Employer Health Benefits 2012 Report

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December 4th, 2012

The Kaiser Family Foundation has recently released the 2012 Employee Health Benefits Annual Survey.  This report is an in depth analysis of employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information.  2012’s report included surveys of 3,326 randomly selected public and private firms with three or more employees.

Results indicate that annual premiums for employer-sponsored family health coverage reached $15,745, an increase of 4 percent from last year. While this increase is moderate by historical standards, it still outpaced the growth of workers’ wages (1.7%) and general inflation (2.3%).  Workers at lower-wage firms on average pay $1,000 more each year through paycheck deduction for family coverage than workers at higher-wage firms ($4,977 and $3,968, respectively).  This occurs even though the firms with many lower-wage workers on average pay less in total premiums for family coverage than firms with many higher-wage workers ($14,694 and $16,427, respectively).

Average Premium Costs for 2012

Below we’ve highlighted some significant details of the benefits survey:

Health Insurance Premiums

The average premium for single coverage ($5,615) is 3% higher and the average premium for family coverage ($15,745) is 4% higher than 2011.

  • $5,588/year for single coverage within a small firm (3 - 199 employees)
  • $5,628/year for single coverage within a large firm (200+ employees)
  • $15,253/year for family coverage within a small firm
  • $15,980/year for family coverage within a large firm

Employee Contributions

Covered workers contribute on average 18% of the premium for single coverage and 28% of the premium for family coverage, the same percentages they contributed in 2011. The average annual premium contributions in 2012 are $951 for single coverage and $4,316 for family coverage.

  • $848/year for single coverage within a small firm
  • $1,001/year for single coverage within a large firm
  • $5,134/year for family coverage within a small firm
  • $3,926/year for family coverage within a large firm

Plan Enrollment

Enrollment distribution varied by size of firm, with PPOs found to be the most common plan type.

  • 56% are enrolled in a PPO.
  • 19% are enrolled in an HDHP/SO.
  • 16% are enrolled in an HMO.
  • Less than 1% are enrolled in a conventional plan.

Employee Cost Sharing

Most covered workers face additional plan costs through copayments, deductibles or coinsurance.

  • 77% in PPOs have a general deductible to be met before any or most services will be reimbursed by their plan.
  • 60% in POS plans have general deductible requirements to meet before reimbursement.
  • Only 30% in HMOs have a general deductible.


Average Deductible Amounts

  • $733 deductible for single coverage for workers in PPOs.
  • $691 deductible for single coverage for workers in HMOs.
  • $1,014 deductible for single coverage for workers in POS plans.
  • $2,086 deductible for single coverage for workers in HDHP/SOs.

Primary Care Costs

For in-network office visits, the average copayment for primary care is $23 and $33 for specialty care.  The average coinsurance is 18% for primary care and 19% for specialty care.

Emergency Room Costs

58% of covered employees have an emergency room copayment of about $118, and 22% have coinsurance payment requirements.

Prescription Costs

About 99% of covered workers who have prescription drug coverage experience cost sharing for prescriptions.  78% have copayments in three or more tiers:

  • $10 copayment for first-tier drugs
  • $29 copayment for second-tier drugs
  • $51 copayment for third-tier drugs
  • $79 copayment for forth-tier drugs

Employer Sponsored Availability

61% of firms offer health benefits to their employees. Only 50% of employers with 3-9 employees offer coverage, while almost all employers with 1,000 or more employees offer coverage to a portion, if not all of their employees.

Retiree Coverage

25% of large firms that offer health benefits, offer retiree health benefits. Among those, 88% offer health benefits to early retirees, 74% to Medicare-age retirees and 5% for exclusively prescription drugs.


Employers continue to offer wellness programs for their employees to benefit from.

  • 18% of employers ask employees to complete health assessments
  • Among that 18%, 63% provide a financial incentive to employees
  • 11% require employees with an identified health risk to complete a wellness/health management program to avoid financial penalty
  • 9% reward or penalize employees financially based on whether certain health outcomes are met.

Wellness Programs Offered

  • Weight Loss Programs
  • Gym Membership Discounts/ On Site Facilities
  • Biometric Screening
  • Smoking Cessation Programs
  • Personal Health Coaching
  • Nutrition/Healthy Living Classes
  • Web Resources for Health Living
  • Wellness Newsletter

For further detail on the health benefits information gathered by the Kaiser Employee Health Benefits Annual Survey, please visit http://ehbs.kff.org/ for the full survey.