Transcript Survey of Retiree Health Benefits, 2007

Survey of Retiree Health Benefits, 2007:
A Chartbook
Jon Gabel, Heidi Whitmore, and Jeremy Pickreign
National Opinion Research Center
September 2008
Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors
and not necessarily those of The Commonwealth Fund or its directors, officers, or staff. This and other fund publications
are available online at www.commonwealthfund.org. To learn more about new publications when they become available,
visit the Fund’s Web site and register to receive e-mail alerts. Commonwealth Fund pub. no. 1171.
1
Among Firms Offering Retiree Health Benefits, the Percentage of
Large Firms (200+ workers) Offering Retiree Health Benefits to
Medicare-Age Retirees, 1999–2006
100%
80%
60%
40%
76%
71%
73%
76%
78%
75%
81%
77%
1999
2000
2001
2002
2003
2004
2005
2006
20%
0%
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits: 1999–2006.
2
The Medicare Modernization Act of 2003:
The Part D Prescription Drug Benefit
3
How Firms Offering Retiree Health Benefits with Prescription
Drug Coverage to Medicare-Age Retirees Responded to the
Medicare Modernization Act, 2007
Discontinue all retiree health coverage
Offer without Drugs
Offer with Some Drugs
Don't Know
Total
Private 5%1%
93%
Public 2%
1%
2%
93%
4%
200-499 Workers
Private
6%
90%
Public 2%
2%
4%
92%
4%
500-999 Workers *
Private 4%
96%
Public 1%
91%
8%
1000+ Workers
Private
7%
92%
Public 1%
2%
0%
1%
96%
10%
20%
30%
40%
50%
* Distribution is significantly different between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
2%
60%
70%
80%
90%
100%
4
How Firms Offering Retiree Health Benefits with Prescription
Drug Coverage to Medicare-Age Retirees Responded to the
Medicare Modernization Act, 2007 vs. 2006
Discontinue all retiree health coverage
Offer with Some Drugs
Offer without Drugs
Don't Know
Private Employers *
2006 4%
2007
90%
5%1%
6%
93%
2%
Public Employers *
2006 3%
90%
1%
2007 2%
0%
7%
93%
10%
20%
30%
40%
50%
4%
60%
70%
80%
90%
100%
* Distribution is significantly different between 2006 and 2007.
Note: No private firms of 1000+ workers were surveyed in 2006.
Sources: CMWF/NORC Survey of Retiree Health Benefits: 2007; CMWF/HSC Survey of Retiree Health Benefits: 2006.
5
Among Firms Offering Retiree Health Benefits to Medicare-Age
Retirees with Some Drug Coverage, Structure of
Prescription Drug Benefit, 2007 vs. 2006
Offer drug benefit that is at least equal in value to Part D benefit and accept subsidy
Offer supplement to Part D coverage
Establish own Medicare prescription drug plan
Don't know
Private Employers*
2006
54%
2007
11%
68%
11%
8%
24%
9%
15%
Public Employers*
2006
58%
2007
6%
50%
0%
10%
20%
30%
13%
40%
50%
60%
9%
27%
14%
70%
24%
80%
90%
100%
* Distribution is significantly different between 2006 and 2007.
Note: No private firms of 1000+ workers were surveyed in 2006.
Sources: CMWF/NORC Survey of Retiree Health Benefits: 2007; CMWF/HSC Survey of Retiree Health Benefits: 2006.
6
Among Firms Offering Retiree Health Benefits with
Prescription Drug Coverage to Medicare-Age Retirees in 2007,
Is Drug Coverage More or Less Generous than in 2006*
More Generous
Less Generous
No Change
Don't Know
Total
Private 2% 8%
85%
5%
Public 4% 5%
86%
5%
200-499 Workers
Private
6%
86%
Public 3%5%
7%
86%
6%
500-999 Workers
Private 3% 9%
79%
Public 3% 6%
86%
9%
5%
1000+ Workers
Private 4% 8%
Public
87%
7% 5%
0%
10%
1%
85%
20%
30%
40%
50%
4%
60%
70%
80%
90%
100%
* Tests found no significant distributions between Public and Private Firms by Firm Size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
7
Among Firms Offering Retiree Health Benefits with Prescription Drug
Coverage to Medicare-Age Retirees, Will Drug Coverage Be More or
Less Generous Than One Year Ago*
More Generous
Less Generous
Same
Don't Know
Private Employers
2006 5% 4%
86%
5%
2007 2% 8%
85%
5%
Public Employers
2006
6% 3%
80%
2007 4% 5%
0%
10%
10%
86%
20%
30%
40%
50%
5%
60%
70%
80%
90%
100%
* Tests found no significantly different distributions between 2006 and 2007.
