Employer Health Benefits 2005 Annual Survey Section 6: Employee Contributions for Premiums
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Section 6: Employee Contributions for Premiums
The share of total premiums paid by covered workers is essentially unchanged in 2005. Across all plan types, on average, workers pay 16% of premiums for single coverage and 26% of premiums for family coverage. The average monthly worker contribution for single coverage is $51 in 2005. For family coverage, the average monthly worker contribution is $226.
The average percentage of total premiums that workers pay is essentially unchanged from last year: 16% across plan types for single coverage and 26% for family coverage. Percentage contributions for family coverage have been stable over time, while those for single coverage declined between 1996 and 1999 (from 21% to 14%) and have been stable since that time (Exhibit 6.2).
The average monthly worker contribution for single coverage is $51 in 2005. For family coverage, the average monthly worker contribution is $226 (Exhibit 6.1).
On an annual basis, the average worker contribution averages $610 for single coverage and $2,713 for family coverage. Workers in small firms (3 to 199 workers) contribute significantly more ($3,170 annually) on average towards family coverage than workers in large firms (200 or more workers) contribute ($2,487 annually) (Exhibits 6.3, 6.4).
Virtually all covered workers receive a premium contribution of 50% or more from their employer. The majority of covered workers receive a premium contribution from their firm of between 75% and 100% for single coverage and between 50% and 100% for family coverage (Exhibits 6.8, 6.9).
The percentage of covered workers whose employers pay the full cost of single coverage is 21% and the percentage of covered workers whose employers pay the full cost of family coverage is 9% (Exhibits 6.8, 6.9).
Covered workers in small firms (3-199 workers) are more likely to have their employer pay the full cost of coverage than covered workers in large firms (200 or more workers) for both single and family coverage. Forty-one percent of covered workers in small firms have an employer that pays the entire premium for single coverage, compared to 12% of covered workers in large firms. For family coverage, 18% percent of covered workers in small firms have an employer that pays the entire premium for single coverage compared to 5% of covered workers in large firms (Exhibits 6.8, 6.9).
Covered workers in lower wage firms—where 35% or more earn $20,000 or less per year— pay a higher percentage of their premium costs than covered workers in higher wage firms—where fewer than 35% earn $20,000 or less per year. On average, covered workers in low wage firms contribute 20% for single coverage and 36% of the premium for family coverage while covered workers in high wage firms contribute 15% for single coverage and 25% of the family premium. Covered workers in firms that partially or entirely self fund their health benefits pay a higher share of the premium for family coverage (32%) than covered workers in firms that are fully insured (21%) (Exhibit 6.10).
Just 10% of covered workers are in firms that vary the employee’s premium contribution based on the employee’s wage level. Small firms (3-199 workers) are much less likely to do so, at 2%, versus 14% for workers in all large firms (200 or more workers). Varying the employee’s premium contribution based on participation in a wellness program is even less common, affecting just 3% of covered workers (Exhibit 6.16).
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Exhibit 6.1: Average Monthly Worker Premium Contributions for Single and Family Coverage, 1988-2005
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For more information regarding survey methodology, click here to view the Survey Design and Methods section.
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Exhibit 6.2: Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, 1988-2005
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For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.3: Average Annual Premiums for Covered Workers for Single and Family Coverage, by Plan Type, 2005
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For more information regarding survey methodology, click here to view the Survey Design and Methods section.
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Exhibit 6.4: Average Monthly Worker Premium Contributions for Single and Family Coverage, by Plan Type and Firm Size, 2005
Monthly
Annual
Single Coverage
Family Coverage
Single Coverage
Family Coverage
CONVENTIONAL PLANS
All Small Firms (3-199 Workers)
$37
$220
$440
$2,635
All Large Firms (200 or More Workers)
45
176
535
2,115
ALL FIRM SIZES
$41
$193
$498
$2,321
HMO PLANS
All Small Firms (3-199 Workers)
$44
$269*
$531
$3,227*
All Large Firms (200 or More Workers)
48
198
576
2,370
ALL FIRM SIZES
$47
$217
$563
$2,604
PPO PLANS
All Small Firms (3-199 Workers)
$40*
$254*
$480*
$3,050*
All Large Firms (200 or More Workers)
55
204
660
2,453
ALL FIRM SIZES
$50
$220
$603
$2,641
POS PLANS
All Small Firms (3-199 Workers)
$67
$296
$805
$3,547
All Large Firms (200 or More Workers)
55
249
663
2,988
ALL FIRM SIZES
$61
$271
$731
$3,250
ALL PLANS
All Small Firms (3-199 Workers)
$46
$264*
$556
$3,170*
All Large Firms (200 or More Workers)
53
207*
638
2,487*
ALL FIRM SIZES
$51
$226
$610
$2,713
*
Estimate is statistically different from All Firm Sizes within a plan type at p<.05.
