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A family of four with employer-sponsored health coverage is shelling out substantially more since the advent of the Patient Protection and Affordable Care Act. The cost of family coverage also is rising so fast that even this standard employee coverage package could trigger the 2018 Cadillac tax.

These were among the findings of a recent analysis of the cost of providing coverage for a four-member family by the actuarial consulting firm Milliman Inc., which produces an annual medical index that tracks the various cost components of health insurance.

Not only is the average cost rising faster year over year, Milliman said, but the family’s share of the cost has also increased dramatically. And much of the increase can be attributed to the ever-rising price tag for prescription drugs.

Among the study’s findings:

  • The overall cost of coverage will rise by 6.3 percent this year over last, compared to last year’s 5.4 percent — an all-time low for the index.

  • This represents a $1,456 increase over 2014, for a total cost of coverage of $24,671.

  • The employer’s share will be $14,198, with the family’s share pegged at $10,473.

  • $467 of the increase represented the cost of prescription drugs, “a 13.6 percent increase after a five-year period in which prescription drug costs averaged annual increases of 6.8 percent,” Milliman reported.

  • The 2015 drug spike “resulted from the introduction of new specialty drugs as well as price increases in both brand and generic name drugs, increases in use of compound medicines, and other causes,” Milliman said.

  • The cost of prescription drugs has increased 9.4 annually on average since 2001, compared to a 7.7 percent annual average increase for all other services. “Prescription drug costs now comprise 15.9 percent of total health care spending for our family of four, up from 13.2 percent in 2001,” Milliman said.

  • The employee’s share of coverage has increased 43 percent from 2010 to 2015; the employer’s share has gone up 32 percent during that time.

  •  Of the $10,473 paid by the family, $6,408 is attributed to payroll deductions, and $4,065 to out-of-pocket expenses.

  • These upward cost movements could move a family-of-four insurance package into Cadillac tax territory, triggering the excise tax that was created as a governor on “rich” employer sponsored plans.

“For the last several years we’ve noted that the Milliman Medical Index was only indirectly affected by the Affordable Care Act, since the employer-sponsored insurance market was not a focus of the early reforms,” said Chris Girod, co-author of the Milliman Medical Index.

“But now we have the prospect that this family’s health plan — which, in terms of actuarial value, is in a “gold” plan — may trigger the ‘Cadillac tax’ that goes into effect on high-cost health plans in 2018. Whether or not our typical family of four finds themselves affected by the Cadillac tax will depend on whether future trends exceed recent levels, with people insured through smaller employer-sponsored plans potentially being more susceptible.”