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Out-of-pocket costs rising in large employer plans

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in Compensation and Benefits,Human Resources

About one in four people (24%) covered by large employer health insurance plans spent more than $1,000 out-of-pocket on health care in 2015, according to new analysis by the Kaiser Family Foundation. That’s an increase of seven percentage points from 17% in 2005.

Twelve percent of people paid more than $2,000 out-of-pocket in 2015, a distribution that mirrors the distribution of overall health spending, according to the new analysis of claims data. (Dollar amounts are adjusted to 2015 dollars.)

Between 2005 and 2015, covered workers’ average out-of-pocket costs grew 66%, compared to health plans’ average payment per enrollee, which rose by 56%. Wages, meanwhile, rose by 31% during that period.

The study analyzed the demographics of large employer plan enrollees’ spending, as well as differences in out-of-pocket health expenditures across diseases. Some findings:

  • 59% of those who spent more than $1,000 out-of-pocket in 2015 were women. Older enrollees were more likely than younger enrollees to spend more than $1,000.
  • Average annual out-of-pocket spending for large-group enrollees diagnosed with common cancers ($1,510) and all circulatory diseases ($1,508) was nearly twice that for all enrollees ($778).

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