Kaiser Family Foundation (KFF) released its annual Employer Health Benefits Survey with insight into employer-sponsored health insurance premiums and what inflation may mean for health benefits—but the most pressing finding may be that less than half of employers are ready to meet the "huge increase in demand for mental health services."

Survey details and key findings

For the survey, KFF partnered with NORC at the University of Chicago and Davis Research. Davis Research surveyed human resource and benefits managers at 2,188 U.S. employers about employer-sponsored health coverage for individuals and families between February and July 2022.

On average, the survey found that annual premiums for employer-sponsored health insurance were $7,911 for single coverage and $22,463 for family coverage in 2022—similar to the average premiums in KFF's 2021 survey.

While premiums did not increase much in 2022, workers' wages increased by 6.7% and inflation increased by 8%—a gap that may stem from the fact that many of the 2022 premiums were finalized during the fall of 2021.

According to KFF, average premiums may see a higher increase in 2023 as inflation continues to rise. "Employers are already concerned about what they pay for health premiums, but this could be the calm before the storm, as recent inflation suggests that larger increases are imminent," said KFF president and CEO Drew Altman. "Given the tight labor market and rising wages, it will be tough for employers to shift costs onto workers when costs spike."

In 2022, most covered employees contributed toward the cost of the premium for their coverage. For instance, covered workers contributed an average of 17% of the premium for single coverage and 28% of the premium for family coverage.

Overall, 51% of all companies surveyed offered some health benefits to workers this year—a decline from 59% in 2021.

Notably, almost all large companies with at least 200 employees offered health benefits to at least some of their workers. However, small companies with anywhere from three to 199 employees were much less likely to offer benefits.

Employers focus on mental health coverage

This year, almost half of surveyed large employers said that more of their workers were accessing mental health services. However, nearly a third of those employers said their health plan's network did not have enough behavioral health care providers to provide employees timely access to mental health services.

While four in five employers said they had enough primary care providers in their health plan's network, just 44% of all employers said they had enough behavioral health providers, the survey found.

"That is the number that for me shows how bad access to mental health care providers is," said Matthew Rae, KFF's associate director for the program on the health care marketplace. "That, in conjunction with the huge increase in demand for mental health services."

While 14% of large employers reported that more employees were accessing services to treat substance use in 2022, roughly 50% said they did not know whether there had been an increase.

Similarly, among employers with at least 50 workers, 17% said they observed an increase in the number of workers requesting leave for mental health conditions under the federal Family and Medical Leave Act.

In 2022, 27% of large employers said they added mental health care providers to their plan's network—either through in-person or telemedicine visits.

While access to telemedicine services decreased slightly after pandemic lockdowns ended, 90% of all employers said they offered a plan that covers telemedicine services in 2022.

Over 50% of large employers said telemedicine would play a "very important" role in providing their workers with access to behavioral health services moving forward.

However, only around a third of those employers said telemedicine would be "very important" for providing access to primary care, and just 24% said telemedicine would be "very important" for providing access to specialty care.

Along with covering mental and behavioral health care services, 81% of large companies reported having an employee assistance program for mental health services. In addition, 44% said they offered mental health self-care apps to their employees. (Andrews, Kaiser Health News, 10/27; Kaiser Family Foundation 2022 Employer Health Benefits Survey, 10/27)