More on Reimbursement

Survey: Health insurance deductibles increase by 50%

Employees are paying more for out-of-network care, ER visits while employers pay less, survey says.

Susan Morse, Managing Editor

From 2015 to this year, the median in-network deductible for employees increased by 50 percent, from $1,000 to $1,500, according to a health plan survey released Tuesday by United Benefit Advisors.

Employees are also paying more for out-of-network services and emergency room visits, while the price of their premiums remains constant, the survey found.

Employers, meanwhile, are paying less, as costs are being passed on to their employees, according to United Benefit Advisors.

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[Also: Financial assistance enables drop in median marketplace deductibles]

The deductible increases are mostly due to two factors, according to Carol Taylor, director of Compliance & Health Plan Collaborative with the D&S Agency, a UBA partner firm in Virginia.

"First, by raising the deductible $500, you avoid a premium increase of roughly 3 percent to 6 percent," Taylor said in a statement. "The second factor is the result of insurance carriers being forced to comply with 'metal' levels (platinum, gold, silver, bronze) in the Affordable Care Act small group market. As long as insurance carriers are required to meet the ACA metal levels, we can expect to see plan changes in this same direction."

The 50 percent increase in deductibles applies to employer-sponsored Preferred Provider Organization plans. Despite the increase, nearly half of all employees continue to enroll in PPO plans, according to United Benefit Advisors.

Employees' total monthly premiums, combined for all types of plans, remained relatively flat at $509 for a single. The monthly premiums increased only slightly from $140 in 2015 to $144, a 2.6 percent rise.

Family premiums went from $540 in 2015 to $552 in 2016, a 2.2 percent increase.

[Also: Over 40 percent of adults say their deductibles cause undue financial burden, report says]

For an employee electing single coverage, the employer covers 71 percent of the monthly premium, and only 54 percent of a family premium, the survey found.

For employers, costs remained flat and actually decreased slightly in 2016, the survey found.

The average health plan costs for employers decreased from $9,736 in 2015, to $9,727 in 2016. Of the $9,727, employees contributed an average of $3,378 and employers contributed on average $6,350.

This compares to 2015, when employers paid $6,403 of the $9,736 average overall cost, while employees paid $3,333.

"Overall, employer costs remained consistent because they are passing more and more of their increases on to employees - a trend we expect to see more of in the future," said United Benefit Advisors CEO Les McPhearson. "Employers simply cannot continue to absorb unsustainable increases in health care costs. Unfortunately, neither can employees."

Employers shifted costs to employees in median out-of-network deductibles, which jumped 13 percent this year, from $3,000 to $3,400, and median emergency room copays increased from $250 to $300, a 20 percent increase, the survey found.

United Benefit Advisors 2016 Health Plan Survey is an independent survey of 19,557 health plans and 11,524 employers.

Twitter: @SusanJMorse