Insurers Expect Larger Premium Rise for 2016
Rising claims costs portend steeper premium hikes
By Stephen Miller, CEBS
5/26/2015 - SHRM
Health care insurers foresee a steeper jump in premiums into 2016,
with rising claims costs exceeding general inflation for at least the
next 18 months, according to the Spring Healthcare Trend Survey from Wells Fargo.
The survey of more than 65 insurance companies nationwide found that, before
any plan design changes, overall claim costs will continue to increase by 7 to
10 percent, signaling a sharper uptick in premium rates next year.
gRising cost trends will force companies into a delicate balancing act of
providing competitive benefits while also managing costs effectively and
complying with regulations,h said Dan Gowen, national practice leader with Wells
Fargo Insurancefs employee benefits national practice, in a news release.
Claim cost trends are influenced by price inflation or deflation, increased
or decreased use of services, the aging of the population, the leveraging effect
of benefit design features, changes in provider treatment patterns, and
improvements in technology and drug therapies. The Affordable Care Act, which
requires employers to cover a wider range of services for more people, with
greater compliance costs, is also seen as contributing to pricing pressure on
health care services.
Among the surveyfs key predictions:
•
Medical claim cost increases will remain in the high single digits. The
growth in claims costs for 2015 have ranged from 7.2 percent for health
maintenance organizations (HMOs) to 9.0 percent for indemnity fee-for-service
plans, consistent with Wells Fargofs 2015
Employee Benefits Market Outlook released earlier this year.
Projections for 2016 show stepper increases.
Health
Claims Cost Growth |
|
2015
(average) |
2016
(projected) |
Health
maintenance organizations (HMOs) |
7.2% |
8.6% |
Point-of-service
(POS) plans |
7.7% |
8.8% |
Preferred
provider organizations (PPO)s |
7.9% |
8.7% |
Consumer-driven
health plans (CDHPs) |
8.0% |
8.9% |
Indemnity
plans |
9.0% |
9.6% |
Prescription
plans |
10.2% |
10.1% |
Source:
Wells Fargo Insurance |
•
Speciality drug cost and use will continue rising. Despite overall
stability in pharmacy claims cost growth compared to medical claims, the survey
showed a continued increase in prescription drug cost trends as a result of
price increases in generic drugs and the growing use of specialty biotech
drugs.
gEmployers need to have a realistic expectation of what will happen to their
health care cost if they donft make any changes to their plan or health of their
employee population,h Gowen said.
Benefit Design Changes
Similar to the prior year, the surveyed insurers agreed that the top three
plan design changes in 2015 will involve wellness initiatives, accountable
care organizations (ACOs), and narrow
or tiered provider network offerings.
The survey also found that the dental claim trend remains
consistent with past results and lower than medical claims due to a lack of
cost-shifting from public to private plans and improvements in dental
technology.
Other Signs of Premium Growth
In a separate report released in May by actuarial and consulting firm
Milliman, the 2015 Milliman Medical Index showed that in 2015 the cost of
health care for a typical American family of four covered by an average
employer-sponsored PPO plan is $24,671. That amount is predicted to surpass
$25,000 in 2016, largely due to increases in prescription drug costs, which rose
by 13.6 percent from 2014 to 2015, Milliman found.
Of the $24,671 in total health care costs for a typical family, $10,473 is
paid by the family—$6,408 through payroll deductions and $4,065 in out-of-pocket
expenses incurred at the point of care.
Altogether, the health care costs for a typical family have more than doubled
over the past decade, and have nearly tripled since Milliman began tracking this
information in 2001.
Employees continue to shoulder an increasing percentage of this expense, the
report noted. The total employee cost (payroll deductions plus out-of-pocket
expenses) increased by approximately 43 percent from 2010 to 2015, while
employer costs increased by 32 percent.
Stephen Miller, CEBS, is
an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.