The trend of employers transferring some of the burden of increased health care costs to their employees shows no sign of easing up, and many are using new strategies with which to do so.

A growing number of employers (38%) say they are increasing employee-cost sharing through plan design changes, up from 31% last year, according to a recent PricewaterhouseCoopers survey. Meanwhile, 33% of employers have increased employee contributions, compared with 25% last year.

Benefit advisers hoping to stay ahead of the trend should be prepared to discuss multiple cost-sharing tools with employers, including plan design changes, supplemental benefits and even private exchanges.

In employee cost-sharing, “everything is trending up a little bit,” Barbara Gniewek, a principal at PwC, said in a recent webinar on the survey results.

The survey found a whopping 44% of employers are considering a full replacement high-deductible plan (meaning it’s the only health plan option), while 18% have already implemented this; and 24% of employers have increased prescription drug cost-sharing through plan design changes, up from 18% last year.

High-deductible health plans, she continued, “are having the largest enrollment [rates] for employers. So clearly employers are investing really heavily in high-deductible health plans. We see average deductibles over $1,000 and average out-of-pocket maximums over $3,000 now.”

Varied strategies

Companies are also considering private exchanges as a new cost-savings strategy. The survey showed 32% of employers are considering moving their active employees to a private exchange in the next three years. And, among those employers that provide retiree medical coverage, 39% are considering a private exchange for their post-65 retirees, and 43% are considering this for their pre-65 retirees.

However, only 11% of employers said they were considering eliminating health benefits, leaving their employees to turn to the public exchanges. That’s partly because of recruiting and retention concerns, and partly because the Patient Protection and Affordable Care Act requires employers to offer health insurance to workers.

Meanwhile, the survey showed, companies are still footing a large portion of the total health care bill. On average, employers pay 73% of single coverage premiums and 68% of family coverage premiums. Among those offering a high-deductible plan with a health savings account, 22% contribute more than $1,000 to the account for single coverage.

Shifting costs to workers is just one of many tactics that companies are implementing. In addition, there has been a rise in employers choosing to self-insure, even some midsize and small employers, Gniewek noted.

About half of employers are considering implementing or expanding a wellness program, while 39% have already done so.

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