, before inflation became a major economic concern and after the pandemic led to a temporary slowdown in utilization of healthcare services. Following the pandemic, which brought new attention to mental health needs, the survey finds that almost half (48%) of large employers report an increase in the share of workers using mental health care services, and more than a quarter (29%) say more workers are asking for family leave due to mental health issues. A smaller share of large employers say they have seen an increase in the share of workers using substance-use services (14%), while more than four in 10 (43%) say that they are at least somewhat concerned about the growth of substance-use conditions among their workers. The survey finds that more than a quarter (27%) of large employers this year added mental health providers—either in physical offices or virtually through telehealth—to their plan’s networks to expand access. Even with those additions, three in 10 (30%) large employers say their networks do not have enough behavioral health providers to ensure their workers have timely access to care. Nearly half (47%) of large firms say tele medicine matters “a great deal” in providing access to mental health services. Almost all large firms (96%) now cover some form of telemedicine services, either directly through their health plan (46%), through a specialized telemedicine provider (32%), or both (20%). More than half expect telemedicine to be “very important” in providing behavioral

2,917 firms responded to a single question about offering coverage. UNCERTAINTY OF HEALTHCARE COSTS DETERS 35% OF AMERICANS FROM SEEKING CARE AKASA, a developer of AI for healthcare operations, released findings from a new survey conducted on its behalf by YouGov, which highlights how limited price trans parency in healthcare can influence patient decisions on whether to seek necessary care and how the lack of awareness about finan cial resources offered by health systems puts patients at a disadvantage when managing medical bills. More than 2,000 Americans were asked: “If you were unaware of the price ahead of the care or service, would you be deterred from seeking out care or services for any of the following individuals?” When answering for themselves: • 40% said they wouldn’t be deterred from seeking out care from themselves based on lack of healthcare pricing information • 35% said they would be deterred from seeking out care for themselves if they were unaware of pricing for necessary care or services • 25% said they didn’t know if lack of healthcare pricing information would or would not deter them from seeking care for themselves When answering for their dependents: • 51.2% said they wouldn’t be deterred from seeking care for dependents if pricing information wasn’t provided on necessary care or services needed • 18.3% said they would be deterred from seeking care for dependents if they were unaware of healthcare pricing information • 30.3% said they didn’t know if lack of pric ing information would or would not deter them from seeking care for dependents When answering for their parents/ guardians:

6 ABS | benefitspecialistmagazine.com