California Employer Health Benefits: Workers Pay the Price

The percentage of employers offering coverage continued to decline in California, according to a report by the California HealthCare Foundation. Only 57% of employers say they provided health insurance to employees in 2015, down from 69% in 2000. Twenty-seven percent reduced benefits or increased cost sharing, and 41% said they were very or somewhat likely to increase employees’ premium contribution in the next year. This trend will have major implications for household budgets. The report also finds the following:

  • 42% of  firms that had  many workers earning $23,000 or less offered health coverage in 2015 compared to 18% in 2014.
  • Health insurance premiums for family coverage grew 4.5%, which is a slower growth rate than in recent years. Family coverage premiums have seen a cumulative 216% increase since 2002, compared to a 37% increase in prices.
  • The average monthly health insurance premium was $573 for single coverage and $1,554 for family coverage in California, including the employer contribution. It was significantly higher than the national average.
  • 40% of workers in small firms faced an annual deductible of at least $1,000 for single coverage, compared to 10% of workers in larger firms.

Workers Are Satisfied with Their Health Benefits

Sixty-six percent of workers are satisfied with their health benefits and express little interest in changing the mix of benefits and wages, according to a study by the Employee Benefits Research Institute and Greenwald & Associates. Fourteen percent would trade wages to get more health benefits, and 20% trade some health benefits for higher wages. Forty-four percent would give up a wage increase to maintain their health coverage.

However, the preference for health benefits over wages seems to be waning. From 2012 to 2015, the percentage of workers who were satisfied with their health benefits fell from 74% to 66%. At the same time, the percentage who want fewer health benefits and higher wages increased from 10% to 20%. If their coverage became taxable, 50% would continue with their level of coverage, up from 31% in 2011. Twenty-nine percent would switch to a less costly plan; 16% would shop for coverage directly from insurers; and 5% would drop coverage.

Forty-four percent want to continue getting coverage the way they do today; 39% want to choose their insurance plan, having their employer pay the same amount it spends toward that insurance, and pay the remaining amounts themselves; and 17% want their employer to give them the money, allowing the worker to decide whether to purchase coverage and how much to spend. Eight in 10 say choice of health plan is extremely important (41%) or very important (39%)

American Workers Choose Wages Over Benefits

American workers are satisfied with their health insurance benefits, but there is a long-term trend toward wanting more cash and fewer benefits, according to a survey by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates. A third of workers surveyed would change the mix of wages and health benefits, which may reflect a growing desire for real wage growth. From 2012 to 2015, the percentage of workers who are satisfied with their health benefits fell from 74% to 66%. At the same time, the percentage who would rather have fewer health benefits and higher wages increased from 10% to 20%. For more information, visit ebri.org.

Financial Stress Affects a Majority of Employees

Financial stress affects 75% of employees, according to a study by GuideSpark. Employees surveyed said that the following areas give them the most financial stress:

  • 69% Saving enough to meet retirement goal.
  • 68% Having enough cash savings to cover the employee and their family if one loses their job.
  • 63% Being financially prepared for expected life changing events (i.e. marriage, new child, job change.

The study also reveals the following:

  • 81% employees are less likely to leave a company that helps them improve their financial standing.
  • 87% of Millennials expect employers to help them prepare for their financial future.
  • 78% of employees would chose to join a company that offers financial health benefits over one that doesn’t.
  • 81% of employees are less likely to leave a company helps them improve their financial standing.

Employees say these are the top benefits of a financial wellness program:

  • 81% Reduce financial stress
  • 76% Appreciate their company more
  • 65% Lower their healthcare costs
  • 62% Improve their physical health
  • 56% Enable them to focus more on their jobs

Most Prospective Employees Consider Healthcare Benefits

Eighty-six percent of Americans say that competitive benefits would factor into their job choice, according to a survey by the Harris Poll on behalf of Collective Health. The study also reveals the following:

  • They are are not prepared for an out-of-pocket medical bill of $5,000 or more: 80% of Millennial women (ages 18-34), 71% of 18- to 34-year-olds, 69% of parents with a child under 18 in their home, and 61% of Americans in general.
  • 81% percent of parents with a child under 18 say healthcare benefits would be big factor in where they decide to work.
  • 72% of 18- to 34-year-olds are often confused about their benefit options.
    66% of Americans prefer a plan that takes more out of their monthly paycheck, but covers more of their medical bills.
  • 61% of Americans are often confused by their healthcare options (e.g. PPO vs. HMO, provider, FSA/HSA).
  • 59% of Americans have been confused by a bill from a healthcare professional.

