In a ‘War for Talent,’ Employers Hold the Line on Health Benefit Costs


More than half of Americans younger than 65 had health coverage through an employer in 2020, according to the Kaiser Family Foundation.

Families with job-based health insurance contributed an average of $5,600 toward the cost of health coverage last year, with employers paying more than $15,000, according to the Kaiser Family Foundation. The foundation expects to release its report on 2021 costs in November.

Given all the moving parts, employers are taking different tacks to manage costs next year.

Nearly a third said they would consider narrowing the network of doctors and other providers available to patients, Willis Towers found. (It surveyed 378 employers of varying size, representing almost six million workers, in June and July.) A quarter of employers said they charged extra for covering a working spouse, if additional coverage was available through the spouse’s employer, and 9 percent said they were planning to add such “spousal surcharges” in the next year or two.

And in a trend to make care more affordable for lower-wage workers, some employers may vary their contributions to employee health care premiums, based on the employees’ jobs and their level of pay. Employers may contribute less to higher-paid workers’ health premiums, shifting more cost to them, and contribute more to lower-paid workers, to help them pay for the care they need. About a fourth of employers do this now, and 8 percent more are planning on doing it in coming years, Willis Towers found.

“It’s aimed at affordability,” which is a “hot topic,” Ms. Stone said.

The financial services company Synchrony, which has a large number of hourly workers, has used tiered premiums for years. The company’s entry-level tier offers health coverage starting at $2 a week for an individual and $10 a week for a family of five; higher-tier employees might pay twice as much or 10 times as much. The plans have the same type of coverage across tiers; just the premium varies, said Aaron Brown, the company’s senior vice president of total rewards.

“It’s the right thing to do, to make sure health care is affordable for our employees,” he said. Employees seem receptive; the company says the share of employees who elect medical coverage is consistent across wage levels.

Employers see mental health as a top priority, said Mr. Bernstein of Mercer, and are responding by increasing the number of covered therapy visits, and offering digital tools to help increase access to providers. Online services like Ginger, for example, let workers schedule remote visits quickly and offer exercises to help reduce anxiety.


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