.bodytext {float: left; } .floatimg-left-hort { float:left; margin-top:10px; margin-right: 10px; width:300px; clear:left;} .floatimg-left-caption-hort { float:left; margin-bottom:10px; width:300px; margin-right:10px; clear:left;} .floatimg-left-vert { float:left; margin-top:10px; margin-right:15px; width:200px;} .floatimg-left-caption-vert { float:left; margin-right:10px; margin-bottom:10px; font-size: 10px; width:200px;} .floatimg-right-hort { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 300px;} .floatimg-right-caption-hort { float:left; margin-right:10px; margin-bottom:10px; width: 300px; font-size: 10px; } .floatimg-right-vert { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 200px;} .floatimg-right-caption-vert { float:left; margin-right:10px; margin-bottom:10px; width: 200px; font-size: 10px; } .floatimgright-sidebar { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 200px; border-top-style: double; border-top-color: black; border-bottom-style: double; border-bottom-color: black;} .floatimgright-sidebar p { line-height: 115%; text-indent: 10px; } .floatimgright-sidebar h4 { font-variant:small-caps; } .pullquote { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 150px; background: url(http://www.dmbusinessdaily.com/DAILY/editorial/extras/closequote.gif) no-repeat bottom right !important ; line-height: 150%; font-size: 125%; border-top: 1px solid; border-bottom: 1px solid;} .floatvidleft { float:left; margin-bottom:10px; width:325px; margin-right:10px; clear:left;} .floatvidright { float:right; margin-bottom:10px; width:325px; margin-right:10px; clear:left;} The trend toward consumer-driven health plans continues among Iowa companies, according to the ninth annual survey of Iowa employers conducted by Clive-based David P. Lind & Associates LLC.

The 2007 Iowa Employer Benefits Study found that about 26 percent of the companies surveyed offered either Health Reimbursement Arrangement or Health Savings Account plans. Among the companies in the survey with more than 1,000 employees, 43 percent offered a CDHP.

The numbers are increasing rapidly; two years ago, just 3 percent of the largest companies and 4.5 percent overall offered such programs in Iowa. Asked in the most recent survey about possible changes in the next 12 months, nearly 17 percent of large companies said they were “very likely” to switch to a consumer-driven health plan.

In the CDHP concept, an employer allocates money to offset the employees’ portion of a high-deductible plan. The popularity of CDHPs correlates with company size; the plan is offered by just 11 percent of companies with fewer than 20 workers.

The overall 26 percent rate in Iowa compares with about 10 percent nationally, as reported by the Kaiser Family Foundation. The Iowa respondents in that category “at least offer a CDHP-type plan,” noted David Lind, president of the company behind the survey. “It doesn’t mean they completely replace their other plan; it means they are giving the CDHP as an option to their employees. We’re not seeing a lot of employers completely eliminate traditional plans.”

Lind’s company received 819 responses to 1,898 queries in its 2007 survey; the 43 percent response rate is the highest in the survey’s history.

In general, “we continue to see the trend of health-care costs and insurance rates going up,” Lind said. “Deductibles also are continuing to move up, which means employers are shifting costs to employees.”

In the preferred provider organization category, the average deductible for in-network family coverage has increased 152 percent in nine years; for single coverage, it’s up 180 percent. The average single-coverage deductible was $305 in 1999 and now stands at $853.

Forty-eight percent of employers said they responded to increased health insurance rates in the past year by increasing employer contributions through payroll deductions. Twenty-six percent said they have raised deductibles, 17 percent have raised out-of-pocket maximums and 14 percent have switched insurance providers.

About 14 percent said the organization absorbed the entire increase in costs, and less than 6 percent said the entire cost increase was passed on to employees.

Such responses “are no different than we’ve seen in prior years,” Lind said. “Employers are very hesitant about passing on additional costs through payroll deduction, but are more open to plan design changes. Employees may have to pay more.”

Overall, monthly premiums have increased about 100 percent in the nine years covered by the Lind survey. In that same time span, employee contributions have increased 63 percent.

“In all fairness to employers, the way the rates have been going up, employers have paid their fair share of that increase,” Lind said. “We’ve been monitoring the percentage of the total premium, and the percentage the employer pays has been very stable.”

The survey revealed significant differences between collectively bargained plans and non-bargained plans. The collectively bargained plans have higher monthly medical premiums and higher monthly employee contributions, but much lower claim costs.

The average bargained plan carries a $987 deductible for family coverage compared with a $1,941 deductible in the average non-bargained plan. The average bargained plan sets the maximum out-of-pocket expenses at $2,357 for family coverage compared with $4,262 for the non-bargained plans.

The survey also found a number of advantages for employees of large companies compared with small ones.

The smallest companies reported an average increase of 17 percent in health insurance rates. The largest companies saw an 11 percent increase. “

However,” the report notes, “when factoring in those employers who experienced either no rate change or a rate decrease, the average overall rate increase is 8.2 percent.”

In reference to that statistic, Lind said, “It’s important that people understand that increase is the increase employers received prior to making any changes on their medical plan.

“We want to monitor what happens to influence the benefit changes that are made. Some studies monitor changes (in premiums, etc.) after benefit changes have been made.”