Employees Aren’t Taking Steps to Reduce Eyestrain

Employees are spending more time on electronic devices than they did five years ago – increasing their risk for digital eyestrain and other vision issues, according to a survey conducted by Wakefield Research for Transitions Optical. Forty-four percent of employees are spending more time during their work day using electronic devices  including smart phones, tablets, computers, and laptops. Fifty-four percent are extending their digital day by increasing use at home.

Extended use of electronic devices can lead to numerous vision problems including eyestrain, fatigue, and headaches. In fact, one-third say that light reflected from a computer screen and personal devices bothers their eyes at work. Taking breaks to rest the eyes can help alleviate problems. But 80% of employees spend at least part of their break time using devices.

Jonathan Ormsby, strategic account manager, Transitions Optical said, “We live in a digital world, so it makes sense that many employees are depending heavily on their devices throughout the day; that likely won’t change. The unfortunate consequence is that this increased and extended use is likely hurting their eyes and productivity.”

Very few employees take steps to reduce visual disturbances. Only one-third adjust the settings on their computer screens or personal devices; 16% adjust light in their work space; and one-third wear eyeglasses with advanced lens technology to improve their vision.

Ormsby added that employers have a tremendous opportunity to educate employees about the risks of extended digital use and to reinforce the importance of using their vision benefit to get regular eye exams and get eye wear that reduces glare and provides more comfortable vision.

Eighty percent of employees want more protection for their eyes. Seventy percent want more protection outdoors from the sun or ultraviolet light , and 50% want more protection indoors from harsh artificial light or glare from personal devices.

Less than 40% of employees say their plans cover anti-reflective coating fully or offer discounts while only one-third say their plans cover photochromic lenses. Twenty-seven percent of employees who have  visual disturbances at work, including eyestrain, have not told anyone about the issue. Indoor workers are three times less likely to discuss eye health concerns with eyecare professionals than are outdoor workers. Transitions Optical offers employee and employer focused tools and education free of charge at HealthySightWorkingforYou.org.

Some Really Good Reasons to Maintain Employee Health Benefits

Employers who fail to fully sponsor their employees’ health benefits would face widespread employee dissatisfaction, lower productivity, and the loss of nearly a third of their employees within a year, according to new research by Accenture. Seventy-six percent of workers say health insurance is a vital factor in staying with their employer. Thirty-one percent say that if they lost their health insurance, they would leave their job within 12 months, with 15% saying that they would quit immediately. If their employer dropped health coverage 64% of workers said they would be very dissatisfied with their employer; 34% would be less motivated to work hard; and 21% would be absent more often. For a company with 1,000 employees who earn an average salary of $50,000, these turnover costs could climb to more than $3 million in the first year alone

Employers Expect Changes to Employee Health Benefits

Complimentary Benefit Seminars in CaliforniaEighty-four percent of employers expect to make changes to their full-time employee health benefit programs over the next three years, despite cost increases remaining at historically low levels, according to new research from Towers Watson. In addition to aggressive cost management, employers are evaluating the implications of the changing provider landscape, embracing new ways to deliver care through innovative network arrangements, focusing on increasing employee engagement and exploring new options for delivering benefits. This includes assessment of active employee private exchanges and a rapid migration of Medicare retirees to private exchanges.

Employers are using and actively considering various options to manage cost, change employee behaviors and optimize program performance.

Employers project health care costs to increase 4% in 2015 after plan changes, compared to the 4.5% employers predicted for 2014. Without plan changes, projections are for an increase of 5.2%. These modest increases are still more than double the rate of inflation and are a primary factor driving employers’ affordability concerns as the 2018 excise tax in the Affordable Care Act approaches. Two in five employers that have done extensive modeling of their plans say they will trigger the excise tax in 2018. Two-thirds say the tax will have an impact on their health program strategies.

Randall Abbott, a senior consulting leader at Towers Watson said, “Employers have strived to keep their cost increases at the market average, but increasingly, this just isn’t enough. The new focus is on reducing cost trends to the CPI or below. This means driving cost growth to roughly 2% or less, which requires an acute focus on all aspects of health plan performance. In addition to solving the rate of cost trend, employers must pay attention to the base cost. We are seeing a wide variation across and within industries even after adjusting for unique group characteristics. High-performance health care has become the new mantra emphasizing not just reducing costs but improving workforce health, better engaging employees and leveraging new health technologies.”

Among the actions gaining traction are changes to benefits for spouses and dependents. For example, the percentage of employers using spousal surcharges (when coverage is available elsewhere) is expected to nearly double, from 32% now to 61% in three years. Fifty-three percent of respondents plan to significantly reduce subsidies for spouses and dependents by 2018. In addition, 41% say they may adopt a defined contribution arrangement (capping employer contributions at a flat dollar amount) by 2018.

