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STATISTICAL BRIEF #405:
Changes in Premiums for Civilian Employees: Employer-Sponsored Health Insurance, by Census Division, 2008 and 2011

April 2013

Karen E. Davis, MA

Highlights

Among civilian employees with employer-sponsored health insurance in 2011, 49.3 percent had a single coverage health insurance plan, 18.8 percent had employee-plus-one coverage, and 31.9 percent had family coverage.
Average premiums for civilian employees in 2011 were $5,385 for single coverage, $10,524 for employee-plus-one coverage, and $15,206 for family coverage.
During 2008 to 2011, the overall change in average annual health insurance premiums per enrolled civilian employee with family coverage was 20.7 percent.

Introduction

Employer-sponsored health insurance for current workers is one of the primary sources of health insurance coverage in the United States. According to data from the Insurance Component of the 2011 Medical Expenditure Panel Survey (MEPS-IC), approximately 111.6 million of the 127.7 million civilian employees (including private and State and local, but not federal employees) worked where the employer offered health insurance. Of those employees who worked where health insurance was offered, approximately 67.6 million were enrolled (data not shown).

The MEPS-IC provides data to analyze changes over time in premiums for employer-sponsored health insurance coverage. Beginning in September 2011, the Rate Review program established under the Patient Protection and Affordable Care Act requires health insurers to justify premium rate increases of 10 percent or more before the increase can take effect. This Statistical Brief presents MEPS-IC estimates by type of coverage (single, employee-plus-one, and family) on average premiums for 2011 and changes relative to 2008 (the height of the economic downturn). Estimates are also presented by census geographic division for employees who enrolled in offered health insurance plans. Only those estimates that had a statistically significant difference from the national average at the 0.05 percent significance level are noted in the text.

Findings

Among the 127.7 million civilian employees who worked for private and public sector employers in 2011, 87.4 percent worked where the employer offered health insurance and 67.6 million enrolled (estimates not shown in figures). Among those enrolled in 2011, 49.3 percent had single coverage, 18.8 percent had employee-plus-one coverage, and 31.9 percent had family coverage (figure 1). The percentage of enrollees that enrolled in family coverage decreased slightly by 0.9 percentage points, and increased slightly for employee-plus-one coverage by 0.8 percentage points over 2008. There was no significant difference in enrollment for single coverage in 2011 versus 2008.

In the U.S. as a whole, civilian employees had average premiums in 2011 of $5,385 for single coverage, $10,524 for employee-plus-one coverage, and $15,206 for family coverage (figure 2). Each of these averages was approximately 20 percent higher than in 2008, which exceeds the 4.5 percent rise between 2008 and 2011 in overall consumer prices for urban consumers (i.e., CPI index).

Single, employee-plus-one, and family coverage variations by census geographic division
In 2011, the New England, Middle Atlantic, and Pacific geographic divisions had single premiums significantly higher than the national average at $5,946, $5,671, and $5,489, respectively (figure 3.1). The East South Central, West South Central, and Mountain areas had below national average single premiums of $5,037, $5,046 and $5,129, respectively. During 2008 to 2011, the overall change in average annual health insurance premiums per enrolled civilian employee with single coverage was 18.7 percent (figure 3.2). This percentage change in single premiums for the Pacific division (21.5 percent) was significantly higher than average during this period.

In 2011, the New England ($12,059), Middle Atlantic ($11,272), and Pacific ($11,078) geographic divisions had employee-plus-one premiums significantly higher than the overall U.S. average (figure 4.1). The East South Central, West South Central, South Atlantic, and Mountain areas had below average employee-plus-one premiums at $9,672, $9,970, $10,031, and $10,124, respectively. From 2008 to 2011, the change in average annual health insurance premiums per enrolled civilian employee with employee-plus-one coverage was 20.7 percent (figure 4.2). The percentage change in employee-plus-one premiums for the East North Central division (15.2 percent) was significantly lower than the national average, while the percentage change for the Pacific division (26.0 percent) was significantly higher over this period.

