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One reason employers' health claims are going up is that the workers are getting older.
Average health plan claim costs for workers ages 55 to 64 are much higher than average claim costs for workers ages 25 to 34, according to a new report from the Health Care Cost Institute and West Health.
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Bianca Silva Gordon and Jessica Chang, the analysts who prepared the report, used employer plan claim data for 2022 from HCCI member insurers to show how much workers' age affects claim costs.
They looked at workers in four age groups: 25-34, 35-44, 45-54 and 555-54.
The workers who are ages 55 or older are all now younger baby boomers or members of Generation X.
Few workers in any age category used inpatient hospital care, but, overall, average inpatient hospital costs were about $2,000 for workers in the 55-64 age group, compared with about $1,000 for workers in the other age groups.
For physician services and other professional services, the average cost was about $3,000 for workers in the 55-64 category and about $1,500 for workers in the 25-34 category.
The gap was bigger for prescription drugs, with average costs of about $3,000 for workers in the 55-64 category and just $1,000 for workers in the 25-34 category.
Related: Sickest 10% drive employer plan spending increases, researchers find
The gap was biggest for the outpatient hospital care category, with workers in the 54-64 category generating about $3,500 in claims and workers in the 25-34 category generating only about $1,000 in claims.
What it means: Analysts at the Pew Research Center have reported that about 34% of the people now in the U.S. workforce are ages 50 or older, compared with 24% in 2000.
Federal law prohibits employers from discriminating against older workers based on age. But the new claim analysis shows the kind of cost pressure builds up when the average age of employers' health plan participants rises.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
