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State employee health plans

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State employee health insurance accounts for the second-largest portion of state healthcare spending, behind only Medicaid. The total cost of insurance for state workers was $30.7 billion nationwide in 2013, with $25.1 billion paid for by the states. Premium costs varied widely, with higher premiums found in states such as New Hampshire and Vermont compared to those in states like Arkansas and Mississippi. Part of this variation is due to demographic factors and provider prices, and part may be attributed to differences in what is known as health plan richness, or the cost sharing between the insurer and health plan enrollees, such as deductibles and copayments.[1]

State health plans were generally "rich," paying on average 92 percent of the typical enrollees’ health care costs. By way of context, these plans would be designated "platinum" plans within the new health insurance marketplaces.[2]

—The Pew Charitable Trusts

Several states are experimenting with various cost-containment methods. "Pooled public employee health benefit programs" are one such strategy, which merges state employee health plans and those of other, smaller public employers, such as city governments and school districts. The idea is to save on administrative costs for insurers and leverage the larger pool to negotiate lower premium rates. Evidence of cost savings is mixed, with the smaller public employers reaping most of the benefits. Programs for pooling public employee health plans have been implemented in 31 states.[3]

Between 2011 and 2013, net expenditures for state employee health plans nationwide decreased by about 1 percent. The average premium for single plans in 2013 was $570 per month, and for family plans it was $1,233 per month.[1]

State employee health plan spending

The table below displays spending totals for state governments on employee health plans, as well as the change between 2011 and 2013 in each state. Nebraska saw the largest decrease in such expenditures during that time at 22 percent. Meanwhile, Hawaii saw the largest increase, 39 percent.[1]

Note: Due to such variations as demographics, plan richness and provider rates, "higher spending is not necessarily an indication of waste, and lower spending is not necessarily a sign of efficiency."[1]

State employee health plan spending (in thousands)
State Total state expenditures (gross) Change Total state expenditures (net) Change
2011 2013 2011 2013
Alabama $319,012 $299,038 -6% $244,199 $222,317 -9%
Alaska $85,541 $98,993 16% $80,828 $95,760 18%
Arizona $643,261 $611,180 -5% $575,517 $546,816 -5%
Arkansas $197,142 $211,181 7% $135,036 $151,762 12%
California $2,394,406 $2,594,322 8% $1,854,783 $2,008,166 8%
Colorado $232,886 $255,009 9% $198,617 $212,794 7%
Connecticut $792,597 $748,368 -6% $676,750 $640,886 -5%
Delaware $434,778 $421,270 -3% $394,218 $378,873 -4%
Florida $1,709,924 $1,600,160 -6% $1,483,773 $1,388,552 -6%
Georgia $562,834 $596,437 6% $432,056 $432,725 0%
Hawaii $388,456 $475,080 22% $196,731 $274,419 39%
Idaho $176,243 $185,724 5% $160,547 $168,004 5%
Illinois $1,437,226 $1,445,274 1% $1,254,846 $1,277,612 2%
Indiana $285,790 $281,023 -2% $254,772 $227,826 -11%
Iowa $337,110 $294,531 -13% $324,734 $284,875 -12%
Kansas $333,327 $315,503 -5% $252,369 $242,313 -4%
Kentucky $320,842 $325,409 1% $245,138 $247,361 1%
Louisiana $428,832 $388,490 -9% $286,817 $259,850 -9%
Maine $187,912 $168,110 -11% $160,755 $133,077 -17%
Maryland $818,422 $832,815 2% $664,594 $676,735 2%
Massachusetts $1,088,666 $1,123,453 3% $814,743 $840,959 3%
Michigan $544,571 $513,122 -6% $451,303 $421,767 -7%
Minnesota $636,916 $650,843 2% $586,588 $599,412 2%
Mississippi $323,775 $315,057 -3% $251,250 $243,504 -3%
Missouri $485,182 $469,779 -3% $383,611 $366,946 -4%
Montana $125,260 $126,146 1% $117,986 $114,348 -3%
Nebraska $195,532 $151,944 -22% $154,471 $120,036 -22%
Nevada $249,849 $231,934 -7% $213,909 $191,121 -11%
New Hampshire $175,628 $181,458 3% $167,580 $169,977 1%
New Jersey $1,373,931 $1,585,271 15% $1,296,545 $1,442,024 11%
New Mexico $170,827 $141,909 -17% $119,578 $99,335 -17%
New York $2,646,170 $2,628,715 -1% $2,208,734 $2,008,619 -9%
North Carolina $1,287,932 $1,384,628 8% $808,739 $862,289 7%
North Dakota $148,546 $153,828 4% $148,546 $153,828 4%
Ohio $552,207 $558,156 1% $460,642 $470,481 2%
Oklahoma $367,381 $329,316 -10% $367,381 $329,316 -10%
Oregon $749,358 $755,073 1% $749,358 $717,319 -4%
Pennsylvania N/A N/A N/A N/A N/A N/A
Rhode Island $151,015 $162,333 7% $120,812 $129,867 7%
South Carolina $398,741 $423,073 6% $289,021 $310,733 8%
South Dakota $89,070 $83,576 -6% $75,584 $71,239 -6%
Tennessee $775,292 $788,116 2% $627,953 $635,043 1%
Texas $1,768,987 $1,934,805 9% $1,467,911 $1,603,648 9%
Utah $220,376 $205,677 -7% $209,529 $187,035 -11%
Vermont $93,959 $94,088 0% $75,168 $75,271 0%
Virginia $910,886 $899,135 -1% $813,062 $788,561 -3%
Washington $1,112,783 $1,131,014 2% $982,450 $962,552 -2%
West Virginia $305,171 $303,365 -1% $223,082 $216,775 -3%
Wisconsin $1,155,116 $1,117,769 -3% $1,090,626 $976,360 -10%
Wyoming $121,589 $100,647 -17% $110,623 $92,325 -17%
United States $30,311,259 $30,692,147 1% $25,263,863 $25,071,413 -1%
Note: "Gross expenditures include employer and employee premium contributions. Net expenditures include only employer premium contributions. All spending figures are in 2013 dollars."
Source: The Pew Charitable Trusts, "State Employee Health Plan Spending"

