Preliminary Findings From the 2011 Ohio Employer Health Benefits Survey

Transcription

1 Preliminary Findings From the 2011 Ohio Employer Health Benefits Survey Prepared by the Ohio Family Health Survey Research Team July 29, 2011 Hosted by: The Mid-Ohio Foodbank Grove City, Ohio

2 Presentation Outline 1. Survey background 2. Offer rates, eligibility, and participation 3. Plans offered 4. Premiums & out-of-pocket expenses 5. Which employers insure workers and their dependents? 6. Health insurance costs as a share of resources 7. Conclusions

3 Background The 2011 Ohio Employer Health Benefits Survey (OEHS) is the business complement to the 2008 and 2010 Ohio Family Health Surveys (OFHS). The purpose of the 2011 OEHS is to examine the characteristics of employers who offer and do not offer health insurance benefits.

4 Background The four primary benefits of the OEHS are: 1. To provide data that will address the health care reform needs of Ohio s business community; 2. To provide employer-oriented data as a match to the findings of the 2008 and 2010 OFHS; 3. To provide data that uniquely informs how varying sizes of employers are addressing pressures related to health insurance; and 4. To provide data that can be compared to other data sources that track Ohio s economic and job trends. 4

5 Background: Survey Topics Employer-sponsored health insurance status Benefit package characteristics Employee health assistance offerings Financial burden related to health benefits Demographics (e.g., # employees, annual revenues, and geographic location)

6 Survey Methodology The OEHS used a methodology similar to the national Medical Expenditure Panel Survey Insurance Component collected by AHRQ. Employers were randomly selected from a list maintained by ODJFS within strata defined by: Size (2-10, 11-49, , and 250 employees) County type (Appalachian, metropolitan, rural non- Appalachian, and suburban counties)

7 Survey Methodology Employers were initially contacted by phone. The most informed individual was asked about the basic characteristics of the business and whether it offers insurance coverage to employees. Mail questionnaires were used to collect the data. 7

8 Survey Methodology 2,289 usable surveys were returned, yielding a 31% response rate. For this report, we dropped employers with employees outside of Ohio. All participating employers received an individual report summarizing responses to employers of similar size and to overall statewide results. Qualitative interviews were conducted with a sample of employers in Central and SE Ohio. 8

9 2011 Ohio Employer Health Benefits Survey Preliminary Findings

10 Key Findings: Offer rates, eligibility, and participation 60% of responding Ohio employers offer some form of employersponsored group health insurance plan. Rural areas have lower offer rates, public entities have higher rates, and large employers with 250+ employees have the highest offer rates. Among employers that offer insurance, an average of 81% of employees are eligible to participate. Only 23% of part-time workers and 4% of seasonal workers are eligible to participate in the employer s group plan. Participation among eligible workers is relatively constant across all employer types. 77% of workers who are eligible to participate in their employer-sponsored plan elect to take-up that coverage. Participation is higher for public (83%), metropolitan (77%), and large employers (81%).

11 Key Findings: Offer rates, eligibility, and participation Percent of employers offering health insurance 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Ohio For profit Not-forprofit Public

12 Key Findings: Offer rates, eligibility, and participation Among employers that offer insurance, percent of all eligible w orkers 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Ohio For profit Not-forprofit Public

13 Key Findings: Offer rates, eligibility, and participation Percent of eligible em ployees that participate in plan 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Ohio For profit Not-forprofit Public

14 Key Findings: Plans offered Few Ohio employers offer more than one group insurance plan. 72% offer one plan, and 20% offer two plans. 33% of employers with over 250 employees offer two plans and 23% offer three or more group plans. The largest plan was a PPO at 59%, and 26% of employers reported a high deductible plan as their preferred option (NOTE: high deductible was defined by each respondent). HMOs and Conventional/Traditional Indemnity insurance have become uncommon, with only 7% of employers reporting that those plans are the largest. 14

15 Key Findings: Plans offered The percent of employers whose largest plan is PPO, high deductible, or other 100% 90% 80% 70% 60% 50% 40% PPO High Deductible Other 30% 20% 10% 0% Ohio For profit Not-for-profit Public 15

16 Key Findings: Plans offered The percent of employers w hose largest plan is PPO, high deductible, or other 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% PPO High Deductible Other NOTE: There were not enough other types at 250+ employees to report an estimate. 16

17 Key Findings: Premiums & outof-pocket expenses The median employer in Ohio offering a health plan pays $5,040 per year for employee-only coverage and $12,960 for family coverage. The typical employer requires employees to pay 20% of the premium for employee only plans and 28% for family plans. The average HDHP with an HSA requires a $3,076 annual deductible per person while those without an HSA requires a $2,801 deductible. The average indemnity plan requires a $1,627 per person deductible. The average HMO plan require a $20 co-payment for a physician s office visit, while PPO plans require $22 for an in-network office visit and $33 for an out-of-network office visit. The average employer-sponsored PPO requires the worker to pay 17.5% of each bill paid by the insurance plan (the insurance plan pays the other 82.5%). 17

18 Key Findings: Premiums & outof-pocket expenses Total annual premium (in dollars) $18,000 $16,000 $14,000 $12,000 $10,000 $8,000 Single Coverage Family Coverage $6,000 $4,000 $2,000 $0 Ohio For profit Notforprofit Public

19 Key Findings: Premiums & outof-pocket expenses Percent of total premium paid by the employee 50% 45% 40% 35% 30% 25% 20% 15% Single Coverage Family Coverage 10% 5% 0% Ohio For profit Notforprofit Public

