Recent Trends in Employer Health Insurance Coverage and Benefits
October 1996
American Hospital Association
Employer health coverage has continued to erode throughout this decade despite the success employers have had in controlling health care costs. Employers responded to the rapid growth in health care costs early in this decade by shifting workers to managed care plans that control costs through price competition and aggressive cost control. However, employers also adopted policies that have led to reductions in the number of covered individuals. For example, some large employers with generous benefits have outsourced many production and service jobs to outside contractors where health insurance is less common and benefits are less comprehensive. Some employers also have discontinued their retiree coverage programs which will ultimately reduce coverage among early retirees. To control costs, employers have also increased employee cost sharing under their health plans and have discontinued coverage for certain specialized services. For example, deductibles and copayments have increased under traditional indemnity plans, partly as an incentive for individuals to shift to managed care alternatives. Coverage for expensive specialty services such as infertility treatments has also declined despite a recent increase in the number of states requiring insurers to cover these services. In addition, employers have increased premium contribution requirements for family coverage, which may be partly responsible for the recent decline in employer coverage among dependents. Some of the reduction in employer coverage will be curtailed by the recently enacted "Health Insurance Portability and Accountability Act of 1996" which requires portability of employer coverage across jobs. However, the impact of this legislation is likely to be negligible since 45 states had already enacted similar legislation by 1995. Thus gaps in employer coverage are likely to continue to be the primary reason for becoming uninsured well into the future.