b' Wordw w w. w m i m u t u a l . c o mCompany Health Insurance BenefitsHOW DO YOURS COMPARE?Its that time again time to review the annual em- In the large employer group, 99% offeredBy David Leo,ployee benefit survey that was recently published by the Kaiserhealth benefits in 2021. In contrast, onlyPresident ofFamily Foundation (KFF). As employers struggle to balance58% of small employers offered a healthWMI Mutualinflationary pressures and to attract employee talent, its im- benefit plan (an increase of 3% over theInsurance Companyportant to know how company health benefits compare to whatprior year). Overall, 59% of all surveyed& WMI TPA is being offered by competition. The entire KFF survey can becompanies provide health benefits to their found at https://www.kff.org/report-section/ehbs-2021-section- employees. This represents an increase of 2% over the 2020 rate 1-cost-of-health-insurance, but for those of you who want the(see Graph 1).CliffsNotes version, here it is. Graph 1*In accordance with the KFF citation andHealth Benefits reprint policy, I am using their materialsby Plan Type: In freely and with full attribution. Impor- 2021, 75% of tant Note: If your companys benefitfirms that offered plan is grandfathered or transitionalhealth benefits under the Affordable Care Act (theoffered only one ACA or Obamacare), you shouldtype of health be aware that any changes to your planplan. As has been will most likely result in forfeiture ofthe case for de-that preferential status. Since I believecades, Preferred grandfathered and transitional statusProvider Organi-under the ACA is extremely beneficialzation (PPO) to employers and employees alike, plans remained I would strongly recommend that the most com-you preserve your companys pre- mon type of plan Obamacare status if at all possible.covering U.S. Employee Health Insurance Plans: According to employees. These plans are generally viewed as the most user eHealthInsurance.com, employer-sponsored health insurancefriendly because they allow members to use any provider they programs cover 49% of the non-elderly population in the want, but they pay a higher benefit if the member uses a pre-United States (approximately 156 million Americans). Whileferred in-network provider. Among firms offering health ben-benefit programs and insurance plans vary significantly, theyefit plans, 67% of all workers are covered by a PPO plan. By have a few very important features in common: they arecomparison, only 23% of workers are covered under a more offered by employers to ensure that workers and their fami- restrictive Health Maintenance Organization (HMO) plan, lies can have meaningful access to health care; they protectwhich generally limits members to a closed panel of providers employees from the financial strife or ruin that can result fromand only covers out-of-network providers in the event of an catastrophic illness or injury; and they are an extremely impor- emergency. High deductible health plans (which are generally tant part of the compensation package of most employees. used in conjunction with health savings accounts (HSAs)) may be offered in conjunction with PPO plans or HMO plans Health Benefits by Employer Size: One of the most accurate(or other types of coverage). Approximately 58% of workers are predictors of the type and level of employer-sponsored benefitscovered under these types of plans (see Graph 2).(and the amount an employer contributes to those benefits) isHealth Benefit Cost and Employer Contribution: In 2021, the company size. The KFF study breaks employer groups intoaverage annual premium for employer-sponsored healthtwo main categories: (1) small employers (i.e., those withinsurance coverage was $7,739 for single coverage and 3-199 workers); and (2) large employers (i.e., those with 200+$22,221 for family coverage, increases of 3.6% and 4.1% workers). As a general rule, larger companies offer more gen- respectively. On average, workers contributed $1,296 (16.7%) erous health insurance benefits than smaller companies, andtoward the cost of single coverage and $5,964 (26.8%) for they usually pay a higher portion of the premium. family coverage, both percentages up slightly over 2020. This 44 www.wpma.com / Winter 2022'