Actuarial News - News, Actuary Wiki, SOA & CAS exam study materials and more

The California increase of 11.4 percent in premiums for employer-sponsored health insurance was statistically equivalent to the national average of 11.2 percent and over six times the California inflation rate of 1.7 percent. Between 2000 and 2004 premiums have increased a total of 61 percent.

Historically, premiums in California have been lower than national premiums, but over the past several years they have steadily approached the U.S. average. At $10,013, a typical family policy in California is about the same as the national average of $9,950, the survey found. Single coverage averaged $3,685 in California in 2004, compared to $3,695 nationally. This year for the first time, the average cost for a family PPO plan in California exceeds that in the U.S. by 15 percent.

HMOs remained the least expensive type of health plan, costing nearly 30 percent less for single coverage than PPO plans. About 50 percent of California workers were enrolled in HMOs in 2004, compared to 25 percent nationally. However, health plan enrollment in California has shifted somewhat to PPOs over the past year. PPOs increased their market share from 29 percent in 2003 to 36 percent in 2004, according to the survey.

The percentage of California employers offering health insurance to their workers was 67 percent in 2004, about the same as in 2003. As with prior years, firms cited the high cost of coverage as the primary reason they did not offer health benefits.

On average, workers in California contributed $2,580 for family coverage and $474 annually for single coverage in 2004. Compared to 2003 levels, worker contributions grew 5 percent for family coverage and 13 percent for single coverage. However, workers' average share of the premium costs in 2004 fell slightly to 27 percent for family and 13 percent for single coverage.

"Health insurance premiums in California continued their double-digit climb and the average cost of a family plan is now the same in California as the rest of the nation. These increases are hard for employers as well as for working families who have seen their contributions for family coverage go up repeatedly over the past several years," said Mark D. Smith, M.D., president and CEO of the California HealthCare Foundation.

The California Employer Health Benefits Survey of is an independent survey based on the national employer survey conducted annually by the Kaiser Family Foundation (KFF) and HRET. Between 2000 and 2003, KFF conducted surveys in both California and the nation as a whole. Beginning this year, the California HealthCare Foundation (CHCF) assumes sponsorship from KFF of the California survey, which is separate from and not included in the national survey.

"The California HealthCare Foundation's sponsorship of this special study makes it possible to compare our state with the nation on health care costs and coverage, issues which are very much on the minds of Californians," Kaiser Family Foundation President Drew Altman said.

A detailed chart pack summary of the survey is available at chcf.org. Results of the national survey, which was released in September 2004, is available at kff.org.

"The annual cost of health insurance for a California family of four is now equivalent to 75 percent of the annual earnings of a fully-employed minimum wage worker. This is one more indicator that the cost of health insurance is prohibitively expensive for many employers and workers," said Jon Gabel, vice president for Health Systems Studies at the Health Research and Educational Trust and one of the survey directors.

Other survey highlights include:

-- Nearly all large California employers - those with 200 or more workers - offered health insurance and 55 percent of the smallest companies with 3 to 9 workers provided coverage. Only 20 percent of California employers offered coverage to part-time workers.

-- Eighteen percent of small firms offered a high deductible health plan (a deductible of more than $1,000 annually for single coverage), compared with just 8 percent of all large firms.

-- Employees in California have much greater choice of health plans than workers nationwide. The survey found that 93 percent of workers in large firms (200 or more workers) in California were offered more than one health plan option in 2004, compared to 82 percent of workers in large firms nationally.

-- Almost half of all large firms (44 percent) reported that they were very likely to increase the amount employees pay for premiums in 2005.

-- Few employers viewed current cost containment strategies as highly effective with just 13 - 15 percent reporting disease management, higher employee cost sharing, or tighter managed care networks as "very effective."

-- Thirteen percent of California firms reported that they vary the contribution for family coverage based on whether an employee's family member has the option of obtaining coverage elsewhere.

-- About half of all covered workers faced some form of cost sharing for hospital admissions.

-- While nearly all active workers with insurance coverage had drug coverage in 2004, the use of tiered cost sharing, with higher co-payments for brand name drugs than generics, has grown rapidly with 81 percent of workers now in plans that use them. While average payments for drugs in each of the three tiers (generic, preferred, and non-preferred) increased in 2004, the average co-payment in California for a non-preferred drug ($25.90) remained lower than the national average ($33).