Job-Based Health Benefits In 2002: Some Important Trends

Abstract

Based on a national survey of 2,014 randomly selected public and private firms with three or more workers, this paper reports changes in employer-based health insurance from spring 2001 to spring 2002. The cost of health insurance rose 12.7 percent, the highest rate of growth since 1990. Employee contributions for health insurance rose in 2002, from $30 to $38 for single coverage and from $150 to $174 for family coverage. Deductibles and copayments rose also, and employers adopted formularies and three-tier cost-sharing formulas to control prescription drug expenses. PPO and HMO enrollment rose, while the percentage of small employers offering health benefits fell. Because increasing claims expenses rather than the underwriting cycle are the major driver of rising premiums, double-digit growth appears likely to continue.

The Social Determinants of Health: Coming of Age

“…More-educated individuals experience lower rates of unemployment, which is strongly associated with worse health and higher mortality (4); they are more likely to have jobs with healthier physical and psychosocial working conditions, better health-related benefits (44), and higher compensation (30) (which determines affordability of health-promoting living conditions). Education may also affect health by influencing social and psychological factors.…”

Health Care Costs: On the Rise Again

“…The most common responses by private plans have been to increase the employee share of health insurance premiums (which leads some employees to forego coverage altogether) and to introduce multitiered cost sharing formulas for pharmaceuticals and, more recently, hospitals (Gabel et al, 2002b). Under multitiered cost sharing, consumers make a larger copayment for brand name drugs (or drugs purchased through nonparticipating providers) and a lower copayment for generic drugs (or preferred providers).…”

“…As the costs and concentration of health expenditures increase, this calculus will change in favor of more selection. There is a flurry of interest in health plans that use the Internet and other new communications technologies to permit enrollees to tailor their own benefit packages and provider networks (Gabel et al, 2002b). The development of these plans may be a manifestation of these increased rewards to selection.…”

Health Promotion: Causes, Beliefs and Measurements

“…11 Insurance premiums have had annual increases ranging from 8.3% (Spring 2000) to 12.7% (Spring 2002), which stand in stark contrast to the 3.7% and 4.3% increases in the periods of 1997 to 1998, and 1998 to 1999 respectively. 9,12,13 The aforementioned shield is also disappearing as evidenced by trends that indicate an increase in employee contributions, deductibles and co-payments. It is anticipated that this cycle of double-digit increases will continue since claims expense, rather than the underwriting cycle is the major determinant of premium levels.…”

“…Employer-based health insurance serves as a cornerstone of the United States economy. 12 A healthcare concept that gained popularity in the 1980s was the creation of "wellness programs." Corporations in the United States eagerly adopted the concept of wellness programs in response to the desire to integrate healthy habits into the workplace.…”