In 2011, the New England and Middle Atlantic geographic divisions had family premiums significantly higher than the U.S. average at $17,000 and $16,030, respectively (figure 5.1). The East South Central, West South Central, Mountain, West North Central, and South Atlantic areas had below average family premiums at $13,770, $14,329, $14,516, $14,559, and $14,863, respectively. From 2008 to 2011, the change in average annual health insurance premiums per enrolled civilian employee with family coverage nationally was 21.9 percent (figure 5.2). The percentage change in family premiums for the East South Central division (16.5 percent) was significantly lower than that average over this period.

Data Source

This Statistical Brief summarizes data from the 2008 and 2011 MEPS-IC. The data are available on the MEPS Web site at http://www.meps.ahrq.gov/mepsweb/survey_comp/Insurance.jsp or have been produced using special computation runs on the confidential MEPS-IC data available at the U.S. Census Bureau.

Definitions

Census division
States were grouped into nine census divisions as follows:

New England: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
Middle Atlantic: New Jersey, New York, Pennsylvania
East North Central: Illinois, Indiana, Michigan, Ohio, Wisconsin
West North Central: Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota
South Atlantic: Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia
East South Central: Alabama, Kentucky, Mississippi, Tennessee
West South Central: Arkansas, Louisiana, Oklahoma, Texas
Mountain: Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming
Pacific: Alaska, California, Hawaii, Oregon, Washington

Civilian
Civilian employees include those employed in the private sector and in the public (State/local government) sector. Federal government employees, postal workers, military, and unincorporated self-employed individuals with no employees are not included.

Employee-plus-one coverage
Health insurance that covers the employee and one other family member at a lower premium level than family coverage. For the MEPS-IC survey, if premiums are different for employee-plus-spouse and employee-plus-child coverage, the costs for employee-plus-child coverage are collected.

Family coverage
Health insurance that covers the employee and one or more members of his/her immediate family (spouse and/or children as defined by the plan). For the MEPS-IC survey, "family coverage" is any coverage other than single and employee-plus-one. Some plans offer more than one rate for family coverage, depending on family size and composition. If more than one rate is offered, survey respondents are asked to report costs for a family of four.

Premium
Agreed upon fees paid for coverage of medical benefits for a defined benefit period. Premiums can be paid by employers, unions, employees, or split between the insured individual and the plan sponsor.

Single coverage
Health insurance that covers the employee only. This is also known as employee-only coverage.

About MEPS-IC

The MEPS-IC is a survey of business establishments and governments that collects information on employer-sponsored health insurance, such as whether insurance is offered, enrollments, types of plans, and premiums. The survey is conducted annually by the U.S. Census Bureau under the sponsorship of the Agency for Healthcare Research and Quality (AHRQ). A total sample of approximately 42,000 private-sector establishments was selected for the 2011 survey, with 6.4 percent of the sample determined to be out-of-scope during the data collection process. The response rate for the private sector was 81.7 percent of the remaining in-scope sample units. For State and local governments, a sample of approximately 3,100 governmental units was selected with a response rate of 94.2 percent. For more information on this survey, see MEPS Methodology Reports 6, 8, 10, 14, 17, 18, and 27 and the MEPS-IC Technical Notes and Survey Documentation, which are available on the MEPS Web site (http://www.meps.ahrq.gov).

References

U.S. Department of Health and Human Services. Key Features of the Law: Insurance Costs. Available at: http://www.hhs.gov/healthcare/rights/index.html

Suggested Citation

Davis, K. Changes in Premiums for Civilian Employees: Employer-Sponsored Health Insurance, by Census Division, 2008 and 2011. Statistical Brief #405. April 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st405/stat405.shtml

* * *
AHRQ welcomes questions and comments from readers of this publication who are interested in obtaining more information about access, cost, use, financing, and quality of health care in the United States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. Please email us at MEPSProjectDirector@ahrq.hhs.gov or send a letter to the address below:

Steve B. Cohen, PhD, Director
Center for Financing, Access, and Cost Trends
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD 20850