Employers reported greater resolve to improve health outcomes per dollar spent, with two-thirds planning to use data extensively to evaluate plan performance and employee behavior changes in lifestyle and health management. In addition, the use of centers of excellence (within health plans or via a separate network) and narrow networks are expected to triple over the next three years. The use of telemedicine services in place of in-person physician visits, when appropriate, will continue to be rapidly adopted, already expanding by 35% in 2015 over 2014. Over 80% of employers say they could be offering telemedicine services by 2018.

Over the next few years, more than 80% of employers will carefully evaluate specialty pharmacy programs and benefits embedded in their medical plans. Sixty-one percent of employers report including coverage and utilization restrictions in their specialty pharmacy strategy.

Employers recognize the business value of a healthy workforce and are encouraging employees to take control of their health. Two of the top five areas employers say will be the focus of their health care activities in 2016 link to employee engagement and accountability: developing or enhancing a workplace culture where employees are responsible for their health (66%), and adopting or expanding the use of financial incentives to encourage healthy behaviors (51%).

The following are the most popular tactics for boosting employee engagement in health care:

  • 48% will place more emphasis on educating employees about how to select providers based on quality and cost information over the next two years. In 2016, 43% of employers will provide price and quality transparency tools to help employees make better consumer choices.
  • 60% of employers deliver health and wellness messages through mobile apps and portals. That percentage will increase to 95% by 2018.
  • 17% of employers offer full-replacement high-deductible plans tied to tax-advantaged health savings accounts. The percentage may increase to nearly 50% by 2018.

Employer confidence in private exchanges is increasing: 17% view private exchanges as a viable alternative for active full-time workers in 2016. Confidence more than doubles to 37% by 2018.

Twenty-six percent of employers have analyzed private exchanges extensively, and 20% say they are more interested in adopting a private exchange than they were a year ago. Companies that have completed extensive analysis of private exchanges twice as likely to find private exchanges a viable alternative in 2016.

Employers report that cost savings and administrative simplicity are key factors in prompting use of private exchanges. Finance will play a role in shifting to a private exchange model. Fifty-three percent report that finance will influence the decision to move to a private exchange or continue to maintain traditional employer-managed health plans

 

How Employees View Their Health Benefits

Workers rank health insurance as their first or second-most important benefit, according to a study by The Employee Benefit Research Institute (EBRI). Sixty-five percent say health insurance is extremely important while 21% say it’s very important. Fifty-eight percent plan to work longer than they would like in order to continue getting health insurance benefits. When asked why, 43% cited the cost of individual health insurance, and 15% cited the cost of medical care.

Thirty-two percent of workers say that an employer’s benefit package is extremely important while 44% say it’s very important. In fact, benefits have been the reason that 21% of workers accepted jobs, quit jobs, or changed jobs. Many workers are not especially satisfied with their employer’s benefit package. Only 11% are extremely satisfied; 33% are very satisfied, 34% are somewhat satisfied, and 11% are not too satisfied or not at all satisfied.

Job satisfaction is strongly tied to satisfaction over benefits. For example, 55% of those who are extremely satisfied with their benefits are extremely satisfied with their job. In contrast, less than 10% of those who are only somewhat satisfied with their benefits are extremely satisfied with their job.

ACA to Bring Profound Changes in 2015

ACAThe Affordable Care Act (ACA) will bring profound changes to health benefits in 2015, according to a statement by Ben Geyerhahn, CEO and Founder of BeneStream. Coverages mandated by the ACA go into effect on January 1. There is also the requirement that companies with 100 or more employees must offer health benefits to all full-time staff under the employer mandate.

The employer mandate will affect the working poor the most. This year the working poor are being offered a range of options by employers, which means that many will have health insurance for the first time in 2015. However, any additional cost to the monthly budget is more than many can afford. That’s why 29 states passed Medicaid expansion. Because of the expansion, Medicaid now covers up to 138% of the poverty rate, which is $32,900 in income per year for a family of four.

With the exchanges, access to health insurance means more preventative care versus emergency care. More people have health insurance upon arrival to the emergency room, which lowers costs. With the employer mandate taking effect, these factors will continue to improve.

However, full-time employees who have been getting health insurance are likely to have fewer plan options than in previous years, and those options will come with narrower networks. Many employees will see higher monthly premiums with higher deductibles along with a smaller range of in-network doctors. And some plans no longer cover out of network doctors.

Also, family coverage will evaporate for many this year. Families can go to the exchange to get the remaining members covered while some may qualify for the Children’s Health Insurance Program (CHIP). 

Last Updated 05/25/2022

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