Segal Unveils 2024 State Employee Health Benefit Study and Interactive Plan Comparison Map Tool
March 29 2024 - 11:13AM
Business Wire
Leading benefits and HR consulting firm Segal released its 2024
State Employee Health Benefit Study today, alongside an interactive
map revealing state-by-state comparisons of health benefit plans.
The study reveals medical and prescription drug plan design and
benefit cost-sharing arrangements available to full-time active
employees enrolled in state benefit plans in all 50 states for
2023-2024.
Key Findings of the 2024 Study:
- 94% of states offer employees a choice of medical plans as
employees seek customizable benefits aligned with their personal
needs.
- High-deductible health plans (HDHPs) are more prevalent in
America today, in fact more than half of state plans offer an HDHP
plan option. Of the 33 states that offer HDHPs, 23 contribute to a
health savings account, at an average employer contribution amount
of $531 annually in 2023.
- While deductibles levels for HDHPs are much higher than
preferred provider organizations (PPOs), the variance of
out-of-pocket (OOP) maximums between these plan types is not as
significant, which is partially due to maximum allowable OOP limits
in place by the Affordable Care Act (ACA). The highest difference
between HDHP OOP maximums and PPO plans is 11 percent.
- Regional differences are significant, for example West Coast
employees contribute 0.78 percent of their salary towards coverage
for their least expensive plan option and 2.75 percent for their
most expensive plan option, while employees in the Midwest pay 1.63
percent for their least expensive plan option and 3.25 percent of
their salary for the most expensive plan option.
- As fixed-dollar prescriptions drug copayments erode in value
over time, some states have adopted coinsurance with
minimum/maximum amounts to protect plan values and improve
participant utilization patterns. Five states now charge
coinsurance for generic drugs for the most expensive plans offered
in their state, with 10 percent being the most common amount. For
more expensive brand drugs, 10 states charge coinsurance with 20
percent being the most common charge.
Complementing the study, Segal's innovative, interactive map
tool enables users to perform detailed state-by-state comparisons,
shedding light on the intricate details of each state's employee
health benefit plan. Available on the Segal site, the map’s free
version offers comprehensive data, while the paid version allows
users to compare states side by side and change the map to view
different cuts of the data, such as average salary, contribution
ratio, plan offerings by state and average cost per visit or
average cost per prescription script. The comprehensive version
also includes the ability to benchmark to specific states to
compare medical and Rx cost sharing features.
“As health benefit coverage costs continue to outpace inflation,
state leaders have placed a renewed focus on health budgets. The
Segal study’s findings underscore the need for targeted
cost-management strategies. Putting numbers into context, a 4
percent increase on a median salary of $60,000 translates to $2,400
in wage growth. This compares to an expected $1,900 increase in
health care spending expected over the same time, or 8 percent of
current health care costs ($24,000). Roughly 80% of budgeted wage
growth could be consumed by health care trend if plan strategies
are not effective in managing spending,” said Melanie Clark, Vice
President and Actuary at Segal. “The interactive map tool is a
gateway to empowering leaders with the insights they need to
navigate the demands of health coverage in a way that is
cost-effective and beneficial for employees across the state.”
By allowing comprehensive comparisons of how peer jurisdictions
structure their employee health benefits the map provides
contextual benchmarks that can guide plan design adjustments. This
groundbreaking study and accompanying digital map are built on
Segal’s extensive expertise gained from decades of advising health
plans.
About Segal
Segal delivers trusted advice that improves lives. Segal is a
privately owned benefits, human capital, communications,
technology, insurance brokerage and investment consulting firm with
more than 1,000 employees throughout the U.S. and Canada. Segal,
Segal Marco Advisors and Segal Benz are all members of the Segal
family.
The State Employee Health Benefit Study is for informational
purposes only and does not constitute legal, tax, financial or
similar advice. It is only intended to identify general trends and
does not cover all fact patterns that may apply to your plan. It is
based on publicly available information available to Segal at the
time it was created. Segal makes no representation or warranty as
to the accuracy of any forward-looking statements and does not
guarantee any particular outcome or result. You are encouraged to
discuss the issues raised here with your legal, tax and other
advisors before determining how the issues apply to your specific
situation(s).
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Dhani Hoyte, Segal@peppercomm.com