ResourcesSmall Business Health Care Hub

Understanding the drivers of health care costs

Why does health insurance keep getting more expensive?

Explore the cost drivers behind your premiums—and what you can do about them.

Employee affordability is affected by many factors

Premiums

The amount that an individual or employer pays to maintain health care coverage. Businesses will determine how they split costs with employees.

Deductibles

The amount an employee pays for covered health care services before their insurance starts to pay. Some plans have separate deductibles for medical services and prescription drugs.

Out-of-pocket maximums

The maximum amount an employee will pay for covered services in a plan year. This does not include the amount of premium that is paid.

Copayment and coinsurance

Businesses also share costs with employees through copayments and coinsurance, or costs owed after meeting deductibles.

Why is health care in the U.S. so expensive?

with Michelle Basta, Vice President

The U.S. spends nearly twice as much per person on health care as other high-income countries, but that doesn't always mean higher quality.

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How health care costs are translated into premiums

with Bea Capistrant, Vice President

Premiums comprise three components: base premiums, rate adjustments and fees.

Benchmark Your Costs: Each year, the Kaiser Family Foundation (KFF) publishes the Employer Health Benefits Survey, which provides detailed data on health insurance costs and trends for businesses of all sizes. Reviewing this survey can help you compare your company’s health care spending to national averages and identify areas for improvement.

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KFF Employer Health Benefits Survey (updated annually)

Your funding model is one of the biggest levers on your premium. Different funding structures — fully insured, level-funded, self-funded, ICHRA — carry different cost implications for your business.

See how they compare — Funding Your Health Insurance

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Take charge of your health insurance expenses and maximize your plan's value.