The average cost of a family health care plan in the United States rose by 4% in 2012, to $15,745 (the average cost was $15,073 in 2011), which was higher than the overall inflation rate of 2.3% and was 30% higher than in 2007 and 97% higher than in 2002. The average premium for family coverage for small employers was $15,253; large employers (200 or more employees) paid an average premium in the amount of $15,980. The average premiums for both family coverage and employee-only coverage are higher in the Northeast ($17,099 and $5,964, respectively) and lower in the South ($14,988 for family coverage and $5,445 for employee-only coverage) than in the rest of the United States.
Employees covered by their employers’ health coverage contributed (paid) an average of 18% ($951) of the total premiums for employee-only coverage and 28% ($4,316) for family coverage. Lower-paid employees who chose family health care plans paid an average of $4,977 toward the costs, plus their family coverage averaged $1,000 less in benefits.
The rise in cost for employee-only health coverage was 3% in 2012 ($5,615), with employees paying approximately $950 of that amount.
About 61.1% of the over three million employers in the United States are employers with 3 to 9 employees and employ 8.3% of all employees (but only 4.4% of employees covered by health insurance). Employers who employ at least 1,000 employees represent less than 1% of the total employers in the United States but they employ 48% of all workers (and they represent 53% of all employees who have health care coverage).
For 2012, 61% of all employers offered health care coverage (98% of employers with at least 200 employees offered their employees health care coverage compared to 61% of employers with 3 to 199 employees) — the cost of health insurance is the primary reason given by employers for not offering health benefits. Sixty percent of covered employees were in a self-funded health plans. Twenty-five percent of large employers offered retiree health benefits compared to 4% for small employers. Ninety-four percent of large employers offered at least one wellness program compared to 63% for small employers. Twenty-two percent of large employers had an on-site health clinic at one (at least) of their major locations to treat employees for work-related or non-work-related conditions (76% of those covered non-work-related conditions). Ninety-nine percent of covered employees in employer-sponsored health plans had a prescription drug benefit.
For those employers that offered health benefits, 62% of their employees were covered by health benefits through their own employer (77% were eligible — 81% of eligible employees took up coverage when it was offered to them). Among all employers (those that offered health benefits and those that did not), 56% of employees were covered under an employer plan. Eighty-two percent of employers offered only one type of health plan, with larger employers more likely to offer more than one type of health plan. Employers were most likely to offer their workers a PPO, HMO, or HDHP/SO plan (High-Deductible Health Plan with Savings Option) and were least likely to offer a conventional plan. Seventy-five percent of covered employees whose employers offered health benefits work for an employer that offered one or more PPOs; 39% work for employers that offered one or more HDHP/SOs; 37% work for employers that offered one or more HMOs; 14% work for employers that offered one or more POS plans; and 4% work for employers that offered one or more conventional plans.
Enrollment in PPOs was the highest, with 56% of covered employees workers, followed by HDHP/SOs (19%), HMOs (16%), POS plans (9%), and conventional plans (less than 1%). PPOs remained more popular for covered employees with large employers and HDHP/SO and POS plans were relatively more popular for employees of smaller employers.
Thirty-four percent of employees covered under their employers’ health care plans have deductibles over $1,000 for single coverage plans (up 3% from 2011). While employers continue to shift more of the cost of health care plans to their employees, that pace slowed in 2012.
The statistics for health plan costs for 2012 were based on a survey conducted from January to May, 2012 of 3,326 randomly selected public and private employers with three or more employees. The 2012 health plan cost statistics report was released on September 11,2012.
One explanation for the smaller rise in health plan costs for 2012 was the likely continuing tendency of employees to limit their use of medical care (which may be due in part to increasing employee deductibles), which helps reduce the costs of health insurance coverage. Nonetheless, it is anticipated that an improving economy will result in greater use of medical care — employers anticipate that the rise in health plan costs in 2013 will be 7% (recent increases in the use of outpatient services and physician services have been reported).
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