For the large employers' report, the study found companies working to respond to a changing labor market. As the Great Resignation created a new focus on attracting and retaining employees, the report found that companies have moved to make their health benefits more attractive. At the same time, large employers are showing more interest in areas such as mental health and financial planning.

More options, lower cost increases

A major finding of the report is that large employers clearly are making an effort to respond to employee concerns about high health care costs.

One strategy for doing that is holding down cost increases to employees. "In the 2021 plan year, employers took on more of the premium burden for health plans than in previous years to mitigate impacts of the pandemic for employees," the report noted. Over the last two years, the report said, "Employers [have picked] up the five percent premium increase for individual PPOs, and out-of- pocket cost increases were two percent or less on average," the report said.

Although costs to employees were slightly higher overall in 2022, other adjustments were also seen. For example, the difference in premium costs for individual high deductible health plans (HDHPs) rose 21% in 2022, reducing the average cost difference between individual HDHP plans and individual PPO plans to just $150 a year for employees.

That adjustment came as employees were showing a significant preference for PPOs over HDHPs in the last two years. In 2020, participation in HDHPs and PPOs were less than ten percentage point apart (PPOs were slightly more preferred). By 2022, interest in the two plans had split sharply, with 48% choosing PPOs and 20% choosing HDHPs. (This data was taken from companies that offered at least one HDHP and one PPO plan).

"HDHP elections experienced a significant decline in 2022 for the first time in two years when employees were given the choice between a PPO and HDHP," the report said. "The limited changes to out-of-pocket costs…may also have made PPOs more attractive than HDHPs in 2022."

Large employers were, in general, giving their employees more options, according to the study. Over the five years of the study, the percentage of employers offering both HDHP and PPO plans rose steadily, while the number of companies offering only PPOs or only HDHPs decreased. As of 2022, 77% of large employers now offer an average of five health plan options.

Continued interest in voluntary benefits

The study also found that large employees are interested in voluntary benefits. In the health benefits area, mental health wellness support was a top area of interest. Financial wellbeing, such as help with retirement planning, was another area of interest. In the area of lifestyle voluntary benefits, educational support and maternity/paternity leave were top interests. In the area of professional support, increased paid time off or sick time, along with more flexibility in work arrangements, were the top areas of interest.

"Employers remain persistent in their effort to provide employees with flexible health plan options while also diversifying their voluntary benefit offerings to attract and retain talent," the report said. "However, more choice creates additional complexity for teams that are already stretched thin as well as employees who may already be overwhelmed. The extent to which employers can rely on their technology solutions for reliable data integrations and automation will determine their capacity to maintain a robust benefits package."

Read more: 

• Looking to avoid the Great Resignation? The key could be in your benefits package
• Why paternity leave matters, and 4 ways to make it real
• Flexibility, remote work still top priorities for workers