Consumer-Driven Health Plans Continue Growth but Pace Slows

By Stephen Miller, CEBS Aug 26, 2011

Consumer-driven health plans (CDHPs)—typically, high-deductible plans linked to an employee-owned health savings account (HSA) or an employer-controlled health reimbursement arrangement (HRA)—experienced continued growth in the U.S. during 2011 but at a slower rate than in 2009 and 2010, according to preliminary results from United Benefit Advisors’ (UBA) 2011 UBA Health Plan Survey, a benchmarking survey of 16,421 plans from 10,744 employers.

The survey was conducted from Oct. 4, 2010, through June 3, 2011, by UBA, a member-owned alliance of more than 140 independent benefit advisory firms.

CDHPs grew at a rate of 13.9 percent in 2011, about two-thirds of the 2010 rate, the survey revealed. Among employer-provided health plans:

Preferred-provider organization (PPO) plans represented 48.4 percent of plans.

CDHPs represented 22.9 percent.

Health maintenance organizations (HMOs) represented 17.8 percent.

Point of service (POS) plans represented 9.3 percent.

Among U.S. employees covered:

PPO plans led with 64.4 percent of enrolled employees.

CDHPs covered 17.3 percent.

HMOs covered 11.9 percent.

POS plans covered 4.9 percent.

In the U.S., the Northeast region had the largest concentration of CDHPs (31.3 percent), followed by the Southeast region (27.4 percent). The lowest concentration was in the West (15.8 percent).

In 2011, the average cost increase for all CDHPs at 8 percent was slightly lower than that of the average of all plan types, which increased 8.2 percent.

Contributions to Employee Accounts

Employers continue to offset the higher out-of-pocket costs of CDHPs by offering employees an HSA or HRA and contributing funds. The 2011 UBA Health Plan Survey found the average employer contribution to an HRA was $1,656 (up from $1,481 in 2010) for a single employee and $3,198 for a family (up from $2,857 in 2010).

“We anticipate that in spite of passage of health care reform efforts, health care costs will continue to increase. There still needs to be concerted efforts to change or alter the underlying health care issues that control costs,” said Bill Stafford, UBA vice president for member services.

Other key statistics from the survey were that:

The average employee contribution to the health plan (for plans in which employees pay at least part of the premium) was $117 per month for single coverage and $467 per month for family coverage.

Four-fifths of wellness plans (80.6 percent) offered a health assessment.

About half (49.9 percent) of covered employees elected to cover their dependents, a decline of 6 percent from 2010.

*Eligibility provisions have continued to remain virtually unchanged despite the current economic environment. Over one-half (54.3 percent) of employers use a 30-hour per week minimum eligibility requirement for their health plans, and only 4.7 percent of employers have a waiting period of 180 days or longer.

*Under one-half (40.6 percent) of employers make two or more plan choices available to eligible employees.

About one-fourth of the surveyed plans (26 percent) required no employee contribution for individual coverage, and 7 percent required no employee contribution for family coverage. The highest occurrence for each was within the government/education/utility sector.

Stephen Miller, CEBS, is an online editor/manager for SHRM.​

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