b' Wordw w w. w m i m u t u a l . c o mCompany Health Insurance BENEFITS ~By David Leo, How Do Yours Compare?President ofE To do this, I basically steal a bunch of information from the Kaiser Family Foundations WMI Mutual Every few years, I write an article about employer-sponsored health insurance benefits Insurance Company in the U.S.& WMI TPA annual report (and a few other sources), and I compile various metrics that I hope will give em-ployers a sense of how their company benefits compare to those of similar businesses. With fierce competition for employees, and wages and benefits driving compensation packages to an all-time high, it is my hope that interested employers and their HR teams might find some helpful infor-mation that will give them a competitive advantage in the battle to hire talent.The Kaiser Family Foundation (KFF) annual employee benefitAmongst companies with 200+ workers, 99% offered health ben-survey is an excellent and detailed summary of employer-spon- efits. For small employers with 3-199 workers, only 55% offered sored health insurance benefits in the U.S. The entire report cana health benefit plan. Overall, 57% of all surveyed companies be found at https://www.kff.org/health-costs/report/2020-employ- provide health benefits to their employees (see, Graph 1).er-health-benefits-survey/, and it is loaded with more informationGraph 1than you could possibly need. In accordance with the KFF cita-* This graph was compiled with information and datafrom the KFF survey.tion and reprint policy, I am using their materials freely and with full attribution. Important Note: If your companys benefit plan is grandfathered or transitional under the Affordable Care Act (the ACA or Obamacare), you should be aware that any changes to your plan will most likely result in forfeiture of that preferential status. Since I believe grandfathered and transitional status under the ACA is extremely beneficial to employers and employees alike, I would strongly recommend that you preserve your companys pre-Obamacare status if at all possible. Employee Health Insurance Plans: Employer-sponsored health insurance programs cover nearly half of the non-elderly popula-tion in the U.S. (approximately 157 million Americans). While benefit programs and insurance plans vary significantly, they have a few very important features in common: they are offered by employers to ensure that workers and their families can haveHealth Benefits by Plan Type: As has been the case for decades, meaningful access to health care, they protect employees from thePreferred Provider Organization (PPO) plans remained the financial strife or ruin that can result from catastrophic illness ormost common type of plan offered by U.S. employers. These injury, and they are an extremely important part of the compensa- plans are generally viewed as the most user friendly because they tion package of most employees. allow members to use any provider they want, but they pay a Health Benefits by Employer Size: One of the most accuratehigher benefit if the member uses a preferred in-network provider. predictors of the type and level of employer-sponsored benefitsOf all benefit programs offered by employers, 47% are PPO (and the amount an employer contributes to those benefits) isplans. About 13% of employers provide their benefits through company size. The KFF study breaks employer groups into twomore restrictive Health Maintenance Organization (HMO) main categories: (1) small employers; and (2) large employers.plans, which generally limit members to a closed panel of provid-Small employers are defined as companies with 3-199 work- ers and only cover out-of-network providers in the event of an ers, while large employers are defined as companies with 200+emergency. High deductible health plans (which are generally workers. As a general rule, larger companies offer more generousused in conjunction with health savings accounts (HSAs) rose health insurance benefits than smaller companies, and they usu- to 31% of all offered plans, and certain other relatively uncom-ally pay a higher portion of the premium. mon plans made up the balance (e.g., point-of-service (POS) and indemnity plans) (see, Graph 2).20 www.wpma.com / Autumn 2021'