California Health Care Almanac | California Employer Health

41 Pages·2011·1.85 MB·English

california
Health Care Almanac
California Employer Health Benefits Survey
december 2011
California Employer Health Benefits
overview
Introduction
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employer-based coverage is the leading source of health insurance in California and nationally. Changes in coverage contents
offerings, worker cost sharing, and benefits have major implications for millions of Californians. this report presents the
overview .................................3
highlights of the 2011 California Employer Health Benefits Survey, annual research that tracks changes in employer-based
Coverage availability .....................4
health benefits in the state over time.
Cost of Health insurance ..................9
Key findings include:
Benefits and Cost sharing .............. 16
• since 2002, premiums rose 153.5%, more than five times the 29.3% increase in California’s inflation rate.
Plan enrollment and Choice ............ 27
• the proportion of California employers offering coverage declined from 73% to 63% over the last two years.
employer Views and Practices .......... 31
• Premiums were higher in California than nationally for both single and family coverage. However, the employer
contribution in California was significantly higher than the national average. Methodology ........................... 41
• annual premiums for single coverage in California were $5,970, compared to $5,429 nationally.
family coverage premiums were $15,724 in California and $15,073 nationally.
• employers in California contributed $5,213 annually for single coverage and $11,921 for family coverage.
• Workers in small firms in California were significantly more likely to cover at least half of the premium for family
coverage than workers in large firms.
• enrollment in plans with a deductible of $1,000 or more for single coverage leveled off for California workers in
2011, but has increased considerably in recent years for small firms. twenty-seven percent of workers in small
firms have a deductible of $1,000 or more, up from just 7% in 2006.
• twenty-five percent of California firms either reduced benefits or increased cost sharing for employees in the
past year, while 22% increased employees’ share of the premium (compared to 15% in 2010).
• thirty-six percent of California firms say they are “very” or “somewhat” likely to increase the amount workers
pay for premiums in the coming year.
additional information on the project methodology is available at the end of the presentation on page 41.
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©2011 California HealtHCare foundation
California Employer Health Benefits
overview
Employers, Workers, and Covered Workers,
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by Firm Size, California vs. the United States, 2011*
california firms with three
number of worKers to 49 workers accounted for
 3 to 9  10 to 49  50 to 199  200 to 999  1,000+
91% of employers but just
Employers 2%1%
27% of all workers and 21%
California 60% 31% 6%
of covered workers.
61% 32% 6%
US
<1%
Workers
9% 18% 15% 13% 45%
California
8% 17% 14% 14% 48%
US
Covered Workers
California 5% 16% 14% 13% 51%
5% 13% 14% 15% 53%
US
*tests found no statistically different distributions between california and the united states.
note: in this report, numbers may not add up to 100% due to rounding.
sources: california Healthcare foundation/norc california employer Health benefits survey: 2011. author analysis of data from the Kaiser/Hret survey of employer-sponsored Health benefits: 2011.
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©2011 california HealtHcare foundation
California Employer Health Benefits
coverage availability
Employers Offering Coverage,
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California vs. the United States, 2000 – 2011
the offer rate for employers
declined significantly from
100%
73% to 63% over the last
90%
two years. this is a departure
80% from previous years and
73%
69% 70% 71% 70% 71% 71% 70% 69%
67% 67% could be an early sign of
70% 63% California
68% 68% 69% future changes.
66% 66%
60% 63% 63%
60% 61% 59% 59% 60% United States
50%
40%
30%
20%
10%
0%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010* 2011*
*us estimates are statistically different from the previous year shown.
sources: california Healthcare foundation (cHcf)/norc california employer Health benefits survey: 2007– 2011. cHcf/Hsc california employer Health benefits survey: 2005 – 2006. cHcf/Hret california
employer Health benefits survey: 2004. Kaiser/Hret california employer Health benefits survey: 2000 – 2003. Kaiser/Hret survey of employer-sponsored Health benefits: 2000 – 2011.
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©2011 california HealtHcare foundation
California Employer Health Benefits
Coverage availability
Employers Offering Coverage,
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by Firm Characteristics, California, 2011
the probability of
employers offering
All Firms
63% coverage varied widely
by firm characteristics.
Lower-Wage Firms*
42% only 42% of lower-wage
Higher-Wage Firms* firms offered health benefits
66%
in 2011, versus 66% of
Many Part-Time Workers*
higher-wage ones.
41%
Fewer Part-Time Workers*
70%
At Least Some Union Workers
84%
No Union Workers
61%
0 17 34 51 68 85
*estimates are statistically different between lower- and higher-wage firms, and between many and fewer part-time workers.
notes: lower-Wage firms are defined as those in which at least 35% of workers earn $23,000 or less per year. Higher-Wage firms are those in which less than 35% of workers earn $23,000 or less.
Many Part-time Workers are firms in which at least 35% of workers work part-time. fewer Part-time Workers are first in which less than 35% work part-time.
source: California HealthCare foundation/norC California employer Health Benefits survey: 2011.
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©2011 California HealtHCare foundation
California Employer Health Benefits
coverage availability
Employers Offering Coverage,
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by Firm Size, California vs. the United States, 2011*
slightly more than half of
california’s smaller firms
 California  United States
(three to nine workers)
100
99% 99%
98% 98% provided coverage in 2011,
93%
91%
while the vast majority
80
of larger firms did so.
74% 74%
offer rates were generally
60
63% comparable in california
60%
and the nation.
53%
48%
40
20
0
All Firms 3 to 9 10 to 49 50 to 199 200 to 999 1,000+
Number of Workers
*tests found no statistically different estimates between california and the united states.
sources: california Healthcare foundation/norc california employer Health benefits survey: 2011. author analysis of data from the Kaiser/Hret survey of employer-sponsored Health benefits: 2011.
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©2011 california HealtHcare foundation
California Employer Health Benefits
coverage availability
Employee Eligibility, Take-Up Rates, and Coverage,
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California vs. the United States, 2011
nearly 80% of california
employees working in firms
 California  United States
100 offering coverage were
eligible for health benefits,
and 85% of those elected
80
85%
to enroll. overall 67% of
81%
79% 79%
all employees received
60
67% coverage from their firm.
65%
40
20
0
Employees Who Are Eligible Eligible Employees Employees Covered
Who Take Up Coverage*
*estimates are statistically different between california and the united states.
sources: california Healthcare foundation/norc california employer Health benefits survey: 2011. Kaiser/Hret survey of employer-sponsored Health benefits: 2011.
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©2011 california HealtHcare foundation
California Employer Health Benefits
coverage availability
Worker Coverage Rates, Among Offering Firms,
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by Firm Size, California, 2003–2011, Selected Years*
insurance coverage rates
 2003
have been fairly stable
All Firms  2005
69%  2007 since 2003.
65%
 2009

