Health insurance costs

If you’re employed, you’re paying about $100 a week, a survey shows.

Workers who get health insurance through their employer now pay about $5,500 a year, or more than $100 a week, on average for a family coverage — and they are paying only about 29 percent of the cost.

Deductibles, co-insurance and other out-of-pocket expenses can add more than $2,000 to a family’s annual expenses.

As a result, people can struggle to pay for coverage even with employers paying much of the costs.

That’s one of the takeaways from the Kaiser Family Foundation’s annual survey on the cost of health insurance provided by employers.

“Rising health care costs absolutely remain a burden for employers, but they are a bigger problem for workers as their cost-sharing has been rising really much faster than their wages,” said Drew Altman, president and chief executive officer of the Kaiser Family Foundation.

The average cost of family coverage for employers and employees is $19,616 this year, up 5 percent from last year, with workers paying $5,547 of the premium. The cost has increased 20 percent since 2013 and 55 percent since 2008.

The cost for single coverage is much lower: $6,896 this year, up 3 percent, with workers contributing an average of $1,186.

The increase in premiums, however, doesn’t include deductibles and other out-of-pocket expenses — and those, too, have steadily increased.

About a quarter of workers now are in health plans with a deductible of at least $2,000, and among employers with fewer than 200 workers, 42 percent have deductibles of at least that

amount.

About 152 million Americans get health insurance through an employer.

The annual increases have slowed over the past five and 10 years compared with the sharp increases from 2000 through 2006, when the cost of family coverage increased 78 percent.

The trend is expected continue next year.

The preliminary responses to an annual survey done by Mercer, a benefits consultant, found that the cost of health benefits will increase 4.1 percent on average after changes in plan design next year.

But the increases still far outpace the increase in wages and inflation.

Altman noted that the average annual cost of family health insurance for employers and employees is the cost of a new Honda Civic.

The increases depress wages, given that employers look at total compensation costs. And health systems still consistently raise prices for health plans at a faster pace than inflation.

“Insurers and health plans are paying the health systems what the health systems want, and we have seen health prices go way up,” said Gary Claxton, a vice president and director of the Health Care Marketplace Project at the Kaiser Family Foundation.

The Kaiser survey, now in its 20th year, is the most widely followed benchmark for the cost of employer health benefits. It was based on responses from almost 2,200 small and large employers this year.

The survey is in line with a recent survey by M3, a benefits consultant and insurance broker based in Madison, of its clients in Wisconsin. That survey found that health care costs increased 6.1 percent on average this year, the lowest increase since 2014.

The trend has been for increases of 5 to 7 percent for roughly a decade, said Brian Meyer, director of risk management for M3. The increases have been driven by price increases and the rising cost of prescription drugs, particularly specialty medications.

Costs vary based on the size and type of employer, location and other factors. Among the findings in the Kaiser survey:

❚ Workers in small employers on average must pay a larger share of the cost of family coverage than workers in large firms — 38 percent compared with 26 percent.

❚ An estimated 34 percent of workers in small employers are in a health plan for which they must pay more than half of the premium for family coverage.

❚ Workers for employers in which at least 35 percent of the workers earn $25,000 a year or less pay a larger percentage of the total cost of health insurance — 24 percent for single coverage and 42 percent for family coverage.

The Kaiser survey also found that high-deductible health plans paired with health savings or health reimbursement accounts are becoming increasingly common.

The survey found that 29 percent of employers offer a high-deductible health plan with a savings option — a 50 percent increase since 2013. The plans are more common in the Midwest, where 39 percent of workers are enrolled in health plans tied to a savings account.

Increasing deductibles has helped to keep premium increases relatively low, but the trend may be running its course as unemployment has fallen.

Employers are more of wary of making changes in the design of their health plans, said Meyer of M3.

“The difficulty of attracting and retaining employees is becoming more important,” he said.

At the same time, employers are focusing more on initiatives to help keep employees healthy, Meyer said. That also can be seen in the Kaiser survey: Most large employers — 70 percent — offer health risk assessments or biometric screenings to employees, and 38 percent offer incentives for them to participate.

Employers also are drawing on mobile apps or wearable devices, such as a Fitbit or Apple Watch, in their wellness or health promotion programs. Roughly one in five report that they collect some information from the devices, according to the Kaiser survey.

The high cost of providing health benefits is spurring employers to explore new ways of paying doctors and hospitals, such as so-called bundled payments, in which a health plan pays a set amount for a total episode of care, Meyer said.

More employers also are offering incentives to employees to get care from health care providers who provide quality care at a lower price.

The Alliance, an employer coalition based in Madison, for example, is pushing health systems to accept so-called bundled payments for certain types of services, such as replacing a hip or knee.

The goal is to move away from a system in which health systems and physicians are paid based on the type and number of services they provide, what is known as fee-for-service. It has been slow going.

“It’s taken a ridiculously long time,” said Cheryl DeMars, chief executive officer of the Alliance.