Newly updated data in the SHRM Customized Benchmarking Database, from which SHRM Customized Health Care Benchmarking Reports are derived, show that the median total annual health care cost per covered employee in the U.S. was $6,813 last year. At the 25th percentile, the cost per covered employee was $4,436; at the 75th percentile, it was $9,690.
Data were collected from U.S. companies of all types and sizes from February through April 2012, reflecting plan year 2011. Customized reports based on the updated data can be purchased at www.shrm.org/benchmarks. These reports drill down to provide output based on industry, employee size and other factors, and are designed to target companies that closely match the selected criteria—allowing for a more focused and comparable analysis and interpretation.
Examples of comparative plan data that can be customized include the following:
• The median employer contribution to monthly, employee-only health care premiums was $373 for indemnity plans, $359 for preferred-provider organization (PPO) plans, $351 for point of service (POS) plans, $339 for health maintenance organization (HMO) plans and $297 for high-deductible consumer-driven health plans (CDHPs).
• The median annual in-network deductible for employee-only coverage was zero for HMO plans, $500 for PPO and POS plans, $675 for indemnity plans, and $2,000 for CDHPs.
• The median co-pay for in-network primary care office visits for employee-only coverage was $25 for POS plans, $20 for HMO and PPO plans, $5 for indemnity plans, and zero for CDHPs.
The database reveals that, overall:
• 40 percent of organizations offer only one plan.
• 32 percent offer two plans.
• 28 percent offer three or more plans.
• 39 percent of organizations self-fund health care.
• 74 percent of those organizations have stop-loss coverage.
• The median amount of stop-loss coverage was $115,000.
Regarding coverage of spouses and domestic partners:
• 96 percent of organizations provide spouses with health care coverage.
• 38 percent provide same-sex domestic partner coverage.
• 32 percent provide opposite-sex domestic partner coverage.
“The information provided in customized reports is designed to be a tool to help evaluate decisions and activities that affect your organization’s employee health care benefits,” explains Andrew Mariotti, a strategic research analyst at SHRM. However, “just because your organization has benchmarks that are different from the average or median does not mean that they are favorable or unfavorable. Rather, this difference may be the result of your organization’s particular total rewards strategy, special circumstances or other business initiatives.”
Stephen Miller, CEBS, is an online editor/manager for SHRM.
Health Spending Growth Through 2021, SHRM Online Benefits Discipline, June 2012
Slower Health Care Cost Growth Expected in 2013, SHRM Online Benefits Discipline, June 2012
Typical Health Costs for American Family Now Exceed $20,000, SHRM Online Benefits Discipline, May 2012
Rand Study: CDHPs Could Save Billions in Spending, SHRM Online Benefits Discipline, May 2012