Summary of the 2023 Employer Health Benefits Annual Survey
Nov 26, 2023
Summary of the 2023 Employer Health Benefits Annual Survey

Each year, the Kaiser Family Foundation conducts a survey to examine employer-sponsored health benefits trends. This article summarizes the main points of the 2023 Employer Health Benefits Survey.


Health Insurance Premiums

In 2023, the average premiums for employer-sponsored health insurance were $8,435 for single coverage and $23,968 for family coverage. The average single and family premiums increased by 7% over the last year, which was faster than the previous year (2% and 1%, respectively). Premiums for 2023 were expected to increase more in recent years since many 2022 premiums were locked in months before inflation became a significant concern.


Additionally, the Kaiser report notes an increase of 5.2% in workers’ wages and inflation of 5.8%. The average premium for family coverage has risen 22% over the last five years, compared with a 27% increase in workers’ wages and 21% inflation.


Premiums under high deductible health plans with savings options (HDHP/SOs) were still lower than the average premium. HDHP/SOs’ annual premiums for single and family coverages were $7,753 and $22,344, respectively.


Conversely, on average, the premiums for workers enrolled in preferred provider organization (PPO) plans were higher than others. The average PPO premium was $8,906 for single coverage and $25,228 for family coverage in 2023.


Worker Contributions

The average worker contribution toward the premium was 17% for single coverage and 29% for family coverage in 2023, similar to 2022 percentages.


In terms of dollar amounts, workers contributed $1,401 and $6,575 toward their premiums for single coverage and family coverage in 2023, respectively. Once again, these numbers were similar to 2022 figures but greater than five years ago.


Plan Enrollment

Enrollment figures were reasonably similar to last year’s. The following were the most common plan types in 2023:


  • PPOs: 47% of workers covered
  • HDHP/SOs: 29% of workers covered
  • Health maintenance organizations (HMOs): 13% of workers covered
  • Point-of-service (POS) plans: 10% of workers covered
  • Conventional (indemnity) plans: 1% of workers covered


Self-funding

In the past few years, self-funded plans have become more popular. Many large organizations self-fund or pay for some or all health services for their workers directly from their own funds rather than purchase health insurance. In 2023, 65% of covered workers—including 18% at small firms and 83% in large firms—are enrolled in self-funded plans. The percentage of covered workers in self-funded plans in 2023 was similar to 2022.


Employee Cost Sharing

Most workers must pay a share of their health care costs, and the average deductible for single coverage was $1,735 in 2023, similar to last year’s number. The average annual deductible has increased 10% over the past five years and 53% over the past decade. The percentage of covered workers with a general deductible of $2,000 or greater for single coverage has increased by 5% over the last five years.


Beyond deductibles, most workers cover some portion of the costs of their health care services. For example, 63% of covered workers had coinsurance, and 10% had a copay for hospital admissions. The average hospital admission coinsurance rate was 20% in 2023; the average payment amount is $404.


In addition, nearly all workers are covered by a plan with an out-of-pocket maximum (OOPM), but the costs vary considerably. Among covered workers with single coverage, 13% had an OOPM of less than $2,000, and 21% had an OOPM of $6,001 or more.


Availability of Employer-sponsored Coverage

While nearly all large firms (those with 200 or more workers) offer health benefits to at least some workers, small firms (three to 199 workers) are significantly less likely to do so. In 2023, 53% of all firms offered some health benefits, which was similar to last year’s percentage (51%).


Although the vast majority of workers are employed by firms offering health benefits, many aren’t covered by their employers. Some are not eligible to enroll, while others choose not for various reasons. Overall, 79% of workers are eligible for health benefits at firms that offer coverage, and 75% of eligible workers take up the organization’s offer. That works out to be 59% of workers at firms that offer health benefits enrolling in coverage.


Among firms that offer health benefits and firms that do not, 53% of all workers were covered by health plans offered by their employer. This is similar to last year’s percentage.


Health Promotion and Wellness Programs

Many firms have programs that help workers identify health issues and manage chronic conditions. The 2023 Kaiser report highlights the following programs:


  • Health risk assessments—Among organizations offering health benefits, 36% of small firms and 54% of large firms provided workers the opportunity to complete a health risk assessment, similar to last year. Among large firms that offer a health risk assessment, 59% used incentives or penalties to encourage workers to complete the assessment, higher than the percentage (50%) in 2022.


