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Health Benefits Purchases Not Increasing, One Report Claims

Atlantic Information Services, a news site focuses on healthcare issues released a new analysis explaining recent trends in the healthcare insurance buying market. The report argues that despite many industry observers who expected that the Affordable Care Act’s (ACA) individual mandate would spur more individuals to take advantage of employer offerings and avoid being penalized, and a recent announcement by Wal-Mart Stores, Inc. of a rise in the number of its employees buying company health insurance, data show that employees have not shifted in great numbers to employer plans from 2013 to 2014.

In one study, benefits consulting firm Mercer conducted a survey of more than 700 employer clients (26% with fewer than 500 employees, 49% with 500 to 4,999, and 24% with 5,000 or more) which found that the average number of workers enrolled in a company plan for 2014 was 69.3%. This is only slightly above the 69.1% level of 2013. And when asked to project to 2015, the survey respondents told Mercer they expect a very small increase in employee uptake to 69.8%.

One possible explanation for the unexpected trend is that employers are tracking hours more closely to meet the ACA’s requirement that full-time workers be offered insurance by their employers. “This is all about managing employees better. If they are supposed to be working 25 hours per week and end up working 31,” that has an impact on their insurance status under the Affordable Care Act, Beth Umland, Mercer’s director of employer research for health and benefits, tells HPW.

Another possibility is that some employees opt out of employer-offered health benefits, for a variety of reasons. “The typical opt-out rate is 15% and that is typically people who have coverage elsewhere, through their spouse, through their parents. So they don’t need their employer’s coverage because they have other coverage,” Tracy Watts, senior partner and national health care reform leader at Mercer, tells HPW.

Employees also might not know their options when it comes to obtaining health insurance. “I know of one employer that offered a private exchange last year but employees did not know,” says Paul Fronstin, director of the Employee Benefit Research Institute’s Health Research and Education Program. “The name of the exchange was not used, and workers would only know that they have more choices, from three plans to 20 to 25 now.”

Visit  to read the article in its entirety, which includes analysis from other industry observers, including Shari Davidson, a vice president at the National Business Group on Health.

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Joseph Shaheen
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