Employer Plans Offer Comprehensive Benefits

People with employer-sponsored health plans already get emergency care and hospital care under every healthcare plan. Follow-up care such as in-patient rehab, nursing facilities and hospice care are also covered by 90% to 97% of small-group plans. Prenatal, delivery and infant care along with organ transplants and prescriptions are also covered in nearly every plan, according to a survey by the National Association of Health Underwriters (NAHU).

NAHU surveyed more than 1,100 of its members who specialize in providing health insurance coverage to employers of all sizes. Janet Trautwein, NAHU CEO said, “Employer-based health insurance coverage is the single largest pillar of the American health insurance system. We need to protect and preserve this system that already provides health coverage to more than 160 million Americans.”

Last month the Department of Health and Human Services (HHS) released guidance on the essential benefits package mandated by the Affordable Care Act (ACA). Federal officials are in the process of defining the terms of an essential benefits package, which is the list of treatments that every policy must cover. The nonpartisan Institute of Medicine (IOM) has encouraged regulators to make sure that coverage is comprehensive but also affordable. The more expansive the essential benefits package is, the more expensive insurance premiums will be. And pricier insurance will lead to reduced rates of coverage, as fewer people and businesses will have the means to pay for it.

Trautwein said, “The emphasis on affordability is good news for employers who have been struggling with rising healthcare costs. Over the last decade, the average employer-sponsored insurance premium has risen 113%. Federal policymakers should keep this in mind as they lay out the new essential benefits package. An overly expansive package could exacerbate these cost trends and make insurance less affordable. Or it could cause employers to stop offering health benefits to their workers altogether. Employers are already saddled with costs that have risen faster than wages or inflation. As the IOM report makes clear, for many individuals, coverage that’s exceedingly generous but unaffordable is equivalent to no coverage at all. We recommend that HHS look to employer coverage as the benchmark for their essential benefits package.” For more information, visit www.nahu.org.