Note: Family coverage is defined as health coverage for a family of four.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005.
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.5: Average Monthly Worker Premium Contributions for Single and Family Coverage, by Plan Type and Region, 2005
Monthly
Annual
Single Coverage
Family Coverage
Single Coverage
Family Coverage
CONVENTIONAL PLANS
Northeast
$20*
$58*
$235*
$695*
Midwest
47
211
567
2,528
South
48
226
576
2,716
West
NSD
NSD
NSD
NSD
ALL REGIONS
$41
$193
$498
$2,321
HMO PLANS
Northeast
$59*
$203
$708*
$2,430
Midwest
49
179
591
2,146
South
55
268*
665
3,210*
West
30*
204
355*
2,444
ALL REGIONS
$47
$217
$563
$2,604
PPO PLANS
Northeast
$54
$173*
$648
$2,073*
Midwest
55
202
660
2,429
South
54
263*
650
3,154*
West
31*
205
367*
2,454
ALL REGIONS
$50
$220
$603
$2,641
POS PLANS
Northeast
$70
$241
$837
$2,895
Midwest
57
226
681
2,707
South
59
346*
703
4,154*
West
57
225
680
2,699
ALL REGIONS
$61
$271
$731
$3,250
ALL PLANS
Northeast
$57
$188*
$684
$2,260*
Midwest
54
201*
649
2,417*
South
55
274*
658
3,294*
West
35*
210
416*
2,514
ALL REGIONS
$51
$226
$610
$2,713
*
Estimate is statistically different from All Regions within a plan type at p<.05.
Note: Family coverage is defined as health coverage for a family of four.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005.
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.6: Average Monthly Worker Premium Contributions for Single and Family Coverage in Conventional and HMO Plans, 1988-2005
(object placeholder)
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.7: Average Monthly Worker Premium Contributions for Single and Family Coverage in PPO and POS Plans, 1988-2005
(object placeholder)
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.8: Distribution of Covered Workers by Percentage of Single Premium Contributed by Their Firm, by Firm Size, 2001-2005
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For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.9: Distribution of Covered Workers by Percentage of Family Premium Contributed by Their Firm, by Firm Size, 2001-2005
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For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.10: Average Percentage of Single and Family Premiums Paid by Covered Workers, by Firm Characteristics, 2005
Single Coverage
Family Coverage
PERCENT OF WORKFORCE EARNING $20,000 OR LESS PER YEAR
Less Than 35% (Higher Wage Firms)
15%
25%
35% or More (Lower Wage Firms)
20*
36*
PLAN FUNDING
Self-Funded
16%
32%*
Fully Insured
16
21*
UNION
Firm Has At Least Some Union Workers
15%
21%*
Firm Does Not Have Any Union Workers
17
29*
ALL FIRMS
16%
26%
*
Estimates are significantly different from All Firms at p<.05.
Self-funded plan: An insurance arrangement in which the employer assumes direct financial responsibility for the costs of enrollees’ medical claims. Employers sponsoring self-funded plans typically contract with a third-party administrator or insurer to provide administrative services for the self-funded plan.
Note: Family coverage is defined as health coverage for a family of four.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005.
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.11: Average Percentage of Premium Paid by Firm for Covered Workers, by Plan Type and Firm Size, 2005
Single Coverage
Family Coverage
CONVENTIONAL PLANS
All Small Firms (3-199 Workers)
88%
74%
All Large Firms (200 or More Workers)
85
78
ALL FIRM SIZES
86%
76%
HMO PLANS
All Small Firms (3-199 Workers)
85%
67%*
All Large Firms (200 or More Workers)
84
77
ALL FIRM SIZES
84%
74%
PPO PLANS
All Small Firms (3-199 Workers)
87%*
70%*
All Large Firms (200 or More Workers)
83
77
ALL FIRM SIZES
85%
75%
POS PLANS
All Small Firms (3-199 Workers)
80%
66%
All Large Firms (200 or More Workers)
82
72
ALL FIRM SIZES
81%
69%
ALL PLANS
All Small Firms (3-199 Workers)
86%
69%*
All Large Firms (200 or More Workers)
83
77*
ALL FIRM SIZES
84%
74%
*
Estimate is statistically different from All Firm Sizes within a plan type at p<.05.
Note: Family coverage is defined as health coverage for a family of four.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005.
