2018 Employer Health Benefits Survey

EMPLOYER RETIREE BENEFITS

• In 2018, 18% of large firms that offer health benefits to their workers offer retiree coverage, a significantly lower percentage than in recent years [Figure 11.1]. As discussed above, despite this longer-term decrease, we are skeptical about the magnitude of this change over one year and plan to clarify the question in the future.
• Retiree health benefits offer rates vary considerably by firm characteristics.
  • Among large firms offering health benefits, the likelihood that a firm will offer retiree health benefits increases with firm size [Figure 11.2].
  • The share of large firms offering retiree health benefits varies considerably by industry [Figure 11.2].
  • Despite the lower percentage of public firms reporting that they offer retiree health benefits, among large firms offering health benefits, the share of public firms offering retiree benefits (49%) is higher than the shares of private for-profit firms (10%) or private not-for-profit firms (21%) offering retiree benefits [Figure 11.3].
  • Large firms with at least some union workers are more likely to offer retiree health benefits than large firms without any union workers (29% vs. 14%) [Figure 11.3].

EARLY RETIREES AND MEDICARE-AGE RETIREES

• Among large firms offering retiree health benefits, most firms offer to early retirees under the age of 65 (91%). A lower percentage (67%) of large firms offering retiree health benefits offer to Medicare-age retirees. Despite the change in the overall offer rate for retiree benefits, these percentages are similar to those last year [Figure 11.4].
• Among large firms offering retiree health benefits, 60% offer health benefits to both early and Medicare-age retirees.
• Among large firms offering retiree benefits, a large share (88%) report offering benefits to the spouses of retirees [Figure 11.5].
• Thirty-four percent of large employers offering retiree health benefits to Medicare-age retirees offer coverage through a contract with a Medicare Advantage plan. Firms with 5,000 or more workers are more likely to offer retiree benefits through a contract with a Medicare Advantage plan than other large firms [Figure 11.6].
• Seventy-four percent of large firms offering Medicare-age retirees health benefits through a contract with a Medicare Advantage plan require some or all Medicare-age retirees to choose the Medicare Advantage plan in order to receive a contribution from the firm, while 26% allow Medicare-age retirees to choose another type of plan and still receive a firm contribution [Figure 11.7].

ELIGIBILITY FOR NEW AND RETIRING WORKERS

• Among large firms offering retiree health benefits, 62% report that new hires will be eligible for the firm’s retiree health benefits and 90% report that employees retiring this year will be eligible for retiree health benefits [Figure 11.8].

PREMIUM CONTRIBUTIONS

• Sixty-one percent of large firms offering retiree health benefits make a contribution toward the cost of benefits for at least some of their retirees [Figure 11.9].
  • A defined contribution is a set dollar amount that the retiree can use to purchase a health plan they choose. Among large firms that make a contribution toward the cost of retiree benefits, 31% report that they make a defined contribution for retiree health benefits [Figure 11.10].
  • Among large firms offering retiree health benefits to early retirees, 8% provide retirees a contribution they can use to purchase coverage on their own or through a public exchange such as Healthcare.gov [Figure 11.11].

PRIVATE EXCHANGES

• Private exchanges have received considerable attention over the past several years. They are typically created by a consulting company, broker, or insurer, and are different than the public exchanges created under the Affordable Care Act (ACA). Private exchanges allow employees or retirees from multiple companies to choose from a larger number of health benefit options than one firm would generally provide.
  • Five percent of large firms, including 25% of firms with 5,000 or more workers, offering retiree health benefits report they offer benefits through a private exchange [Figure 11.12]. For more information on the use of private exchanges for active employees, please see Section 14.

COST REDUCTION STRATEGIES

Large firms offering retiree health benefits were asked if they had implemented specified cost reduction strategies within the past two years.

• Eight percent of large firms offering retiree benefits to Medicare-age retirees reported that they started offering benefits through a Medicare Advantage Plan within the past two years [Figure 11.13].
• Among large firms offering retiree health benefits, 20% say they increased patient cost sharing and 29% say they increased retiree premium contributions in the last two years [Figure 11.13]. The percentage of firms reporting increasing retiree premium contributions increases with firm size.
• Small shares of large firms offering retiree health benefits reported other changes: 2% started using a defined contribution approach to permit retirees to purchase benefits on a public or private exchange; 3% eliminated coverage for early retirees; and 3% eliminated coverage for Medicare-age retirees [Figure 11.13].