Note: No private firms of 1000+ workers were surveyed in 2006.
Sources: CMWF/NORC Survey of Retiree Health Benefits: 2007; CMWF/HSC Survey of Retiree Health Benefits: 2006.
8
Among Firms Offering Retiree Health Benefits with Prescription Drug
Coverage to Medicare-Age Retirees, How Likely Is Firm to Change
Its Response to Medicare Part D Benefit in Next Two Years*
Very Likely
Somewhat Likely
Not Too Likely
Not at All Likely
Don’t know
Total
Private 5%
Public 4%
21%
30%
17%
37%
32%
8%
36%
10%
200-499 Workers
Private
6%
Public
7%
19%
22%
16%
40%
30%
14%
38%
10%
500-999 Workers
Private 1%
Public 2%
23%
30%
22%
43%
26%
39%
3%
11%
1000+ Workers
Private
6%
Public 2%
0%
22%
34%
16%
10%
31%
43%
20%
30%
40%
30%
50%
* Tests found no significant distributions between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
60%
70%
80%
7%
10%
90%
100%
9
Likelihood of Employers’ Changing Response to Medicare Part D
Prescription Drug Benefit If Various Changes Occur, 2007*
Very or Somewhat Likely
Not Likely
Don't Know
If Costs Rise
Private
85%
Public
15%
77%
18%
5%
If Part D Benefits Get More Generous
Private
73%
Public
20%
69%
28%
8%
2%
If Part D Benefits are Cut
Private
44%
Public
44%
49%
52%
7%
4%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100
%
* Tests found no significant distributions between Public and Private Firms by response.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
10
Among Employers Offering a Drug Benefits to Medicare-Age Retirees That
Is Expected to Be the Primary Drug Coverage, Percentage of Employers
That Would Allow Retirees to Enroll or Re-Enroll in Employer’s Plan at a
Future Date If Retiree Signs up for a Medicare Part D plan, 2007*
Yes
Private Employers
Public Employers
0%
No
32%
45%
Don't Know
64%
48%
4%
8%
10% 20% 30% 40% 50% 60% 70% 80% 90% 100
%
* Distribution is significantly different between Public and Private Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
11
Percentage of Employers That Made Various Changes to
Retiree Health Benefits in the Past Two Years
Private Employers
40%
35%
30%
Public Employers
35%
26%
25%
19%
20%
25%
21%
14%
15%
11%
10%
5%
5%
3%
5% 4%
2%
2% 1%
0%
Increased
retiree share
of premium*
Increased
cost-sharing
for office
visits
Increased Replaced drug Reduced level
cost-sharing copays with
of benefits
for drugs
coinsurance
Dropped
retiree
benefits for
new hires*
Dropped
retiree
benefits for
active
workers
* Estimates are significantly different between Public and Private Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
12
Percentage of Employers Planning on Making Various Changes^
to Retiree Health Benefit in the Next Two Years
Private Employers
Public Employers
60%
53%
50%
47%
43%
39%
35%
40%
38%
30%
22%
20%
15%
19%
13%14%
9%
10%
10%
10%
8%
3%
0%
Increase
retiree share
of premium
Increase cost- Increase cost- Replace drug
sharing for
sharing for
copays with
office visits
drugs
coinsurance
Reduce level
of benefits
Drop retiree
benefits for
new hires*
Drop retiree
benefits for
active
workers*
Drop benefits
for medicare
age retirees
^ Sum of very or somewhat likely.
* Estimates are significantly different between Public and Private Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
13
Governmental Accounting Standards Board
Regulations (GASB)
14
Percentage of Public Employers Familiar with GASB Regulations,
2007 vs. 2006*
Very Familiar
Somewhat Familiar
Not Too Familiar
Not At All Familiar
Don't Know
Total
2006
11%
2007
12%
25%
25%
28%
38%
23%
1%
36%
0%
200-499 Workers
16%
2006 5%
2007
33%
44%
24%
11%
28%
2%
36%
500-999 Workers
30%
2006 5%
2007
12%
31%
8%
51%
20%
3%
1%
39%
1000+ Workers
2006
2007
0%
34%
23%
32%
19%
20%
40%
20%
17%
60%
23%
32%
80%
100%
* Tests found no significantly different distributions between 2006 and 2007.
Sources: CMWF/NORC Survey of Retiree Health Benefits: 2007; CMWF/HSC Survey of Retiree Health Benefits: 2006.
