Highlights from the KFF 2023 Employer Health Benefit Survey

November 6, 2023

KFF, formerly the Kaiser Family Foundation, published its 2023 survey of employer health benefits in late October. They interviewed representatives of 2133 companies with three or more employees, seeking a representative group of employers based on size, industry and geography. They found that the total cost of family plan premiums increased to about $24,000. In the KFF survey, deductibles remained flat, while the WTW Best Practices Survey found that 22% of employers increased out of pocket costs in 2023, and another 32% were planning or considering this for 2024-2025.

KFF reports that narrow network penetration overall is low (9%), but higher in larger employers (18% for >5K). The 2023 WTW Best Practices in Health Care survey showed prevalence of 18% overall and 9% for employers with under 1000 employees. KFF found larger employers (over 5000) are more likely to have centers of excellence (COEs) in place (45%) than all employers with over 50 employees (12%); WTW found that overall 48% of employers offered COEs through health plans, and 10% used carve-out vendors. WTW also found fewer employers with under 1000 employees offered COEs (25% through health plans and 3% with carve-out vendors.)

Other important information from the KFF employer health benefit survey:

●      Over the last decade family premiums increased by 47% and deductibles increased by 78%, while worker earnings were up 47% and overall inflation was 30%.

●      About a third (31%) of employees had deductibles for a single plan of $2000 or more; this was almost half (47%) for firms with under 200 workers.

●      About a third of employers covered legally provided abortions in most or all circumstances; this was 43% for companies with over 5000 workers.

●      About 7% of firms with over 200 workers provided financial assistance to plan enrollees who traveled out of state to obtain an abortion. About 19% of firms with 5000 or more workers provided such assistance.

●      A quarter (23%) of employers with over 200 employees covered gender affirming surgeries; 62% of companies with over 5000 employees reported offering this coverage.

●      About half (47%) of companies with over 200 employees said they offered reduced or no cost sharing for maintenance drugs.

Implications for employers:

-        The cost of providing health insurance coverage to employees continues to rise, and the combination of provider consolidation, overall inflation, and medical advances makes this likely to continue for at least the next few years.

-        Centers of Excellence represent a promising way to control costs while increasing quality, particularly if they are mandatory.

-        High rates of medical inflation will challenge employers’ ability to avoid shifting costs to employees, even as employers face a tight labor market and health care affordability remains a challenge.   

Hope your weekend is good.

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