The annual survey's results are based on responses from almost 1,700 small and large employers between January and July, and the select findings were published by Health Affairs.

Another survey finding is that the average deductible now stands at $1,669, while the burden is up 92% over the past decade.

"Deductibles are a concern for lower-wage workers, and [employers] want to make a plan that's affordable so the contribution is not too high," Gary Claxton, senior vice president of KFF and a co-author of the study, said during a Nov. 10 webinar KFF hosted to discuss the survey's results. "But the way you have to do that is to make the cost-sharing high. That doesn't make them want to enroll or appreciate the plan."

COVID's impact on telemedicine

This year's KFF survey also assessed how the pandemic affected workplace health benefits, including mental health services and telemedicine. Some employers adapted their plans to address mental health and other challenges facing workers due to COVID-19.

Among firms with at least 50 workers that offer health benefits, almost four in 10 (39%) report making changes to their mental health and substance abuse benefits since the beginning of the pandemic. This includes 31% that increased the ways in which enrollees can access mental-health services (such as telemedicine), and 16% of firms offered new mental health resources (such as employee assistance programs). Others said they expanded their in-network mental health and substance abuse providers (6%), waived or reduced cost-sharing for related services (4%) or increased coverage for out-of-network services (3%).

Overall, 12% of employers with at least 50 workers that offer health benefits reported an increase in their enrollees' use of mental health services. Among the largest employers (with 1,000 or more workers), more than a third reported such an increase. Both Claxton and study co-author Matthew Rae, associate director of KFF's Program on the Health Care Marketplace, told webinar attendees they expect mental health benefits to continue emerging as a top priority for employers.

Prior to the pandemic, the use of telemedicine services by patients had been "modest," Claxton said. That changed significantly in 2021.

Nearly two thirds of offering firms with at least 50 workers reported making changes related to telemedicine, citing the pandemic. Half engaged in greater promotion of their telemedicine benefits to workers, and 31% expanded coverage for additional modes of telemedicine. In addition, nearly a quarter of employers expanded the places where telemedicine could be delivered, expanded the number or types of telemedicine providers, and expanded covered telemedicine services.

What's more, 55% of offering firms with at least 50 workers made changes to their wellness programs due to the pandemic. The most common changes involved expanding online counseling services, expanding or changing existing programs to better meet the needs of people working from home, and adding a new app or other digital program.

"The expansions of telemedicine and mental health benefits were important in meeting the needs of employees and their families in difficult times," Claxton and Rae wrote in Health Affairs. "These types of changes made sense not because employers want to spend more, but because employers want their employees to see their health benefit programs as 'benefits' and to value them as such."

Other study highlights:

• The larger an employer is, the more likely it is to offer health benefits to at least some of its workers, with 99% of all firms with at least 200 or more workers — and 56% of firms with fewer than 50 workers — offering coverage. Small firms that don't offer coverage most often cite cost, their small size, and workers having other coverage as the reasons for not offering benefits.
• About a quarter of firms with at least 200 workers say they expect new federal rules that require health plans to make cost information available to enrollees will help employees "a great deal" in making their health care decisions.
• About a quarter of large firms offer retiree health benefits for at least some current workers or retirees. For those offering benefits to Medicare-age retirees, nearly half offer coverage through a contract with a Medicare Advantage plan.

Read more: 

• Report: Health care costs for family of four decreased during pandemic
• Cancer and mental health drove health care costs in 2020
• Most Americans agree: We need to reduce health care costs