15
Among Public Employers Familiar with GASB,
Percentage Concerned About Financial Impact of Complying
with GASB Regulations, 2007 vs. 2006*
Very Concerned
Somewhat Concerned
Not Too Concerned
Not At All Concerned
Don't Know
Total
2006
43%
2007
29%
12%
52%
8%
30%
6%
7%
8% 3%
200-499 Workers
2006
NSD
2007
32%
48%
10%
9% 2%
500-999 Workers
2006 NSD
2007
32%
50%
4% 8%
6%
1000+ Workers
2006
35%
52%
2007
26%
60%
0%
10%
20%
30%
11% 2%
40%
50%
60%
70%
80%
3%
90%
7%
100%
* Tests found no significantly different distributions between 2006 and 2007.
Note: NSD = Not Sufficient Data.
Sources: CMWF/NORC Survey of Retiree Health Benefits: 2007; CMWF/HSC Survey of Retiree Health Benefits: 2006.
16
Among Public Employers Familiar with GASB, Have or Will These
Employers Make Various Changes to Retiree Health Benefits, 2007
30%
25%
25%
20%
20%
17%
15%
14%
10%
12%
11%
5%
5%
0%
Reduce financial
contribution
Increase
employee
contributions
Increase costsharing
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
Change eligibility
Reduce level of
benefits
Reduce
prescription drug
coverage
Drop retiree
benefits
17
Among Public Employers Familiar with GASB, Percentage of
Public Employers That Have Calculated the Additional Cost of
Retiree Health Coverage as a Result of GASB, 2007
Yes
Total
Don't Know
42%
51%
200-499 Workers
20%
30%
14%
34%
63%
10%
6%
32%
55%
1000+ Workers
7%
56%
38%
500-999 Workers
0%
No
40%
50%
60%
70%
80%
3%
90% 100%
* Tests found no significantly different distributions between Size Group and Total Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
18
Retiree Health Benefits for Medicare-Age
Retirees, 2007
19
Among Firms Offering Retiree Health Benefits to Medicare-Age Retirees,
Percentage of Active Workers That Will Be Eligible for Retiree Health
Benefits After They Retire and Become Eligible for Medicare, 2007
Private Firms
97%
100%
60%
85%
80%
Public Employers
98%
95%
88%
75%
72%
60%
40%
20%
0%
Total*
200-499
Workers
500-999
Workers
1000+
Workers*
* Estimates are significantly different between Public and Private Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
20
Average Annual Premiums and Retiree Premium Contributions
for a Medicare-Age Retiree with Single Coverage in
Firm’s Largest Health Plan, 2000–2007
Total Monthly Premium
Retiree Contribution as
a Percentage of Total
Premium
2000
$178
25%
2001
$193
28%
2004
$276
25%
Private
2006
$318
24%
Public
2006
$320
36%
Private
2007
$342
39%
Public
2007
$325
41%
Private & Public
Sources: CMWF/NORC Survey of Retiree Health Benefits: 2007; CMWF/HSC Survey of Retiree Health Benefits: 2006;
Kaiser/HRET Surveys of Employer-Sponsored Health Benefits Public Use Files: 2000, 2001, 2004.
21
Type of Health Plan with the Largest Number of Medicare-Age
Retirees Enrolled, 2007*
53%
Private Firms
13%
49%
Public Employers
0%
10%
20%
PPO
16%
30%
HMO
POS
40%
50%
Conventional
60%
9%
5%
70%
19%
15%
80%
HSA-eligible HDHP
6%
15%
90%
100%
Other
* Distribution is significantly different between Public and Private Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
22
Among Firms Offering Retiree Health Benefits to Medicare-Age Retirees,
Percentage of Retirees Receiving Benefits from Employers That Have
Capped Contributions for Spending on Medicare-Age Retirees, 2007*
Private Firms
Public Employers
35%
30%
32%
27%
25%
18%
20%
15%
15%
12%
11%
10%
10%
12%
5%
0%
Total
200-499
Workers
500-999
Workers
1000+ Workers
* Tests found no significantly different estimates between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
23
Average Monthly Premiums for Medicare-Age Retirees in
Largest Health Plan, Single Coverage, 2007
Private Firms
Public Employers
500
$466
450
$427
$402
400
350
$379
$375
$356
$342
$333
$323
$312
$351
$339
$310
$302
$293
300
$341
($) 250
200
150
100
50
0
Total
200-499
Workers
500-999
Workers*
1000+
Workers
Northeast
Midwest
South
West
* Estimates are significantly different between Public and Private Firms by firm size or region.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
