Blame it on an economy still on the mend or go so far as tocredit Obamacare. Either way, there's fresh evidence of aslowing in health inflation in the latest survey of employersby Towers Watson and the National Business Group for Health.

The survey also affirmed a trend abundantly familiar to a growingnumber of working Americans: cost-sharing is on therise.

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The cost of providing employer-sponsored health care benefits,according to the survey, is expected to increase 4.4 percentthis year, climbing to $9,560 per employee compared to lastyear's $9,157.

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That's a bigger jump between last year and2012 but not much of one. Employer health costs inthat period rose 4.1 percent, the lowest increase in 15years.

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The survey also found that the employees’ share of premiumsincreased nearly 7 percent, to $2,975, this year.

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Out-of-pocket costs also increased. The total employee costshare has climbed from 34.4 percent in 2011 to 37 percent in 2014.Employees now pay over $100 more each month for health carecompared with just three years ago.

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What’s driving these numbers? Reduced direct coverage, in mostcases.

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As outlined by the results of a TW/NBGH survey, companies aregradually shedding the components of their health plans becauseeveryone else is doing it. The competitive advantage has swung tothose who have divested themselves first of the burdensome expenseof employee health coverage.

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To be sure, this detailed survey of nearly 600 major U.S.companies offers evidence that plenty of employers (95 percent ofrespondents) will continue to view benefits packages that includehealth coverage as something worth retaining. But almost the samenumber — 92 percent — plan to make changes in the near-term tolessen their coverage responsibility.

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The big-picture trend cited by the data is one of the enterprisebacking away from health coverage as other options emerge.

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Employers are banking on the one-two punch of private and publicexchanges to take over the task of providing affordable healthinsurance to current and former employees. While few employers arewilling to completely pull the plug on coverage, there are somewilling to do so. And, if the trends spotted by this surveycontinue, these leaders will be cited as the precedent by others tofollow in their footsteps in order to remain competitive.

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“Despite the moderation, health care costs continue to outpaceinflation and remain a major concern for U.S. employers given thechallenging macroeconomic environment,” said Ron Fontanetta, seniorhealth care consultant for Towers Watson. “To find more effectiveways to manage health costs, many employers are focusing onreshaping their health strategy for the next three to fiveyears.”

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Here are some of the results that support the un-coveragereaction:

Dependent coverage

  • 49 percent of respondents said they increased employeecontributions for dependent tiers at higher rates than forindividuals. Another 19 percent expect to make this move nextyear.
  • 24 percent said they now use spousal surcharges of around $100per month when other coverage is available to the spouse.
  • 70 percent believe offering subsidized coverage for spouses isimportant today. But for 2015 and beyond, only 56 percent believethat subsidized health care for spouses will be veryimportant.

Employee cost-sharing

  • Employees’ share of premiums increased nearly 7 percent thisyear. The total employee cost share rose to 37 percent in 2014, upfrom 34.4 percent in 2011.
  • Employees now pay over $100 more each month for health carecompared with just three years ago.
  • Account-based health plans are the top item these days, withthree-quarters of respondents acknowledging that such programs areat least one component of their package. The most popular, thehealth savings account, is essentially managed by the company butfunded by the employee. In its crystalized form, theseemployee-owned plans shift both cost and responsibility to theindividual.
  • 16 percent of respondents having adopted account plans as theirsole health insurance option for employees, with nearly one-thirdof all companies indicating they may only offer these plans in2015.

Exchange options

  • Two-thirds of companies believe that private exchanges willoffer a viable alternative to employer-sponsored coverage foractive employees as early as 2015. Many also view theprivate exchanges as the future coverage for theirretirees.
  • Nearly two-thirds of employers that offer a sponsored plantoday for retirees say they plan to send all of theirpre-Medicare-age retiring workers to public exchanges.
  • While the survey indicated that employer confidence in publicexchanges is still low, it revealed that respondents are carefullywatching the evolution of the exchanges as they weigh scrappingemployee health insurance and helping them find exchangecoverage.

    “Most employers are taking a wait-and-see approach to gauge whetherthese models can deliver greater value for their active employeesthan self-managed programs,” said Helen Darling, president and CEOof the NBGH.

Photo: The NBGH's HelenDarling.

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While two in five respondents cited the Patient Protectionand Affordable Care Act as the primary driver of their health carestrategy, the slow growth in health spending can mostly beattributed to the economy.

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Between 2009 and 2011, government statistics show that healthspending jumped 3.9 percent every year, marking the slowest growthsince tracking began in 1960. The trend led to an average growth of4.2 percent each year from 2008 to 2012. That was much lowerthan the growth of 8.8 percent between 2001 and 2003.

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Although the recession officially came to an end in 2009, manyexperts project slower-than-typical health care spending forseveral more years.

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The economy accounted for 77 percent of the reduced growth inhealth spending, a Kaiser Family Foundation study last year found,while the other 23 percent was attributed to changes in the healthcare system, such as higher deductibles and other cost-sharingmeasures.

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The TW/NBSH survey was completed by 595 employers betweenNovember and January. Respondents collectively employ 11.3 millionfull-time employees, have 7.8 million employees enrolled in theirhealth care programs and represent all major industrysectors.

Also read:
Benefits managers missing out on key cost-savingmoves
Employers turn to private exchanges
Small businesses hit by rate increases of 20 percent ormore

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.