While its not surprising that in 2013 the trend of employers shifting rising health care costs to employees continued to grow, it also appears employers have begun to design health care plans with looming Affordable Care Act provisions in mind.
The number of employers offering plans with out-of-pocket maximums above $5,000 jumped from 20% in 2012 to 32% in 2013, according to Zywaves 2013 Health Plan Design Benchmark Report. The company speculates the surge could be attributed to employers viewing out-of-pocket maximum limits mandated by the ACA ($6,350 for individuals; $12,700 for families for 2014 the plan year) as targets. More than 40% of plans in 2013 provided a 100% coinsurance, which also could be ACA-related, the report says.
If the out-of-pocket maximum movement was due to plans simply setting it at the ACA maximum amount, then it makes sense to me that employers would set their deductible and out-of-pocket maximum at the ACA-mandated $6,350, then offer 100% coinsurance. We could just be seeing an early adoption of what may become a common plan design for 2014 plans and beyond, Zywaves product director Michelle Jackson says.
Although many employers renewed their health plans early at the end of 2013 to put off 2014 ACA provisions for one more year, most employers seemed to be keeping ACA developments in mind in their 2013 plan designs, Zywave CEO Dave OBrien adds.
The report, based on a survey of more than 50,000 employers and 70,000 health plans, also shows health savings accounts growing in popularity in 2013, with 28% of plans in 2013 incorporating one, up from 21% in 2012 and 16% in 2011.
The number of employers offering plans with little or no prescription drug deductible also jumped in 2013, with 80% of plans being offered with a deductible of $0 to $49, up from less than 50% of plans in 2012.
The increase in plans without a prescription drug deductible is in line with other trends in the market, Zywave says, as HSA plans group prescription drug costs in with the medical plan.
Small groups may also have found the ACA provisions around single out-of-pocket maximum and deductible (medical and prescription drug applying to the same out-of-pocket deductible) advantageous and chosen to move toward it sooner, the report says.
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