  • Biometric screenings—Similar to last year’s trend, in 2023, workers at 15% of small firms and 42% of large firms were given the opportunity to complete a biometric screening. Among large firms with a biometric screening program, 67% use incentives or penalties to encourage workers to complete the assessment. Although this is a larger share than last year (57%), it is not significantly different.


  • Health and wellness promotion programs—Organizations offer such programs to help employees improve their lifestyles and avoid unhealthy habits. Most employers—62% of small and 80% of large—offered a program in at least one of these areas: smoking cessation, weight management, and behavioral or lifestyle coaching. These figures are similar to those of last year.


  • Disease management programs—Among organizations that offer health benefits, 36% of small firms and 64% of large firms offer disease management programs to improve employee health and reduce enrollees’ costs for certain chronic illnesses. These programs aim to educate workers about their disease and suggest treatment options.


Telemedicine

Large firms are more likely than small firms to cover telemedicine services. In 2023, 91% of large employers with 50 or more workers covered health care services through telemedicine in their largest health plan, similar to last year. While small firms are more likely than large firms to provide telemedicine services only through their health plan, large firms are more likely to provide telemedicine services through a specialized telemedicine provider.


Since the COVID-19 pandemic officially ended, medical services are now generally available in person, and many employees have partially or fully returned to their workplaces. The Kaiser report highlighted how employers with 50 or more enrollees felt about the importance of telemedicine going forward. Overall, 28% of organizations believe telemedicine will be “very important” in providing access to enrollees in the future; another 32% say it’ll be “important.” While 41% of organizations say telemedicine will be “very important” in providing access to behavioral health services in the future, an additional 30% say it will be “important.” Fewer organizations feel that primary and specialty care—27% and 16%, respectively—will be “very important” in providing health care access.


Abortion Services

The U.S. Supreme Court decision in Dobbs v. Jackson, overturning Roe v. Wade, and subsequent state activity to regulate abortion has increased interest in coverage for abortion services in employer plans. In the 2023 survey, 32% of large firms (those with 200 or more workers) offering health benefits said that legally provided abortions are covered in most or all circumstances, and 18% said legally provided abortions are only covered under limited circumstances (e.g., rape, incest, or health or life endangerment of the pregnant enrollee). The majority of employers (40%) answered “Don’t know” to the prompt, perhaps reflecting the complexity of the issue and the changing landscape of state laws.


A small percentage (7%) of large firms offering health benefits provide or plan to provide financial assistance for travel expenses for enrollees who travel out of state to obtain an abortion if they do not have access near their home.


Conclusion

As expected, the average annual premiums for both single and family coverage significantly increased in 2023 as the economy impacts health benefits. Looking ahead, inflation and wages are projected to moderate over the next two years. Employers should begin identifying tools and resources to offset higher premiums and offer robust mental health support.


For more information on benefits offerings, contact us today.

Sign up for our newsletter.

DOL Announces Final Overtime Rule Increasing Salary Levels for White-collar Employees

30 Apr, 2024
On April 23, 2024, the U.S. Department of Labor (DOL) announced a final rule to amend current requirements employees in white-collar occupations must satisfy to qualify for an overtime exemption under the Fair Labor Standards Act (FLSA). The final rule will take effect on July 1, 2024. Increased Salary Level The FLSA white-collar exemptions apply to individuals in executive, administrative, professional, and some outside sales and computer-related occupations. Some highly compensated employees may also qualify for the FLSA white-collar overtime exemption. To qualify for this exemption, white-collar employees must satisfy the standard salary level test, among other criteria. This salary level is a wage threshold that white-collar employees must receive to qualify for the exemption. Starting July 1, 2024, the DOL’s final rule increases the standard salary level from: $684 to $844 per week ($35,568 to $43,888 per year); and $107,432 to $132,964 per year for highly compensated employees. On Jan. 1, 2025, the standard salary level will then increase from: $844 to $1,128 per week ($43,888 to $58,656 per year); and $132,964 to $151,164 per year for highly compensated employees. Automatic Updates The DOL’s final rule also includes mechanisms allowing the agency to automatically update the white-collar salary level thresholds without having to rely on the rulemaking process. Effective July 1, 2027, and every three years thereafter, the DOL will increase the standard salary level. The agency will apply up-to-date wage data to determine new salary levels. Impact on Employers The first salary level increase in July is expected to impact nearly 1 million workers, while the second increase in January is expected to affect approximately 3 million workers. Employers should become familiar with the final rule and evaluate what changes they may need to adopt to comply with the rule’s requirements. Legal challenges to the rule are anticipated, which may delay the final rule’s implementation.

