Here’s some news that will surprise almost no one: The cost of claims in employer-sponsored health plans continues to rise, according to a survey from Wells Fargo Insurance.

Although rates remain consistent compared to six months ago, the survey of more than 70 insurance companies nationwide found that overall claim costs will continue to increase in the high single digits next year.

For preferred provider organizations and consumer-driven health plans, the projected increase is 9.3 percent; health maintenance organizations are slightly lower at 8.5 percent.

“Despite ongoing efforts to control health care expenses the survey found that insurers are not expecting a drop in claim costs for 2013,” says Dan Gowen, senior vice president of Wells Fargo Insurance’s national employee benefits practice. “This means that employer premiums will likely rise, and it’s also likely consumers may pay more for their share of employer-sponsored health care plans. Employers seeking to minimize cost increases should explore more sophisticated ways to maintain and improve the health risk of employees and maximize their benefit investment.”

The Wells Fargo Insurance Employee Benefits Survey took place between July and August 2012.

The survey also found dental cost trends are lower than medical trends due to lack of cost shifting from public to private plans, and a negative cost impact from improvements in the dental technology field. The results also indicate prescription costs are down slightly, because of greater availability and wider generic drug use.

In addition to health care reform provisions, claim trends are influenced by price inflation or deflation (changes in unit prices for the same services), increased or decreased use of services, population age, leveraging effect on benefit design, changes in provider treatment patterns, improvements in technology and drug therapies, and cost shifting.

Reflecting claim activity over a six-month period, projected increases in the national average cost of claims are:

• Health maintenance organizations – 8.5 percent

• Point-of-sale – 8.7 percent

• Preferred provider organizations and consumer driver health plans – 9.3 percent

• Exclusive provider organizations – 9.4 percent

• Indemnity plans – 10.2 percent

• Prescription plans – 7.6 percent

Instant Insights /

PPOs, CDHPs projected to jump 9.3 percent in 2013

More From HR Executive

Related Stories

Recommended For You