Medical Insurance Co-Pays Increase in 2010

October 28, 2010    

Kansas City, Kan. — As various components of the healthcare legislation continue to go into effect, employers across the country are finding little reprieve as the cost of providing medical insurance to their employees continues to increase. The newly released Benefits USA 2010/2011 survey results found the average premium increase for PPO plans was 10.2 percent in 2010 with premiums for an employee plus family PPO plan costing employers an average of $900 per month.

Currently, PPO plans are the most common healthcare option as 85.3 percent of organizations report offering a PPO to employees. Employees, however, are not exempt from the increasing cost of this popular medical plan as they are seeing increases to their deductibles, co-insurance and co-pay amounts, on top of the rising premiums.  The average co-pay for a primary care office visit on a PPO plan is $22, up from $20 in 2008. Co-pays for ER visits have gone up 21 percent in the last two years, to $108.  The co-pay to visit a specialist averages $30.

“Because medical insurance costs increase in correlation to healthcare costs, individuals will likely be paying more in premiums, deductibles and co-pays for the foreseeable future,” said Amy Kaminski, director of marketing for Compdata Surveys, the nation’s leading compensation and benefits survey data provider. “It remains to be seen how most individuals will respond to these new costs. Some may be influenced to improve their overall health to avoid additional out of pocket expenses in the future, while others may be inclined to put off needed medical care to save money in the short term.”

Non-formulary prescription costs slowly continue to increase, as the average co-pay for non-formulary drugs range between $44 and $50, across all plan types. Formulary drug co-pays have remained stable for HMO and POS plans at $27, while PPO and HDHP formulary co-pays average $29.  Generic drug co-pays currently average $11 for Indemnity, HMO and PPO plans. The average co-pay for generic drugs on a POS or HDHP plan is $10.

About the Survey
Benefits USA 2010/2011 analyzes national and regional data on benefits eligibility and administration policies with detailed information on benefit plans, premiums and provisions. Information was collected from nearly 4,500 benefit plans covering over 6 million employees across the country.

Compdata Surveys is the nation’s leading compensation and benefits survey data provider. Thousands of U.S. organizations provide data each year ensuring the reliability of our results. Compdata Surveys has been providing comprehensive data at affordable prices to organizations from coast to coast since 1988.  For further information about their compensation and benefits surveys, contact Amy Kaminski at (800) 300-9570.

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