New York Passes Prenatal Leave, Sets End Date for COVID-19 Leave

29 Apr, 2024
The recently enacted New York budget for fiscal year 2024-25 includes provisions mandating paid prenatal leave for the state’s workers, beginning Jan. 1, 2025, and repealing the New York COVID-19 sick leave law, effective July 31, 2025. Paid Prenatal Personal Leave The budget amends the state sick leave law by adding what is being touted as a first-in-the-nation requirement that all employers provide their employees with 20 hours of paid prenatal personal leave per 52-week period, starting Jan. 1, 2025. The amendment does not require employees to accrue the new leave, nor does it impose a waiting period before employees may use the leave; the full 20 hours must be made available on Jan. 1, 2025. Employees on leave must be paid their regular rate of pay or minimum wage if the applicable minimum wage is higher; however, employers are not required to pay out unused prenatal personal leave when an employee separates from employment. Permitted Uses of Prenatal Personal Leave Prenatal personal leave may be taken for health care services received by an employee during their pregnancy or related to the pregnancy, including physical examinations, medical procedures, monitoring and testing, and discussions with a health care provider related to the pregnancy. The new provisions do not require advance notification or documentation after the fact for using leave. Interaction With Paid Sick Leave and FMLA Leave The new requirement is in addition to the annual sick leave the law already mandates, which ranges from 40-56 hours and may be paid or unpaid, depending on the employer’s size and income. The amendment does not indicate that the leave runs concurrently with any federal Family and Medical Leave Act (FMLA) leave taken for prenatal care, meaning the state prenatal personal leave would be in addition to any FMLA leave taken for this purpose. Sunset Date for COVID-19 Leave The budget also establishes July 31, 2025, as the expiration date for New York’s COVID-19 employee sick leave law . The law took effect at the beginning of the COVID-19 pandemic, on March 18, 2020, and requires leave of up to 14 days, depending on the size and income of the employer. As with the regular sick leave law, whether leave must be paid also depends on the size and income of the employer. The sunsetting of the law comes in the wake of expired states of emergency and changed recommendations for isolation and quarantine. Steps for Employers New York employers should prepare for the start of paid prenatal personal leave in January 2025 and watch for any agency regulations and guidance implementing the new leave entitlement. Employers should also train managers and supervisors about the new requirements and make sure employee policies and handbooks are up to date. Employers should continue to allow COVID-19 sick leave when it applies and keep in mind that other leave requirements, such as paid sick leave, may allow employees to take time off from work for illness, including COVID-19.

FTC Announces Rule Banning Noncompetes

25 Apr, 2024
On April 23, 2024, the Federal Trade Commission (FTC) voted to issue a final rule that would ban noncompete agreements in virtually all employment relationships. The final rule has not yet been filed in the Federal Register, but is scheduled to take effect 120 days after such filing. Final Rule The final rule defines a noncompete clause as a term or condition of employment that prohibits a worker from, penalizes a worker for or functions to prevent a worker from: (i) Seeking or accepting work in the United States with a different person where such work would begin after the conclusion of the employment that includes the term or condition; or (ii) Operating a business in the United States after the conclusion of the employment that includes the term or condition. Such terms or conditions include employee contracts or workplace policies, whether written or oral. Subject to very limited exceptions, the final rule provides that: The use of noncompete clauses will be banned as of the effective date; Any existing noncompete clauses (other than those entered into with senior executives) will be invalidated; Employers must notify all employees (other than senior executives whose existing noncompete agreements will remain enforceable) that their existing noncompete agreements will not be enforced. Currently, the enforceability of noncompete clauses is determined by state and local legislatures and courts. The FTC rule would instead govern the enforceability of noncompete clauses at the federal level and supersede any less restrictive state laws or judicial interpretations. Legal Challenges On April 24, 2024, the U.S. Chamber of Commerce sued the FTC, seeking to block the final rule. The complaint was filed in the U.S. District Court for the Eastern District of Texas and argues that the FTC lacks the authority to issue rules that define unfair methods of competition. Additional legal challenges are likely, so employers should monitor for updates and anticipate potential uncertainty in the coming months. Next Steps for Employers Employers may consider reviewing existing employee agreements or form agreements (such as new hire paperwork) to determine whether any contain noncompete clauses that would be invalidated under the rule. Employers may also begin preparing revisions to such agreements and consider whether to use alternatives to noncompete clauses (e.g., nondisclosure clauses) to protect competitive business information.

Have a question? Get in touch.

Share by: