Premiums for employer-sponsored health insurance rose to $12,680 annually for family coverage this year -with employees on average paying $3,354 out of their paychecks to cover their share -and the scope of that coverage has changed, with many more workers now enrolled in high-deductible plans, according to the 2008 Employer Health Benefits Survey by the Kaiser Family Foundation and the Health Research &Educational Trust.
 
Premiums rose a modest 5 percent this year, but they have more than doubled since 1999 when total family premiums stood at $5,791. During the same period, workers’wages increased 34 percent and inflation rose 29 percent.
 
This year many workers are also facing higher deductibles in their plans, including a growing number with general plan deductibles of at least $1,000 -18 percent of all covered workers in 2008, up from 12 percent last year. This is partly driven by growth in consumer-directed plans such as those that qualify for a tax-preferred Health Savings Account.
 
The shift has been most dramatic for workers in small businesses with three to 199 workers, where more than one in three covered workers must pay at least $1,000 out of pocket before their plan generally will start to pay a share of their health-care bills -rising from 21 percent last year. For workers facing deductibles in Preferred Provider Organizations, the most common type of plan, the average deductible rose to $560 in 2008, up nearly $100 from 2007.
 
The annual Kaiser/HRET survey provides a detailed picture of how employer coverage is changing over time in terms of availability, cost and coverage.
 
Rising Enrollment In HSA-Qualified Plans
Preferred Provider Organizations continue to dominate the employer market, covering 58 percent of covered workers. Health Maintenance Organizations cover 20 percent of workers, with 12 percent in Point-of-Service plans, 8 percent in consumer-directed plans, and 2 percent in conventional indemnity plans.
 
 The share in consumer-directed plans -high-deductible plans that include a tax-preferred savings option such as a Health Savings Account or Health Reimbursement Arrangement -has increased to 8 percent today from 5 percent last year and 4 percent in 2006. 
 
The growth in consumer-directed plans occurred mostly among workers at small firms (three to 199 workers), where 13 percent are now in this type of plan, compared with 8 percent in 2007. 
 
Premiums for consumer-directed plans are generally lower than for other types of plans, though in addition to the premiums, employers may also contribute money to the savings accounts.