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October 30, 2014

State report documents trends in mass. Health care, costs

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High-deductible health plans are growing more popular among Massachusetts employers, according to a state report, which also showed nearly 90 percent of employers who do not offer insurance made that choice in part because of high costs.

According to state survey results released Wednesday by the Center for Health Information and Analysis (CHIA), 45 percent of employers in Mass. offered high-deductible plans this year, up 12 percent since 2011, and double the national average.

High-deductible plans offer lower premiums in exchange for higher cost-sharing with employees. Cost-sharing in such plans, especially at larger employers, may be offset by the use of flexible spending, health reimbursement and health savings accounts.

The report, measuring 2011 against 2014 and coming on the heels of a 2012 cost control law, also showed rising health insurance premiums in Massachusetts, with employees paying a greater share of those premiums and employers contributing less compared to previous years.

Between 2005 and 2014, average Massachusetts premiums for single and family coverage remained higher than the U.S. average; though the gap has narrowed as in-state premiums have grown more slowly. Between 2011 and 2014, the average monthly Massachusetts premium increased 3.1 percent for single coverage and 7.1 percent for family coverage plans.

The average monthly premium for single coverage in Massachusetts in 2014 was $535, or 6.6 percent more than the $502 U.S. average. The average monthly family coverage premium in Massachusetts this year was $1,482, or 5.6 percent more than the U.S. average family premium.

The agency's 2014 employer survey, conducted between January and April, showed 76 percent of Mass. employers offered health insurance, a rate that has held steady since 2011. The national "employer offer" average is 55 percent, down from 60 percent in 2011.

State researchers found that employer offer rates varied depending on the size of businesses. For instance, the offer rate was 69 percent at companies with between 3 and 10 employees, 90 percent at companies with between 11 and 50 employees, and 98 percent at larger businesses, which were more likely to receive assistance from insurance brokers.

About 73 percent of employees eligible for benefits under employer health plans enrolled in those plans this year, a decline from 2011.

Among Massachusetts employers that do not offer health insurance, 93 percent reported that their employees "have insurance options elsewhere" and 78 percent said their workers have access to insurance at the Health Connector or MassHealth, state programs where costs of insurance are largely borne by taxpayers and through the state budget.

While 89 percent of employers who did not offer insurance cited the cost of premiums, 93 percent of those employers said the reason they did not offer insurance was because their employees are generally covered elsewhere. Eighty-four percent said they didn't offer insurance because their company was too small, and 76 percent said they can attract good employees without offering insurance.

Employers told CHIA that cost and flexibility to create health plan options were the most important factors guiding their selection of health plans to offer employees.

According to CHIA, 601 questionnaires were completed as part of its survey. That worked out to a 42 percent response rate after employers, reflecting companies of different sizes, were selected from Dun & Bradstreet listings and asked to answer up to 52 questions.

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