News & Trends

2003 Employer Health Benefits Survey from the Kaiser Family Foundation, Latest Household Survey from the Substance Abuse and Mental Health Services Administration, PricewaterhouseCoopers' "Trendsetter Barometer" study of CEO's rating company's health plans





The percentage of premiums paid by employees has remained unchanged for the past two years at 16 percent for single coverage and 27 percent for family, according to the 2003 Employer Health Benefits Survey from the Kaiser Family Foundation. On average, workers contributed $508 of the $3,383 of single coverage and $2,412 of the $9,068 for family coverage in 2003 up $174 and $793, respectively, from 2000. In the same period, PPO deductibles rose 57 percent to $275 for preferred providers and 65 percent to $561 out-of-network. Rx copays of $19 for preferred drugs and $29 for nonpreferred drugs are up 46 percent and 71 percent respectively.

Despite three straight years of double-digit premium increases, employers are staying in the game, although smaller firms continue to be much less likely to offer health insurance. Just over half of the smallest companies (three to nine workers) offer health benefits, as opposed to three-fourths of firms with 10 to 24 workers, 84 percent of employers with 25 to 49 employees, and more than 9 out of 10 firms with 50 or more.

The Kaiser survey found few major changes in benefit structure, suggesting that employers may be reluctant to significantly alter arrangements that employees are used to or may simply lack confidence in available alternatives. Disease management was the most popular approach (22 percent said it was very effective) to potentially reduce future cost growth. Other options included consumer-driven health plans (14 percent), higher cost sharing (10 percent) and tighter managed care networks (six percent).

Watch for further analysis of the survey in the next issue of Business & Health.

The biggest managed care group just got bigger. Board members of the American Association of Health Plans (AAHP) and the Health Insurance Association of American (HIAA) have recommended the merging of the two leading trade groups. Using the temporary name AAHP/HIAA, the new group’s members will provide coverage for over 200 million Americans.


Last year, roughly 22 million Americans — 9.4 percent of the population age 12 or over — abused or were dependent on alcohol or illicit drugs, according to the latest Household Survey from the Substance Abuse and Mental Health Services Administration. Of these, 3.2 million were hooked on both, 3.9 million on drugs and 14.9 million on alcohol.

Three out of four drug users 18 or older were employed full or part time, the survey reported, while 23 percent of Americans participated in binge drinking at least once in the 30 days prior to the survey, and nearly 7 percent were heavy drinkers.

About 1.4 million people received specialized substance abuse treatment for an illicit drug problem and 1.5 million for alcohol problems. Over 94 percent of people with substance use disorders who did not receive treatment believed they didn’t need it.

Of the 362,000 people who recognized that they needed treatment for drug abuse last year, 88,000 were unable to get treatment even after trying. Over three times as many (266,000 people) couldn’t obtain treatment for alcohol abuse. Thirty four percent of those who received specialty treatment for an illicit drug problem in the past year paid out of their own pocket compared with 46 percent of those treated for an alcohol problem. Public assistance funded 49 percent of drug treatment and 44 percent of alcohol treatment. Private health insurance paid for 30 percent of drug treatment and 32 percent of alcohol treatment.

Consumers can now use their flexible spending accounts to pay for over-the-counter drugs, according to a recent IRS and Treasury Department announcement. Using allergy, pain and cold meds as examples, the IRS ruling allows use of FSA funds to pay for "medicine and drugs" but not for dietary supplements "that are merely beneficial to the general health."


Fewer than 4 out of 10 CEOs at America’s fastest growing companies rated their organizations’ health benefits plan as "excellent — above industry standards," reveals the latest PricewaterhouseCoopers’ "Trendsetter Barometer" study. While 36 percent gave the "excellent" rating, about 46 percent described their plans as "good — in line with industry standards," and 15 percent labeled theirs as merely "fair — below industry standards."

Similarly, 24 percent of the CEOs said their employees’ satisfaction with current plans was "excellent," 55 percent "good" and 16 percent "fair." But is this anything more than speculation? Only 43 percent of the companies regularly survey employees about satisfaction and needs related to health care. Those that conduct surveys apparently found good news: 84 percent reported "excellent" or "good" ratings compared with 78 percent among those not surveying.

After just three weeks of outpatient mental health treatment, work-impaired individuals’ productivity loss declined from 31 percent to 18 percent, according to a four-year study by PacifiCare Behavioral Health. Decreased productivity and absenteeism from mental illness will cost businesses nearly $312 billion annually, says the National Institute of Occupational Safety and Health.


News & Trends.

Business and Health

Sep. 15, 2003;21.