More Workers Face Annual Deductibles In Health Plans

from Spencer’s Benefits Reports: Employees who obtain health care coverage through their employers are significantly more likely to face a general annual deductible than they were in 2006, and the average deductible has nearly doubled in those six years, according to the Kaiser Family Foundation. In 2012, 72 percent of covered workers faced a general annual deductible, up from 52 percent of workers in 2006. Among workers facing an annual deductible, the average deductible for single coverage across all types of plans was $1,097 in 2012, up from $584 in 2006. The study, The Prevalence and Cost of Deductibles in Employer Sponsored Insurance, is based on information from the 2012 Employer Health Benefit Survey.

According to Kaiser, the number of covered workers with a general annual deductible has increased both because of shifts in enrollment patterns among plan types as well as the increasing prevalence of deductibles within plan types. For example, there are differences in the use of deductibles among plan types; deductibles are much more common for workers enrolled in preferred provider organizations (PPOs) than for workers enrolled in health maintenance organizations (HMOs). Since 2006, the percentage of workers enrolled in plan types which are less likely to require a deductible, such as HMOs, has decreased (from 20 percent to 16 percent) and enrollment in high-deductible health plans with savings options (HDHP/SOs; such as a health reimbursement arrangement (HRA) or health savings account (HSA)) has increased from 4 percent to 19 percent.

In addition, Kaiser noted that there has been a significant increase in the prevalence of deductibles for covered workers enrolled in each plan type since 2006. For example, in 2012, 77 percent of covered workers enrolled in a PPO plan had a general annual deductible for single coverage, compared to 69 percent in 2006. General annual deductibles also have become common for workers enrolled in HMO plans, growing from 12 percent of workers enrolled in an HMO plan in 2006 to 30 percent in 2012.

Deductibles Increasing

More workers are facing a deductible, and the amount of deductibles has steadily increased since 2006, Kaiser found. Since 2006, the average general annual deductible among covered workers who have a deductible for single coverage has increased for each plan type. Overall, the average general annual deductible is $1,097 for covered workers enrolled in a single coverage plan requiring a deductible; an increase of 88 percent since 2006, with significant annual increases in four of the last five years.

The growing prevalence and amount of deductibles has resulted in an increasing percentage of covered workers enrolled in a plan with high deductibles, Kaiser noted. In 2012, 34 percent of covered workers were enrolled in a plan with a deductible of a $1,000 or more compared to 10 percent in 2006, and 14 percent were enrolled in a plan with a deductible of $2,000 or more compared to 3 percent in 2006. The study also found that in 2006, 50 percent of workers had a deductible between $250 and $665. In 2012, 50 percent of workers had a deductible between $417 and $1,500.

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