24
Average Annual Deductibles for Medicare-Age Retirees in
Largest Health Plan, Single Coverage, 2007
Private Firms
Public Employers
300
$283
$264
$263
250
$193
200
($) 150
$181
$150
$125
$118
100
50
0
Total*
200-499
Workers
500-999
Workers
1000+
Workers*
* Estimates are significantly different between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
25
Distribution of Type of Cost-Sharing for Office Visits for
Medicare-Age Retirees in Largest Health Plan, 2007*
Co-Payment
Coinsurance
Both
None
Total
Private
43%
Public
39%
47%
1%
22%
11%
17%
20%
200-499 Workers
Private
53%
9%
6%
59%
Public
31%
19%
2%
20%
500-999 Workers
Private
51%
Public
49%
31%
20%
0%
1%
18%
29%
1000+ Workers
39%
Private
Public
0%
46%
47%
10%
20%
22%
30%
40%
50%
60%
0%
12%
70%
14%
20%
80%
90%
100%
* Tests found no significantly different distributions between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
26
Percentage of Medicare-Age Retirees with a Separate Annual
Deductible for Prescription Drugs in Largest Health Plan, 2007*
Total
Private
18%
Public
14%
200-499 Workers
Private
8%
Public
11%
500-999 Workers
Private
15%
Public
11%
1000+ Workers
Private
20%
Public
0%
14%
5%
10%
15%
20%
25%
* Tests found no significantly different estimates between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
27
Average Annual Prescription Drug Deductibles for Medicare-Age
Retirees in Largest Health Plan, 2007*
160
$152
140
120
100
($)
$90
80
60
40
20
0
Private Firms
Public Employers
* Tests found no significantly different estimates between Public and Private Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
28
Distribution of Medicare-Age Retirees with Various Cost-Sharing
Formulas for Prescription Drug Coverage in Largest Health Plan, 2007
Four Tier
Three Tier
Two Tier
Same
None
Other
Total*
Private 5%
Public
55%
6%
10%
59%
23%
6%1%
32%
3%
200-499 Workers
Private 2%
44%
Public 1%
19%
34%
44%
46%
6%1%
2%
500-999 Workers*
Private 2%
79%
Public 2%
10%
44%
33%
6% 3%
19%
2%
1000+ Workers
Private
6%
Public
7%
0%
53%
9%
24%
61%
10%
20%
30%
40%
8%
31%
50%
60%
70%
80%
1%
90%
100%
* Distributions are significantly different between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
29
Distribution of Type of Prescription Drug Cost-Sharing for
Generic, Preferred, Non-Preferred, and Lifestyle Drugs for
Medicare-Age Retirees in Largest Health Plan, 2007*
Co-Payment
Private
Coinsurance
Both
Neither
Generic Drugs
Private
63%
Public
29%
91%
3%5%
8%1%
Preferred Drugs
Private
Public
Employers
63%
Public
25%
89%
12%
8% 3%
Non-Preferred Drugs
Private
Public
64%
24%
89%
12%
10% 1%
* Tests found no significantly different distributions between Public and Private Firms by drug type.
Note: Responses may not add to 100% because of rounding.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
30
Among Medicare-Age Retirees with Copayments for Prescription
Drugs, Average Copayments in Largest Health Plan, 2007*
Private
Public Employers
$9.05
Generic Drugs
$8.41
$23.88
Preferred Drugs
$21.64
$44.00
Non-Preferred
Drugs
$38.67
0
10
20
($)
30
40
50
* Tests found no significantly different estimates between Public and Private Firms.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
31
Distribution of Medicare-Age Retirees with Various Annual
Out-of-Pocket Limits in Largest Health Plan, Single Coverage, 2007
$999 or Less
$1,000 - $1,999
$2,000 - $2,999
$3,000-$3,999
$4,000-$4,999
$5,000 or More
No Limit
Total*
Private
7%
37%
Public
24%
29%
3%
35%
11%
2%
2%
19%
32%
200-499 Workers
Private
18%
Public
17%
45%
23%
13%
15%
2% 5%
8% 2%
17%
35%
500-999 Workers
Private
6%
Public
44%
26%
14%
22%
10%
16%
5%1%4%
2%
19%
33%
1000+ Workers*
Private
5%
34%
Public
28%
30%
0%
10%
1%
36%
20%
30%
40%
50%
14%
1%
1%
60%
70%
19%
32%
80%
90%
100%
* Distributions are significantly different between Public and Private Firms by firm size.
Source: CMWF/NORC Survey of Retiree Health Benefits: 2007.
32