20 Key Findings: Premiums & outof-pocket expenses Average annual deductible per person (in dollars) $3,500 $3,000 $2,500 $2,000 $1,500 Conventional/Traditional Indemnity Plan High Deductible w ith HSA High Deductible w ithout HSA $1,000 $500 $0 Ohio NOTE: There were not enough high deductible without HSA responses among 250+ employees to report an estimate. 20

21 Key Findings: Premiums & outof-pocket expenses Average copayment (in dollars) for an office visit $40.00 $35.00 $30.00 $25.00 $20.00 $15.00 HMO PPO In-Network PPO Out-of-Network $10.00 $5.00 $0.00 Ohio For profit Not-for-profit Public NOTE: There were not enough HMO responses among 250+ employees to report an estimate. 21

22 Key Findings: Premiums & outof-pocket expenses Average coinsurance (percent), PPO 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Ohio For profit Not-forprofit Public

23 Key Findings: Which employers insure workers and their dependents? Statewide, the average employer insures a total of 1.2 workers and dependents per employee. Public employers insure more Ohioans than for-profit and not-for-profit employers. Employers with over 250 employees insure the most workers and dependents, covering 1.6 lives per employee. Statewide, few very small employers (2-10 employees) reported having an uninsured worker, even if they do not offer health insurance. Only 9.3% of very small employers offering health insurance report having any uninsured workers. Only 32% of very small employers not offering health insurance reported having any uninsured workers. 23

24 Key Findings: Which employers insure workers and their dependents? Lives covered as a share of total workers (ratio) Ohio For profit Not-forprofit Public

25 Key Findings: Which employers insure workers and their dependents? Among employers with 2-10 employees, estimated percent of employers with at least one employee receiving the various sources of insurance Offer insurance Do not offer insurance Any Uninsured Employees? 9.3% 31.9% Any Employees with Public Insurance? 15.3% 28.1% Any Employees insured through a Spouses Employer? 39.5% 67.5% Any Employees with Private Insurance, including employer s plan? 62.3% 47.8% Any Employees with Unknown Insurance Status? 11.8% 27.2% 25

26 Key Findings: Health insurance costs as a share of resources The average employer in Ohio offering health insurance spends $4,683 on health insurance for every employee they hire. Health insurance requires 13% of the average employer s total compensation expenses. Health insurance as a share of total compensation was highest for public employers (15.8%) and employers with 250 or more employees (14.5%). The average employer offering health insurance spends 4.6% of total revenues (not profits) on health insurance for its employees. Public and large employers with 250 or more workers dedicate higher proportions of their revenue to health insurance costs (7.0% and 6.9%, respectively). 26

27 Key Findings: Health insurance costs as a share of resources Health insurance expenditures (in dollars) per employee $8,000 $7,000 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0 Ohio For profit Not-forprofit Public

28 Key Findings: Health insurance costs as a share of resources Health insurance expenditures as a share of total revenue and compensation (percent) 50% 45% 40% 35% 30% 25% 20% Total Revenue Total Compensation 15% 10% 5% 0% Ohio For profit Notforprofit Public

29 Implications for Medicaid A major goal of the OEHS is to assist with analysis and planning for the 2014 Medicaid expansions. Some key Medicaid trends: The expansions will fill coverage gap for part time and seasonal workers; More employers are resisting covering workers spouses; Medicaid will be a key alternative for dependent coverage Total health insurance expenditures require $4,683 per worker; Medicaid coverage will improve employment opportunities for: 1. Low income workers 2. Middle age workers with higher health expenditures 3. Benefits will be largest at small businesses

30 Conclusions Several key statistics emerge from the OEHS findings: 60% of Ohio employers offer an employer-sponsored insurance plan; 81% of workers are eligible to participate in the insurance plan; On average, total health insurance expenditures requires 13% of all compensation expenses, or $4,683 per worker The total health insurance premium costs on average $5,052 in Ohio (employer and employee contributions); The average employer requires its workers to pay 20% of the total insurance premium for employee-only coverage; 28% for family coverage; 54% of employers not offering insurance responded they did not offer because it was too expensive and 46% did not offer because their employees already had coverage.

31 2011 Ohio Employer Health Benefits Team The OEHS Research Team expresses gratitude to the many people who contributed their time and energy to lead the process and review the 2011 Ohio Employer Health Benefits Survey. Eric Seiber, Ph.D., The Ohio State University College of Public Health Amy Ferketich, Ph.D., The Ohio State University College of Public Health Bo Lu, Ph.D., The Ohio State University College of Public Health Timothy R. Sahr, MPH, MA, MDiv, ThM, Government Resource Center Rachel Tumin, Government Resource Center Daniel Weston, MBA, Government Resource Center Barry Jamieson, MS, Government Resource Center David Dorsky, Ohio Department of Job and Family Services Donald Reed, Ph.D., Ohio Department of Health Carol Carstens, Ph.D., Ohio Department of Mental Health Chris Brock, Ohio Department of Insurance Matthew Denker, MBA, ICF-Macro

32 Initial results from the OEHS are available in this report and through data fact sheets and analyses located at the Ohio Colleges of Medicine Government Resource Center website at Additional analyses and the OEHS data will be available starting in August 2011 through the Government Resource Center website. Questions and assistance relating to this report and posted materials should be directed to the Government Resource Center in the care of Timothy R. Sahr or Barry Jamieson To become a sponsor of the 2012/13 Ohio Family Health Survey please contact Lorin Ranbom at , lorin.ranbom@osumc.edu