America's Benefit Specialist December 2023

NOTEWORTHY

inflation (5.8%). Over the past five years, premiums rose 22%, in line with wages (27%) and inflation (21%). Among workers who face an annual deductible for single coverage, the average this year stands at $1,735, similar to last year. The average deductible amount has increased 10% over the last five years and 53% over the last 10 years. Workers at small firms (under 200 workers) on average face much larger deductibles than workers at larger firms ($2,434 vs. $1,478). The modest rise in deductibles may reflect employers’ perceptions about the burden of cost-sharing on workers. More than half (58%) of employers say that their workers have at least a moderate level of concern about the affordability of their plan’s cost-sharing requirements. “Rising employer healthcare premiums have resumed their nasty ways, a reminder that while the nation has made great progress expanding coverage, people continue to struggle with medical bills, and overall the nation has no strategy on health costs,” KFF President and CEO Drew Altman said. Almost 153 million Americans rely on employer-sponsored coverage, and the 25th annual survey of more than 2,100 small and large employers provides a detailed picture of the trends affecting it. Among large employers (with at least 200 workers) that offer health benefits to at least some workers, the vast ma jority (88%) say their plan has enough primary care doctors to provide timely access for enrollees. Substantially fewer say the same about their mental health (59%) and substance use condition (58%) networks. Nearly one in five (18%) of large offering firms say that they took steps in the past year to increase the number of mental health providers in their largest plan’s network. This includes 44% of the largest employers (with at least 5,000 workers). On the other hand, one in five (21%) of large offering em ployers say their plan has limits on the number of covered mental health services, potentially restricting access for enrollees with long-term needs. Other findings include: Nearly all employers with at least 200 workers offer health benefits to at least some workers, though smaller firms are increasingly less likely to offer health benefits as they get smaller. For example, 83% of firms with 10 to 199 employees offer health benefits to at least some of their workers, while just 42% of firms with three to nine workers do so. Among firms offering health benefits, most also offer separate dental coverage (91%)—double the share that did so in 2010 (46%). Most also offer vision (82%) insurance, also up sharply since 2010 (17%). Fewer offer long-term care insurance (26%). Among employers with at least 200 workers, 23% cover gender-affirming survey in their largest health plan. More

than a third (37%) say they do not cover such surgeries, while a large share (40%) are not sure about such coverage. Among the largest firms (at least 5,000 workers), nearly two thirds (62%) cover gender-affirming surgery, many of which expanded the benefit in the past two years. About one in five (19%) offering employers with at least 200 workers say their plan includes a “center of excellence” program for specific services, either limiting enrollees to a narrower group or providers or offering lower cost-sharing for doing so. Among these firms, 22% have introduced a new center of excellence program within the last two years. Among firms with a center of excellence program, 45% had a program for joint replacement, 42% for back or spine surgery, 31% for bariatric surgery, 30% for mental health and 28% for substance use disorders. KFF conducted the annual employer survey between Jan uary and July. It included 2,133 randomly selected, non-fed eral public and private firms with three or more employees that responded to the full survey. An additional 2,759 firms responded to a single question about offering coverage. MAJORITY OF HEALTHCARE BUSINESSES EXPECT U.S. ECONOMY TO IMPROVE Across the board, healthcare leaders are focused on one of their most important assets: employees. Talent acquisition and retention is among the top three areas of business focus, a top investment priority, and among their top concerns. To address employee recruitment and retention matters, 22% plan to invest in recruitment and retention ahead of market ing (21%) and cybersecurity (15%). These insights are part of a nationwide survey of small and middle-market companies across the U.S. conducted by Umpqua Bank as part of its annual 2023 Business Ba rometer report. Over half of healthcare professionals expect the country’s economic conditions to improve over the next 12 months. Additionally, 67% expect an increase in revenue and 62% expect an increase in profitability. The survey also found that healthcare, manufacturing and agricultural businesses are the most optimistic as it relates to the country’s future eco nomic conditions. “Healthcare businesses are focused on enhancing their fundamentals as they prepare for 2024. This translates into increased attention to managing staffing issues, promoting their services and investing in cybersecurity,” said Umpqua Head of Middle Market Banking Richard Cabrera. “Although an essential industry, healthcare leaders are not taking this status for granted and are intent on improving efficiencies, strengthening financial management as well as employee recruitment and retention.”

8 ABS | benefitspecialistmagazine.com