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.12: Average Percentage of Premium Paid by Covered Workers in Conventional and HMO Plans, 1988-2005
(object placeholder)
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.13: Average Percentage of Premium Paid by Covered Workers in PPO and POS Plans, 1988-2005
(object placeholder)
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.14: Average Percentage of Premium Paid by Firm for Covered Workers, by Plan Type and Region, 2005
Single Coverage
Family Coverage
CONVENTIONAL PLANS
Northeast
92%
91%*
Midwest
80*
86
South
86
73
West
NSD
NSD
ALL REGIONS
86%
76%
HMO PLANS
Northeast
82%
78%*
Midwest
84
79*
South
82
69*
West
89*
73
ALL REGIONS
84%
74%
PPO PLANS
Northeast
84%
82%*
Midwest
84
78*
South
83
69*
West
91*
77
ALL REGIONS
85%
75%
POS PLANS
Northeast
79%
75%*
Midwest
81
73
South
82
59*
West
84
75
ALL REGIONS
81%
69%
ALL PLANS
Northeast
83%
80%*
Midwest
83
77*
South
83
68*
West
89*
75
ALL REGIONS
84%
74%
*
Estimate is statistically different from All Regions within a plan type at p<.05.
NSD: Not Sufficient Data.
Note: Family coverage is defined as health coverage for a family of four.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005.
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.15: Percentage of Premium Paid by Firm for Covered Workers, by Plan Type and Industry, 2005
Single Coverage
Family Coverage
CONVENTIONAL PLANS
Mining/Construction/Wholesale
NSD
NSD
Manufacturing
NSD
NSD
Transportation/Communications/Utility
NSD
NSD
Retail
NSD
NSD
Finance
NSD
NSD
Service
80
67
State/Local Government
NSD
NSD
Health Care
NSD
NSD
ALL INDUSTRIES
86%
76%
HMO PLANS
Mining/Construction/Wholesale
85%
71%
Manufacturing
83
78
Transportation/Communications/Utility
85
80
Retail
78
68
Finance
80*
74
Service
83
68*
State/Local Government
93*
83*
Health Care
86
77
ALL INDUSTRIES
84%
74%
PPO PLANS
Mining/Construction/Wholesale
81%
71%
Manufacturing
81*
78
Transportation/Communications/Utility
86
81*
Retail
77*
70
Finance
86
76
Service
87
72
State/Local Government
90*
80*
Health Care
90*
77
ALL INDUSTRIES
85%
75%
POS PLANS
Mining/Construction/Wholesale
86%
80%*
Manufacturing
79
74
Transportation/Communications/Utility
NSD
NSD
Retail
72
66
Finance
NSD
NSD
Service
82
64
State/Local Government
87
78*
Health Care
81
63
ALL INDUSTRIES
81%
69%
ALL PLANS
Mining/Construction/Wholesale
82%
73%
Manufacturing
81*
78*
Transportation/Communications/Utility
86
80*
Retail
77*
68
Finance
84
75
Service
85
69*
State/Local Government
91*
81*
Health Care
88*
76
ALL INDUSTRIES
84%
74%
*
Estimate is statistically different from All Industries within a plan type at p<.05.
NSD: Not Sufficient Data.
Note: Family coverage is defined as health coverage for a family of four.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005.
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
Error in element (see logs)
Exhibit 6.16: Percentage of Covered Workers in Firms That Vary Worker Premium Contributions by Wage Level or by Participation in Wellness Program, by Firm Size and Region, 2005
Percentage of Covered Workers in Firms That Vary Worker Premium Contributions by Wage Level
Percentage of Covered Workers in Firms That Vary Worker Premium Contributions by Participation in Wellness Program
FIRM SIZE
ALL SMALL FIRMS (3-199 Workers)
2.4%*
1.0%*
Midsize (200-999 Workers)
7.7
4.2
Large (1,000-4,999 Workers)
15.8
4.8
Jumbo (5,000 or More Workers)
16.3
4.4
ALL LARGE FIRMS (200 or More Workers)
14.3%
4.4%
REGION
Northeast
20.2%*
6.0%
Midwest
9.1
3.9
South
8.1
2.3
West
5.5*
1.4
ALL FIRM SIZES AND REGIONS
10.3%
3.3%
*
Distribution is statistically different from All Firm Sizes and Regions at p<.05.
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005.
For more information regarding survey methodology, click here to view the Survey Design and Methods section.
The Kaiser Family Foundation and Health Research and Educational Trust Program Area: Health Care Marketplace Project |Publication Date: 09/14/2005