State employee health plan premiums

Below are average monthly premiums for state employees along with employer and employee contributions by state. According to the Pew Charitable Trusts, "States that are reported as having a negative contribution (credits) offer cafeteria-style plans in which the employer gives the employee a benefit allowance that can be applied to a range of offerings, often including medical, dental, vision, and disability insurance. ... A reported negative contribution does not necessarily mean that the employee will receive additional cash for choosing a particular benefit."[1]

Average state employee health plan monthly premiums, 2013
State Single Family Employer contribution percentage Employee contribution percentage
Total premium Employer contribution Employee contribution Total premium Employer contribution Employee contribution
Alabama $383 $298 $85 $1,038 $763 $275 74% 26%
Alaska $1,375 $1,330 $45 $1,375 $1,330 $45 97% 3%
Arizona $602 $557 $44 $1,409 $1,244 $165 89% 11%
Arkansas $415 $327 $88 $902 $612 $290 72% 28%
California $646 $494 $152 $1,465 $1,127 $337 77% 23%
Colorado $446 $405 $41 $1,027 $825 $203 83% 17%
Connecticut $608 $543 $65 $1,534 $1,297 $237 86% 14%
Delaware $563 $506 $57 $1,203 $1,081 $121 90% 10%
Florida $549 $500 $50 $1,242 $1,063 $179 87% 13%
Georgia $518 $395 $122 $1,171 $833 $338 73% 27%
Hawaii $435 $251 $184 $1,237 $714 $523 58% 42%
Idaho $458 $421 $37 $1,063 $958 $105 90% 10%
Illinois $692 $633 $60 $1,545 $1,348 $197 88% 12%
Indiana $517 $379 $138 $1,378 $1,120 $258 81% 19%
Iowa $518 $518 $0 $1,211 $1,136 $74 97% 3%
Kansas $552 $472 $80 $969 $689 $280 77% 23%
Kentucky $653 $577 $76 $1,258 $815 $443 76% 24%
Louisiana $547 $410 $137 $1,031 $652 $379 67% 33%
Maine $728 $655 $73 $1,539 $1,151 $387 79% 21%
Maryland $621 $503 $117 $1,275 $1,037 $239 81% 19%
Massachusetts $585 $437 $148 $1,418 $1,062 $356 75% 25%
Michigan $496 $407 $89 $1,174 $964 $210 82% 18%
Minnesota $503 $503 $0 $1,480 $1,333 $146 92% 8%
Mississippi $391 $356 $35 $729 $356 $373 77% 23%
Missouri $551 $460 $92 $1,292 $990 $301 78% 22%
Montana $712 $733 -$21 $890 $733 $157 91% 9%
Nebraska $471 $372 $99 $1,366 $1,079 $287 79% 21%
Nevada $631 $552 $79 $1,111 $875 $236 82% 18%
New Hampshire $659 $616 $43 $1,778 $1,666 $112 94% 6%
New Jersey $758 $663 $95 $1,623 $1,490 $134 91% 9%
New Mexico $389 $272 $117 $883 $618 $265 70% 30%
New York $610 $506 $104 $1,477 $1,099 $378 76% 24%
North Carolina $449 $433 $15 $951 $462 $489 62% 38%
North Dakota $427 $427 $0 $1,029 $1,029 $0 100% 0%
Ohio $478 $406 $72 $1,325 $1,115 $210 84% 16%
Oklahoma $439 $641 -$202 $1,061 $1,272 -$211 125% -25%
Oregon $1,030 $978 $51 $1,366 $1,298 $68 95% 5%
Pennsylvania N/A N/A N/A N/A N/A N/A N/A N/A
Rhode Island $589 $471 $118 $1,650 $1,320 $330 80% 20%
South Carolina $408 $311 $98 $851 $616 $235 73% 27%
South Dakota $496 $496 $0 $675 $493 $183 85% 15%
Tennessee $615 $494 $120 $1,337 $1,078 $259 81% 19%
Texas $469 $469 $0 $1,018 $744 $275 83% 17%
Utah $402 $366 $37 $1,023 $930 $93 91% 9%
Vermont $676 $541 $135 $1,611 $1,289 $322 80% 20%
Virginia $504 $450 $54 $1,166 $1,017 $150 88% 12%
Washington $536 $459 $77 $1,187 $1,008 $179 85% 15%
West Virginia $473 $368 $106 $980 $683 $297 71% 29%
Wisconsin $681 $594 $87 $1,697 $1,482 $216 87% 13%
Wyoming $686 $636 $50 $1,415 $1,292 $123 92% 8%
United States $570 $502 $68 $1,233 $1,004 $230 84% 16%
Note: "Due to rounding, the sum of employer and employee contributions may differ from total premium."
Source: The Pew Charitable Trusts, "State Employee Health Plan Spending"

Healthcare policy in the 50 states

Click on a state below to read more about healthcare policy in that state.

http://ballotpedia.org/Healthcare_policy_in_STATE

See also

Footnotes

  1. 1.0 1.1 1.2 1.3 1.4 The Pew Charitable Trusts, "State Employee Health Plan Spending," August 2014
  2. Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
  3. National Conference of State Legislatures, "State Employee Health Benefits," accessed July 20, 2015