Health benefits in 2012: Moderate premium increases for employer-sponsored plans; young adults gained coverage under ACA

Health Affairs

Volumn 31, Issue 10, 2012, Pages 2324-2333

  Claxton, Gary ^a   Rae, Matthew ^a   Damico, Anthony ^b   Kenward, Kevin ^c   Osei Anto, Awo ^d  

^a HENRY J KAISER FAMILY FOUNDATION   (United States)

^b UNIVERSITY OF CHICAGO   (United States)

^c Health Research and Educational Trust   (United States)

^d BRANDEIS UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; CONTROLLED STUDY; EMPLOYEE; EMPLOYER; FAMILY; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH CARE PREMIUM; HEALTH CARE SYSTEM; HEALTH INSURANCE; HEALTH SURVEY; HUMAN; HUMAN EXPERIMENT; PRIVATE PRACTICE; PUBLIC HEALTH; TELECONSULTATION;

DATA COLLECTION; HEALTH BENEFIT PLANS, EMPLOYEE; HUMANS; INSURANCE COVERAGE; PATIENT PROTECTION AND AFFORDABLE CARE ACT; QUALITATIVE RESEARCH; UNITED STATES; YOUNG ADULT;

EID: 84871858288     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2012.0708     Document Type: Article

References (20)

1. Kaiser Commission on Medicaid and the Uninsured. The uninsured: a primer-key facts about Americans without health insurance [Internet]. Washington (DC): The Commission; 2011 Oct [cited 2012 Aug 16]. (Issue Brief). Available from: http://www.kff.org/uninsured/upload/7451-07.pdf
2. Kaiser Family Foundation, Health Research and Educational Trust. Employer health benefits: 2012 annual survey [Internet]. Menlo Park (CA): KFF; 2012 Sep [cited 2012 Sep 11]. Available from: http://ehbs.kff.org/
3. Weights greater than six times the interquartile range were reduced to that threshold. Although still accounting for the different probability selections between large and small firms, this method ensures that individual respondents do not overly influence statistics calculated among subpopulations.
4. Analysis of the 2011 survey data using both R and SUDAAN (the statistical package used prior to 2012) produced the same estimates and standard errors
5. For a more detailed description of the survey methodology, see Kaiser Family Foundation. Survey design and methods. Chapter in: Employer health benefits: 2012 annual survey [Internet]. Menlo Park (CA): KFF; 2012 Sep [cited 2012 Sep 11]. Available from: http://ehbs.kff.org/?page=charts&id=1&sn=1&p=1
6. Kaiser Family Foundation. Technical supplement: standard error tables for selected estimates [Internet]. Menlo Park (CA): KFF; 2012 Sep [cited 2012 Sep 11]. Available from: http://ehbs.kff.org/pdf/2011/8345-Standard%20Error.pdf
7. The survey defines a health maintenance organization as a plan that does not cover nonemergency out-of-network services. Preferred provider organizations and point-of-service plans have lower cost sharing for innetwork services than health maintenance organizations do. Point-ofservice plans use a primary care gatekeeper to screen for specialist and hospital visits.
8. Federal law requires a deductible of at least $1,200 for single coverage and $2,400 for family coverage for high-deductible health plans qualified to offer health savings accounts in 2012. See Internal Revenue Service. Health savings accounts and other tax-favored health plans [Internet]. Washington (DC): IRS; 2012 Jan 11 [cited 2012 Aug 28]. (Publication No. 969). Available from: http://www.irs.gov/pub/irspdf/p969.pdf
9. Kaiser/HRET surveys use the Aprilto-April time period, as do the sources in this and the following note. The inflation numbers are not seasonally adjusted. Bureau of Labor Statistics. Consumer Price Index-all urban consumers [Internet]. Washington (DC): Department of Labor; 2012 [cited 2012 Aug 27]. Available from: http://data.bls.gov/timeseries/CUUR0000SA0?include_graphs=false&output_type=column&years_option=all_years
10. Wage data are based on the change in total average hourly earnings of production and nonsupervisory employees. Bureau of Labor Statistics. Employment, hours, and earnings from the Current Employment Statistics survey (national) [Internet]. Washington (DC): Department of Labor; 2012 [cited 2012 Aug 28]. Available from: http://data.bls.gov/timeseries/CES0500000008
11. To access the Appendix, click on the Appendix link in the box to the right of the article online
12. The standard errors are 6.8 percent for small firms and 3.3 percent for large firms.
13. The average attachment point in small firms is about $140,000, which is almost twice the amount reported in 2011 for small firms. This value has a very high relative standard error (40 percent) because there are very few small, self-funded employers represented in the survey, and one of them reported a very high value ($2,000,000). Including this firm increases the average by almost 100 percent.
14. The estimate for small firms is not reported in the text because of the high standard error associated with this estimate. Although 19 percent of small firms that ask their employees to complete a health risk assessment reported that they offer a financial incentive, the relative standard error is 0.36, which indicates considerable uncertainty. The difference between large and small firms is statistically significant at the 0.05 confidence level.
15. The percentages of small and large firms offering financial rewards or levying penalties for completing wellness programs or meeting biometric outcomes are not significantly different. The small firm estimates are not reported because of the high relative standard errors for the percentage of firms that levy financial penalties for not completing wellness programs and not meeting biometric outcomes (0.56 and 0.68, respectively). Smoking cessation is not included as a biometric outcome within this question.
16. If those firms that reported offering "other" types of wellness programs are included, the percentage offering at least one wellness benefit is 64 percent. Of the firms that said they offered "other" programs, 2 percent offer flu shots and 7 percent offer employee assistance programs.
17. Firms that offer only web-based resources for healthy living or a wellness newsletter as opposed to one of the other specified wellness programs were not asked about their use of financial incentives. The most common financial incentives were gift cards (8 percent of firms), followed by lower premiums (3 percent) and higher contributions to health reimbursement arrangement or a health savings account and lower cost sharing (both 1 percent).
18. We defined an on-site health clinic as a clinic at a workplace staffed by health professionals such as nurses or doctors where employees can receive health care for either workrelated or non-work-related conditions
19. Departments of the Treasury, Labor, and Health and Human Services. Group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act: interim final rule and proposed rule. Fed Regist. 2010;75(116):34538-70.
20. Departments of the Treasury, Labor, and Health and Human Services. Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Fed Regist. 2010;75(221):70114-22.