Section 6: Worker and Employer Contributions for Premiums

Premium contributions by covered workers average 18% for single coverage and 28% for family coverage. 1 The average monthly worker contributions are $79 for single coverage ($951 annually) and $360 for family coverage ($4,316 annually).  These percentage and dollar values are similar to the values reported in 2011.

  • In 2012, covered workers on average contribute 18% of the premium for single coverage and 28% of the premium for family coverage, the same contribution percentages reported for 2011 (Exhibit 6.1).
  • On average, workers with single coverage contribute $79 per month ($951 annually), and workers with family coverage contribute $360 per month ($4,316 annually), towards their health insurance premiums, similar to the amounts reported in 2011 (Exhibit 6.2), (Exhibit 6.3), and (Exhibit 6.4).
    • Worker contributions in HDHP/SOs are lower than the overall average worker contributions for both single and family coverage ($765 and $3,720) (Exhibit 6.5).
    • Worker contributions in POS plans are lower for single coverage ($743) compared to the overall average worker contribution for single coverage.  Worker contributions in HMO plans are higher for single coverage ($1,114) than the overall average worker contribution amounts (Exhibit 6.5).
  • Workers in small firms (3-199 workers) contribute a lower amount annually for single coverage than workers in large firms (200 or more workers), $848 vs. $1,001.  In contrast, workers in small firms with family coverage contribute significantly more annually than workers with family coverage in large firms, ($5,134 vs. $3,926) (Exhibit 6.8).
  • There is a great deal of variation in worker contributions to premiums.
    • Twenty-eight percent of covered workers contribute $1,332 or more annually (140% or more of the average worker contribution) for single coverage, while 18% of covered workers have an annual worker contribution of less than $571 less than (60% of the average worker contribution) (Exhibit 6.14).
    • For family coverage, 22% of covered workers contribute $6,043 or more annually (140% or more of the average worker contribution), while 23% of covered workers have an annual worker contribution of less than $2,590 (less than 60% of the average worker contribution) (Exhibit 6.14).
  • The majority of covered workers are employed by a firm that contributes at least half of the premium.
    • Sixteen percent of covered workers with single coverage and 6% of covered workers with family coverage work for a firm that pays 100% of the premium (Exhibit 6.15).
    • Covered workers in small firms (3-199 workers) are more likely to work for a firm that pays 100% of the premium than workers in large firms (200 or more workers). Thirty-six percent of covered workers in small firms have an employer that pays the full premium for single coverage, compared to 6% of covered workers in large firms (Exhibit 6.16). For family coverage, 16% percent of covered workers in small firms have an employer that pays the full premium, compared to 2% of covered workers in large firms (Exhibit 6.17).
    • Five percent of covered workers in small firms (3-199 workers) contribute more than 50% of the premium for single coverage, compared to 1% of covered workers in large firms (200 or more workers) (Exhibit 6.16). For family coverage, 30% of covered workers in small firms work in a firm where they must contribute more than 50% of the premium, compared to 6% of covered workers in large firms (Exhibit 6.17).
  • The percentage of the premium paid by covered workers varies by several firm characteristics.
    • For family coverage, workers in firms with many lower-wage workers (35% or more earn $24,000 or less annually) contribute a greater percentage of the premium than those in firms with fewer lower-wage workers (less than 35% earn $24,000 or less annually) (34% vs. 28%) (Exhibit 6.20).
    • Workers with family coverage in firms that have at least some union workers contribute a significantly lower percentage of the premium than those in firms without any union workers (22% vs. 32%) (Exhibit 6.20).
    • For workers with family coverage in large firms (200 or more workers), the average percentage contribution for workers in firms that are partially or completely self-funded is lower than the average percentage contributions for workers in firms that are fully insured (24% vs. 29%) 2 (Exhibit 6.20).
  • Among firms offering health benefits with fewer than 20 employees nearly half (47%) contribute different dollar amounts toward premiums for different employees (Exhibit 6.25).
  • Among firms offering health benefits with fewer than 20 employees, 72% have at least one plan that provides a bill itemizing per employee premium costs.  Of these firms, 51% report being charged a different premium amount for different employees (Exhibit 6.25).
  • Among firms offering health benefits, 4% vary worker premium contributions by wage level.  Large firms (200 or more workers) are more likely to vary contributions by wage level than small firms (10% vs. 4%) (Exhibit 6.26).

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Section 6: Worker and Employer Contributions for Premiums

exhibits

Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, 1999-2012
Average Monthly Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, 1999-2012
Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Single Coverage, 1999-2012
Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Family Coverage, 1999-2012
Average Annual Firm and Worker Premium Contributions and Total Premiums for Covered Workers for Single and Family Coverage, by Plan Type, 2012
Average Annual Worker Contributions for Covered Workers with Average Annual Worker Contributions for Covered Workers with
Average Annual Worker Contributions for Covered Workers with Family Coverage, by Firm Size, 1999-2012
Average Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Firm Size, 1999-2012
Average Annual Firm and Worker Premium Contributions and Total Premiums for Covered Workers for Single Coverage, by Plan Type and Firm Size, 2012
Average Annual Firm and Worker Premium Contributions and Total Premiums for Covered Workers for Family Coverage, by Plan Type and Firm Size, 2012
Average Monthly and Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Plan Type and Firm Size, 2012
Average Monthly and Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Plan Type and Region, 2012
Average Monthly Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, by Plan Type, 1999-2012
Distribution of Worker Premium Contributions for Single and Family Coverage Relative to the Average Annual Worker Premium Contribution, 2012
Distribution of Percentage of Premium Paid by Covered Workers for Single and Family Coverage, 2002-2012
Distribution of Percentage of Premium Paid by Covered Workers for Single Coverage, by Firm Size, 2002-2012
Distribution of Percentage of Premium Paid by Covered Workers for Family Coverage, by Firm Size, 2002-2012
Distribution of the Percentage of Total Premium Paid by Covered Workers for Single and Family Coverage, by Wage Level, 2012
Average Percentage of Premium Paid by Covered Workers for Single Coverage, by Firm Characteristics and Size, 2012
Average Percentage of Premium Paid by Covered Workers for Family Coverage, by Firm Characteristics and Size, 2012
Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type and Firm Size, 2012
Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type, 1999-2012
Average Percentage of Premium Paid by Covered Workers for Single and Family Coverage, by Plan Type and Region, 2012
Average Percentage of Premium Paid by Covered Workers, by Plan Type and Industry, 2012
Among Firms Offering Health Benefits with Fewer Than 20 Employees, Variations in Premiums and Firm Premium Contributions for Single Coverage, 2012
Among Firms Offering Health Benefits, Percentage That Vary Worker Premium Contributions by Wage Level, by Firm Size and Region, 2012
Section 5: Market Shares of Health Plans Section 7: Employee Cost Sharing
x

Exhibit 6.1

x

Exhibit 6.2

x

Exhibit 6.3

x

Exhibit 6.4

x

Exhibit 6.5

x

Exhibit 6.8

x

Exhibit 6.14

x

Exhibit 6.15

x

Exhibit 6.17

x

Exhibit 6.16

x

Exhibit 6.20

x

Exhibit 6.25

x

Exhibit 6.26

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