Half of large employers see increasing demand for mental health services; 3 in 10 say their plan has too few behavioral health providers to ensure timely access to care
Annual family premiums for employer-sponsored health insurance are averaging $22,463 this year, similar to last year ($22,221), the 2022 KFF Employer Health Benefits Survey finds. On average, workers this year are contributing $6,106 dollars in the cost of the family premium, with employers paying the rest.
Among workers facing an annual deductible for single coverage, the average this year stands at $1,763, similar to last year ($1,669) but up 61% since 2012 ($1,097).
“Employers are already concerned about what they pay for health premiums, but this may be the calm before the storm, as recent inflation suggests that larger increases are imminent,” said KFF President and CEO Drew Altman. “Given the tight labor market and rising wages, it will be difficult for employers to shift costs to workers when costs rise.”
The report reveals persistent disparities in the burden of health care costs for workers at the smallest and largest employers. Workers at small firms (fewer than 200 workers) pay an average of $7,556 out of their wages each year for family coverage — nearly $2,000 more than workers at larger firms ($5,580).
For single coverage, workers at small and large firms contribute similar amounts to their coverage, although workers at small firms face much larger deductibles on average ($2,543 vs. $1,493). Looked at another way, nearly half (49%) of workers at small firms face an average deduction of at least $2,000, while only a quarter (25%) of workers at large firms do.
Nearly 159 million Americans rely on employer-sponsored coverage, and the 24th annual survey of more than 2,100 small and large employers provides a detailed picture of the trends affecting it. In addition to the full report and summary of findings published today, the journal Health Affairs is publishing an article with selected findings online. The article will also appear in its December issue.
The modest change in premiums may not continue as inflation is rising in the 2023 contracts
The modest change in premiums this year is unusual as it is less than the increase in inflation (8%) or workers’ wages (6.7%) over the same period. Even with this year’s minimal change, average premiums for family coverage have risen 43% since 2012, more than the displacement of inflation (25%) and slightly more than wages (38%) over the same period.
Employer costs for this year were largely determined last year, before inflation became a major economic concern and after the COVID-19 pandemic led to a temporary slowdown in the use of health care services.
Large firms see a growing need for mental health, but some doubt the capacity of their network
In the wake of the COVID-19 pandemic, which brought new attention to mental health needs, the survey finds that almost half (48%) of large employers report an increase in the percentage of workers using mental health care services, and more that a quarter (29%) say more workers are taking family leave because of mental health issues.
A smaller proportion of large employers say they have seen an increase in the proportion of workers using substance use services (14%), while more than four in ten (43%) say they are at least somewhat concerned for growth substances -conditions of use among their workers.
The survey finds that more than a quarter (27%) of large employers this year added mental health providers – either in physical offices or virtually via telehealth – to their plan networks to expand access. Even with these additions, three in ten (30%) large employers say their networks do not have enough behavioral health providers to ensure their workers have timely access to care.
Nearly half (47%) of large firms say telemedicine is “very important” in providing access to mental health services.
Almost all large firms (96%) now cover some form of telemedicine services, either directly through their health plan (46%), through a specialty telemedicine provider (32%), or both (20%) .
More than half expect telemedicine to be “very important” in providing behavioral health services (55%) and serving enrollees in remote areas (54%). Smaller but still significant shares say that telemedicine will be “very important” in providing primary care (35%) and specialty care (24%).
“Many large employers are struggling to add enough mental health and substance use providers to meet the growing needs of their workforce,” said Gary Claxton, a KFF senior vice president and director of the Healthcare Market Project. , the lead author of the study and also. of the article Health Issues. “Most consider telemedicine as an important part of the solution.
Other findings include:
- Bid rate. Almost all (99%) large employers offer health benefits to at least some of their workers, although smaller firms are increasingly less likely to offer health benefits as they get smaller. For example, two-thirds (67%) of firms with 10 to 199 employers offer health benefits to at least some of their workers, while only 39% of firms with three to nine employees do so.
- Spousal Coverage Limitations. While most employers allow a worker’s spouse to enroll in coverage even if other coverage is offered to them, 16% do not allow spouses to enroll in such circumstances, and another 14% place restrictions on spousal enrollment. Some (5%) charge spouses more for coverage if they have access to other coverage.
- Help employees purchase non-group coverage. The survey finds 11% of firms that offer health benefits to at least some workers and 7% that do not provide funds for some employers to purchase non-group coverage, such as that offered in the Affordable Care Act marketplaces. Such assistance may be provided in a tax-preferred manner through Individual Health Coverage Reimbursement Agreements.
- Coverage for insulin and statins. Most covered workers are in plans that cover the cost of at least some insulin products (70%) and statins to treat high cholesterol (71%) before meeting their annual deductible. This follows a 2019 policy change that allowed eligible plans to be used with a Health Savings Account to cover these costs as preventive services.
METHODOLOGY
KFF conducted the annual employer survey between February and July 2022. It included 2,188 randomly selected non-federal public and private firms with three or more employees who responded to the full survey. Another 2,917 firms answered a single question about providing coverage. For more information on the survey methodology, see the Survey Design and Methods section.
Meeting the need for reliable information on national health issuesKFF is a non-profit organization based in San Francisco, California.
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Health Affairs is the leading peer-reviewed journal at the intersection of health, health care and policy. Published monthly by Project HOPE, the magazine is available in print and online. Recent content is also available through healthaffairs.org, Health Affairs Today and Health Affairs Sunday Update.
Project HOPE is a global health and humanitarian aid organization that puts the power in the hands of local healthcare workers to save lives across the globe. The HOPE Project has been publishing Health Affairs since 1981.
