Employer-sponsored health coverage redefined in ACA era

While employer-sponsored plans typically have much lower deductibles than the most popular plans found on the exchanges, more employees have deductibles, and those deductibles are increasing. Over all, employees have deductibles that are about 50 percent higher than they were five years ago. Four out of five covered employees pay a deductible, which averages about $1,500 each, Kaiser found. Employees who get insurance through a smaller company have deductibles that now average $2,100. Workers are also paying a greater share of the premiums, contributing $5,277 annually toward a family plan, nearly a third of the total cost.

Source: Workers Pay More for Health Care as Companies Shift Burden, Survey Finds

The Patient Protection and Affordable Care Act is predicated on the principle that the vast majority of working age Americans are covered by employer-sponsored health insurance (ESI). In the not too distant past, ESI could have been accurately described as an employee benefit since employees paid little or nothing for their coverage.

In line with the trend of the past several years to have employees share in the cost of their coverage, the Affordable Care Act redefined ESI as “employer shared responsibility,” referring to the law’s requirement that employers of 50 or more offer nearly all full time employees coverage providing minimum value. That’s a critical distinction that reshapes the traditional view of ESI.


Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email fpilot@pilothealthstrategies.com or call 530-295-1473. 

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Frederick Pilot

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