Figure data for accessible table follows the image

	Single	Employee-plus-one	Family
Figure 1. Percentage of civilian* employees enrolled in health insurance, by type of coverage, 2008 and 2011
Percentage enrolled, 2008	49.3	18.0	32.8
Percentage enrolled, 2011	49.3	18.8	31.9
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2008 and 2011

Type of coverage	Average premium, 2008	Average premium, 2011
Figure 2. Average premium per enrolled civilian* employee by type of coverage, 2008 and 2011
Single	$4,538	$5,385
Employee-plus-one	$8,719	$10,524
Family	$12,471	$15,206
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2008 and 2011

Census division	Average premium, single coverage
Figure 3.1 Average premium per enrolled civilian* employee for single coverage by census division
United States	$5,385
New England (significantly above national average)	$5,946
Middle Atlantic (significantly above national average)	$5,671
East North Central (no significant difference from national average)	$5,426
West North Central (no significant difference from national average)	$5,275
South Atlantic (no significant difference from national average)	$5,365
East South Central (significantly below national average)	$5,037
West South Central (significantly below national average)	$5,046
Mountain (significantly below national average)	$5,129
Pacific (significantly above national average)	$5,489
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2008 and 2011

Census division	Percentage change in average premium, single coverage
Figure 3.2. Percentage change in average premium per enrolled civilian* employee with single coverage, by census division, 2008 and 2011
United States	18.7
New England	17.7
Middle Atlantic	19.9
East North Central	16.0
West North Central	20.0
South Atlantic	18.3
East South Central	14.9
West South Central	19.0
Mountain	18.7
Pacific	21.5
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2008 and 2011

Census division	Average premium, employee-plus-one coverage
Figure 4.1 Average premium per enrolled civilian* employee for employee-plus-one coverage by census division, 2011
United States	$10,524
New England (significantly above national average)	$12,059
Middle Atlantic (significantly above national average)	$11,272
East North Central (no significant difference from national average)	$10,434
West North Central (no significant difference from national average)	$10,176
South Atlantic (significantly below national average)	$10,031
East South Central (significantly below national average)	$9,672
West South Central (significantly below national average)	$9,970
Mountain (significantly below national average)	$10,124
Pacific (significantly above national average)	$11,078
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2011

Census division	Percentage change in average premium, employee-plus-one coverage
Figure 4.2. Percentage change in average premium per enrolled civilian* employee with employee-plus-one coverage, by census division, 2008 and 2011
United States	20.7
New England	21.2
Middle Atlantic	23.6
East North Central	15.2
West North Central	19.6
South Atlantic	19.5
East South Central	18.4
West South Central	20.7
Mountain	20.4
Pacific	26.0
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2008 and 2011

Census division	Average premium, family coverage
Figure 5.1 Average premium per enrolled civilian*employee for family coverage by census division, 2011
United States	$15,206
New England (significantly above)	$17,000
Middle Atlantic (significantly above)	$16,030
East North Central (no significant difference)	$15,303
West North Central (significantly below)	$14,559
South Atlantic (significantly below)	$14,863
East South Central (significantly below)	$13,770
West South Central (significantly below)	$14,329
Mountain (significantly below)	$14,516
Pacific (no significant difference)	$15,438
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2011

Census division	Percentage change in average premium, family coverage
Figure 5.2. Percentage change in average premium per enrolled civilian* employee with family coverage, by census division, 2008 and 2011
United States	21.9
New England	19.6
Middle Atlantic	26.2
East North Central	20.7
West North Central	18.9
South Atlantic	20.9
East South Central	16.5
West South Central	21.5
Mountain	21.2
Pacific	24.1
*Civilian excludes federal government employees. Source: Center for Financing, Access, and Cost Trends, AHRQ, Insurance Component of the Medical Expenditure Panel Survey, 2008 and 2011

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STATISTICAL BRIEF #405: Changes in Premiums for Civilian Employees: Employer-Sponsored Health Insurance, by Census Division, 2008 and 2011