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2019 Iowa Employer Benefits Study©
Employers Report 7.1% Increase in Health Premiums

Today, we issued our 20th Iowa Employer Benefits Study© results. As with past studies, the wealth of data is immense. This year’s study found that Iowa employer health insurance premiums increased an average of 7.1 percent from 2018 to 2019.

The 7.1 percent increase is an average that factors in employers receiving no rate change, an increase or decrease in their health premiums. This number represents the average increase in premiums employers received PRIOR to making design changes to their medical plans – such as increasing cost-sharing arrangements with employees.

The 2019 Iowa Employer Benefits Study© found that average annual premiums for employer and employee contributions (combined) were $7,017 for single coverage and $19,335 for family coverage. Since 1999, the year this study began, the single premium has increased by 240 percent while the family premium has jumped by 251 percent. (NOTE: In a number of slides below, the year 2017 was excluded because no survey was performed.)

During the post-ACA period (2011-2019), total family premiums increased by 45.4 percent, while employees with family coverage experienced a 30.5 percent increase to their payroll-deducted premiums. Employers continue to make sizeable contributions to keep the employee cost ‘manageable.’ This information is depicted in the following graph.

How did Iowa employers respond? They continue to ratchet up employee cost-sharing arrangements by increasing employee premium contributions and plan-sharing responsibilities, which results in higher deductibles and out-of-pocket maximums.

For the first time in this study’s history, employers were asked to gauge their ‘cost-shifting fatigue.’ On a 10-point scale, where 1 means the employer has a minimum cost-shifting fatigue and 10 means the employer has reached its limit of shifting costs to employees and is now considering to no longer offer health coverage, Iowa organizations reported their fatigue level was 3.5 out of 10. Despite experiencing rate hikes for years, Iowa employers are not yet likely to discontinue offering health coverage. Below is a slide that depicts employer responses by employee-size categories.

Iowa employees were asked to contribute an annual average of $1,313 for employee-only coverage, while employees with family members were asked to pay $5,794 annually. Over the course of 20 years (1999-2019), employee contributions have increased by 196 percent for single coverage and 173 percent for family coverage.

The overall 2019 statewide weighted-average deductible for single coverage is now $2,192, while the family weighted-average is $3,975. Since 2004, deductibles for both single and family have risen by 288 percent and 235 percent, respectively.

The post-Affordable Care Act (ACA) period (2011-2019) reveals the deductibles continue to climb for both single and family coverages, approximately 46 percent and 25 percent respectively.

In addition to revealing updated results for dental coverage, group life insurance, short and long-term disability coverages, the 2019 Study also reveals whether Iowa organizations offer a large number of work-life and convenience benefits in their workplace setting. The top five benefits offered by Iowa employers include:  Jury Duty Leave (89.2 percent), Bereavement/Funeral Leave (87.5 percent), Unpaid Leave (83.7 percent), Maternity Leave (72.6 percent), and Personal Days (63.6 percent).

The above information is just a small fraction of our survey results. The complete 2019 Iowa Employer Benefits Study© is available for purchase and download on this site.

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