Annual EBRI Survey Explores Employee Attitudes Regarding Health Plan Choices in a Post-ACA World

Monday, April 13, 2015
Michael Gomes

Earlier this year, the Employee Benefits Research Institute (EBRI) published their latest version of the Views on Employment-Based Health Benefits: Findings from the 2014 Health and Voluntary Workplace Benefits Survey. This survey explores current worker attitudes regarding their employee-based health benefits and coverage before and after the implementation of Affordable Care Act (ACA). According to the report, “Enactment of the (ACA) has raised questions about whether employers will continue to offer health coverage to their workers in the future. Yet, the importance of benefits as criteria in choosing a job remains high, and health insurance in particular continues to be, by far, the most important employee benefit to workers.”

Interestingly, the study notes that there was “relatively little net change in the number of people with employment-based coverage in the short term” as a result of the ACA, but we cannot be sure if this will be true for the long term. However, some have expressed concerns that fewer employers might offer coverage in the future due to the ACA Exchanges system. For example, the Congressional Budget Office predicted that 20 percent fewer workers will have coverage through their employer by 2025.

Understanding some of these trends can help Brokers better advise their clients on which health insurance options to consider. Here is a snapshot of some of the key EBRI findings:

Level of Wages versus Benefits

In terms of employee attitudes regarding their current wages and benefit levels, the 2014 research poll found that:

  • Nearly 70 percent of respondents say they are satisfied with their health benefits
  • 12 percent would trade wages to get more benefits
  • 19 percent would give up benefits for higher wages

These findings have held fairly steady over the past few years, with only a slightly higher interest in receiving higher wages than benefits. Overall, it appears that employers are balancing the level of wages and benefits fairly well.  

Impact of Making Employer-Coverage Taxable

If current tax preferences were to change and the benefits for employment-based coverage were to become taxable, about half of the respondents would keep the same employer coverage, but the other half would make a change:

  • 47 percent would continue with their current level of coverage
  • 26 percent would switch to a less costly plan provided by their employer
  • 20 percent would shop for coverage directly from insurers
  • 7 percent would drop coverage altogether

Method for Obtaining Health Coverage

Results were mixed if workers are given a choice on how to obtain health insurance coverage:

  • 40 percent prefer to get coverage the way they do now
  • 41 percent prefer to choose their insurance plan, having their employer pay the same amount and pay the remainder themselves
  • 19 percent prefer their employer give them money and allow them to decide whether to purchase coverage

Although four out of ten respondents like the status quo, it looks like a majority of respondents (60 percent) would like to take a lead in selecting coverage, but still have the employer help pay for the insurance premium.

Satisfaction Ratings

In terms of satisfaction with employee coverage, just over 50 percent of the respondents are extremely satisfied (12 percent) or satisfied (39 percent) with their employer-based coverage and only 11 percent are dissatisfied to some degree:

  • 12 percent are extremely satisfied with their coverage
  • 39 percent are very satisfied
  • 38 percent are somewhat satisfied
  • 9 percent are not too satisfied
  • 2 percent are not at all satisfied

Interestingly, it looks like there has been an 8 to 10 percent drop in the extremely satisfied ratings over the past five years.

Plan Selection

In regard to confidence in their employer (or union) to select the best available health plan, employees reported the following:

  • 11 percent are extremely confident that their employer selected the best available health plan
  • 30 percent are very confident
  • 44 percent are somewhat confident
  • 11 percent not too confident
  • 4 percent not confident at all

If their employer (or union) were to stop offering coverage, about 40 percent are extremely or very confident in their ability to choose their own plan:

  • 12 percent are extremely confident they could choose their own plan
  • 29 percent are very confident
  • 39 percent are somewhat confident
  • 16 percent are not too confident
  • 4 percent are not at all confident

As to the importance of offering a choice of health plan through an employer or union, the vast majority of respondents believe that choice is extremely or very important:

  • 46 percent say that health plan choices are extremely important
  • 36 percent say is it very important
  • 15 percent somewhat important
  • 3 percent say is it not too or not at all important

A slight majority of workers would like more choices as well, with only one out of four not very interested in more choices:

  • 14 percent are extremely interested in more choices
  • 27 percent are very interested
  • 36 percent are somewhat interested
  • 19 percent are not too interested
  • 4 percent are not at all interested

Using a Rating System

Although many people expressed interest in seeing more health plan options, 42 percent of respondents were either extremely (9 percent) or very (33 percent) comfortable with using an objective rating system to help them choose a health plan, about half were somewhat comfortable and less than 10 percent were not comfortable in using a rating system:

  • 9 percent say they would be extremely comfortable
  • 33 percent say they would be very comfortable
  • 49 percent say they would be somewhat comfortable
  • 8 percent say they would be not too or not at all comfortable.

When the same question was asked regarding the “confidence” (versus the “comfort”) level of using a rating system to select a health plan, the respondent results were almost identical to the first question.  

The research then assessed the important of using independent quality measures when selecting a health plan:

  • 25 percent responded independent quality measures are a major consideration
  • 53 percent say they are a minor consideration
  • 22 percent say they are not a consideration

Interestingly, quality measures do not appear to be as highly rated as many public policy makers would think. Of course, the survey probably did not define in much detail what “quality” means, which in part might explain why one in four respondents rated it as a major consideration.

Cost Still a Major Factor

For individuals choosing a health plan, premiums and cost sharing (deductibles and co-payments) are important factors for consideration:

  • 80 percent say premiums and cost sharing are a major consideration
  • 15 percent say they are a minor consideration
  • 3 percent say they are not a consideration

The EBRI highlights that employer-sponsored coverage remains a dynamic marketplace for workers.  Expectations vary depending on the issue, but the 2014 survey results highlight that certain factors like health plan choice and cost remain key considerations.  

Stay Tuned

At BenefitMall, we hope this information will benefit Brokers in better assisting their many clients towards the best possible health benefits solution. In the meantime, stay tuned as we continued to report on consumer attitudes towards the ACA and health benefits, as well as any other issues affecting Brokers.

The views expressed in this post do not necessarily reflect the official policy, position, or opinions of BenefitMall. This update is provided for informational purposes. Please consult with a licensed accountant or attorney regarding any legal and tax matters discussed herein.