66%  2011

65%
67%
Small Firms (3 to 199 workers)
73%
73%
71%
67%
66%
Large Firms (200+ workers)
66%
60%
63%
64%
67%
0 10 20 30 40 50 60 70 80
*tests found no statistically different estimates from previous year shown within firm size.
sources: california Healthcare foundation (cHcf)/norc california employer Health benefits survey: 2007, 2009, and 2011. cHcf/Hsc california employer Health benefits survey: 2005.
Kaiser/Hret california employer Health benefits survey: 2003.
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©2011 california HealtHcare foundation
California Employer Health Benefits
cost of Health insurance
Average Increases in Premiums, Family Coverage,
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by Product Enrollment Status, California vs. the United States, 2011
among california firms that
offered the same health
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plan or plans in 2010 and
2011 (fixed enrollment), the
9.5%
8 average family coverage
9.1%
premium increase for those
8.1%
plans was 8.1%.
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When the calculation
includes california firms
4
that changed plans or had
workers who switched plans
2 (variable enrollment), the
average family premium
increase was 9.1%.
0
California California United States
(fixed enrollment) (variable enrollment) (variable enrollment)
sources: california Healthcare foundation/norc california employer Health benefits survey: 2011. Kaiser/Hret survey of employer-sponsored Health benefits: 2011.
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©2011 california HealtHcare foundation
California Employer Health Benefits
cost of Health insurance
Premium Increases Compared to Inflation, Family Coverage,
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California, 1999–2011
Health insurance premiums
for family coverage in
18%
california grew by 8.1%
15.8%*
16%
in 2011, statistically
13.4%*
14% unchanged in recent years.
11.4%* Premiums continue to
12%
10.0%* Premiums rise much faster than the
10%
8.7%
8.2%* 8.3% 8.3%
8.1% 8.1% california inflation rate.
7.5%
8%
6.7%
6% 4.8%
Overall Inflation
4%
3.5%
3.1%
2%
0%
-2%
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
*estimates are statistically different from the previous year shown.
sources: california Healthcare foundation (cHcf)/norc california employer Health benefits survey: 2007–2011. cHcf/Hsc california employer Health benefits survey: 2005–2006; cHcf/Hret california
employer Health benefits survey: 2004. Kaiser/Hret california employer Health benefits survey: 1999 – 2003. california division of labor statistics and research, consumer Price index, california average of
annual inflation (april to april) 1999 – 2011.
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©2011 california HealtHcare foundation