the new state health plan exchanges under the Affordable Care Act are comparable to -- and in some cases lower than -- plans currently offered by employers with similar levels of coverage. According to a study released recently by PricewaterhouseCooper's Health Research Institute 1, the new state health plan exchanges under the Affordable Care Act are comparable to -- and in some cases lower than -- plans currently offered by employers with similar levels of coverage. The average premium costs for a working population nationally in the public exchanges were analyzed and HRI calculated that the median 2014 premium for a plan with coverage similar to that of the average employer sponsored plan was $5,844. The average employer premium for a single worker, by comparison, was $6,119, a 4% difference. The premiums were calculated without subsidies. The ACA's 51 state exchanges allow consumers to choose from four plan levels -- bronze, which pays 60% of healthcare costs; silver, which covers 70%; gold, which covers 80% and platinum, which covers 90%. On average, current employer-sponsored health plans cover approximately 85% of healthcare costs, with employees paying the remainder, according to the PwC study. | The study found at every level, across the board, average exchange premiums are lower than this year's average employer-sponsored premiums. The study found at every level, across the board, average exchange premiums are lower than this year's average employer-sponsored premiums. This data is likely unexpected. "Employers may be surprised that exchange premiums in 2014 are comparable to employer premiums and in some states, significantly lower than employer-based premiums," says the report. What should employers take away from this? You may have more options in heading towards a consumer-driven healthcare model than you first anticipated. "Employers contemplating future limits to their health care spending could face less resistance if employees are given a wider range of options at different price points via an exchange." it says. 1 There is a "caveat emptor" here. ACA still doesn't show signs of being rock solid yet, pending legislation could negatively affect exchange premiums, and provider networks must also be compared to really make this analysis "apples to apples." Our advice is to proceed with cautious optimism. 1 Employee Benefit News, "Public Exchanges Competitive with Employer-Sponsored Plans," Michael Giardina, January 30, 2014 |
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