Employer health plans need a makeover

Are you satisfied with your health benefits plan? That’s one of the many questions asked of over 2,000 employers, running large and small businesses, by the annual survey from KFF. Approximately 153 million workers and their families receive health benefits from employers in the U.S. Therefore, the survey results offer a window on the current satisfaction (or lack thereof) of health plans, whether by self-insured entities or as part of a comprehensive benefits package offered by non-federal public and private firms.

As you might expect, employers have experienced rising costs for health benefits beyond the rate of inflation over the past several years. While the percentage of costs assumed by employees has remained relatively constant (around 25 percent), the costs of premiums, deductibles, and co-pays have risen. Given the low level of unemployment and the need to retain workers, employers are shouldering most of the increases. This trend affects businesses that fully insure their health benefits and those that contract with health insurance companies and their associated physician networks.

The most striking observation from the survey was the section “Employer Perception of Enrollee Satisfaction.” In the following four categories, employers acknowledge “moderate to high” concern by employees: appointments 49 percent; prior authorization 47 percent; finding in-network providers 26 percent; and affordability of cost sharing 58 percent. These numbers reflect managers’ perceptions of their employees’ concerns without regard to the actual survey results of the employees themselves. It is safe to conclude that such employer perceptions are derived from those employees brave enough to speak out on these issues to management. I would wager that a much higher percentage of workers are not just concerned but unsatisfied regarding issues of access and cost.

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