The Kaiser Family Foundation and the Health Research and Educational Trust (Kaiser/HRET) conduct this survey of employer-sponsored health benefits. For many years the international consulting and accounting firm, KPMG Consulting, Inc. (now Bearing Point), supported the study. In 1998, KPMG divested itself of its Compensation and Benefits Practice, and part of that divestiture included donating the annual survey of health benefits to HRET. HRET, a nonprofit research organization, is an affiliate of the American Hospital Association. The Kaiser Family Foundation provides financial support and conducts this survey in partnership with HRET. HRET subcontracts with researchers at The Center for Studying Health System Change, who work with Foundation and HRET researchers in conducting the study. Kaiser/HRET retained National Research LLC (NR), a Washington, D.C.-based survey research firm, to conduct telephone interviews with human resource and benefits managers. NR conducted interviews from January to May 2006 with 3,159 firms. The Kaiser Family Foundation provides independent research and analysis on health policy issues, and is not affiliated in any way with the Kaiser Permanente health plan.
Changes to 2006 Survey
As in past years, Kaiser/HRET asked each participating company as many as 400 questions about its largest health maintenance organization (HMO), preferred provider organization (PPO), point-of service (POS), and high deductible health plan with savings option (HDHP/SO).1 For the first time this year, Kaiser/HRET asked questions about the highest enrollment HDHP/SO as a separate plan type, equal to the other plan types. In prior years, data on HDHP/SO plans were collected as part of one of the other types of plans. Therefore, the removal of HDHP/SOs from the other plan types may affect the year to year comparisons for the other plan types. Given the decline in conventional health plan enrollment (see Exhibit 5.1) and the addition of HDHP/SO as a plan type option, Kaiser/HRET eliminated nearly all questions pertaining to conventional coverage from the survey instrument.2 We continue to ask firms whether or not they offer a conventional health plan and, if so, how much their premium for conventional coverage increased in the last year, but respondents are not asked additional questions about the attributes of the conventional plans they offer. Because we have limited information about conventional health plans, we must make adjustments in calculating all plan averages or distributions. In cases where a firm offers only conventional health plans, no information from that respondent is included in all plan averages. The exception is for the rate of premium growth, for which we have information. If a firm offers a conventional health plan and at least one other plan type, for categorical variables we assign the values from the health plan with the largest enrollment (other than the conventional plan) to the workers in the conventional plan. In the case of continuous variables, covered workers in conventional plans are assigned the weighted average value of the other plan types in the firm.
This year Kaiser/HRET began asking employers if they had a health plan that was an exclusive provider organization (EPO). We treat EPOs and HMOs together as one plan type and report the information under the banner of “HMO”; if an employer sponsors both an HMO and an EPO, they are asked about the attributes of the plan with the larger enrollment.
This year’s survey included questions on the cost of health insurance, offer rates, coverage, eligibility, health plan choice, enrollment patterns, premiums,3 employee cost sharing, covered benefits, prescription drug benefits, retiree health benefits, health management programs, and employer opinions. However, this year, information about plan deductibles and out-of-pocket maximum amounts has been expanded. Throughout this report, we use the term "in-network" to refer to services received from a preferred provider and "out-of-network" to refer to services received from a non-preferred provider. Family coverage is defined as health coverage for a family of four. Changes related to industry classification, weight trimming, and statistical testing are discussed below.
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