05 Nov 2015 UBA Health Plan Survey Executive Summary available

The data are in for the 2015 Health Plan Survey! For quick reference, here’s a brief punch list of the top trends compiled by UBA:

Rates are up modestly, but increases are on the horizon.

• Factors driving rates higher: Small groups forced into community-rated, high-cost plans that are compliant with the Patient
• Protection and Affordable Care Act (ACA), and lack of negotiating power among small groups.
• Factors temporarily holding costs steady: Large group negotiating power, grandmothered employers avoided ACA-compliant plans,
• UBA Partners leveraged their bargaining power.
• Rate outlook: Overall, rates are expected to rise and employers will continue to reduce benefits and pass costs to employees.

Overall costs vary significantly by industry and geography.

• Retail, construction and hospitality employees cost the least to cover; finance and government employees (the historical cost leader) and finance employees (the new leader) cost the most.
• Plans in the Northeast cost the most; plans in the Central U.S. cost the least.
• Retail and construction employees pay the most toward their coverage; government employees pay the least (bad news for taxpayers).

The upcoming Cadillac tax isn’t restricted to “rich” plans alone. In fact, a surprising number of employers are expected to exceed the Cadillac tax threshold.

Employees feel the squeeze financially, but have more shopping options.

• Employee contributions are up modestly; copays held steady.
• Deductibles and out-of-pocket maximums are rising rapidly.
• Health savings account (HSA) plan contributions decreased.
• Employers are offering more plan options at different price points.

PPOs, CDHPs and 4-tier prescription plans have the biggest impact.

• Preferred provider organization (PPO) plans cost more than average but still dominate the market.
• Consumer-directed health plans (CDHPs) cost less than average and enrollment is increasing.
• Prescription plans are rapidly moving to four tiers with blended copay/coinsurance models, making it the fastest growing pharmaceutical cost-containment strategy.

Overall, wellness program adoption is up, but program design is changing.

• Health risk assessments are down while biometric screenings and physical exams are on the rise.

Statistics to watch in 2016:

• Increase in self-funding for all group sizes.
• Decrease in dependent coverage.
• Rate stabilization in groups with 51 to 100 employees as an ACA amendment helps them avoid community rating.
• Mail order pharmaceutical programs more for convenience than cost savings.

Metal levels are now tracked in the UBA Health Plan Survey.

• Most plans are gold metal level or higher.