National Survey of Employer-Sponsored Health Plans

Our annual health benefits survey, with over 2,000 respondents in 2022, is one of the largest of its kind. It provides trends in benefit cost and plan design and looks at employers’ strategies for managing cost and supporting employees.

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Health program trends reflect a complex business environment

Employers will be challenged to absorb higher cost increases, but with inflation putting stress on their employees’ household finances, budget concerns must be balanced with healthcare affordability and the need to offer attractive benefits. The focus now is on strategies to rein in cost growth without shifting more cost to employees.

Health benefit cost growth ahead

Health benefit cost per employee rose 3.2% on average in 2022 – but an average increase of 5.4% is expected for 2023. It is likely that benefit cost growth will continue to accelerate as multi-year health plan contracts are renewed and begin to reflect inflation-driven cost increases.
A&R considerations

Health benefit costs may be on the rise, but employers continue to face a tight labor market and are well aware that healthcare benefits weigh heavily in employment decisions. This year, “enhancing benefits to improve attraction and retention” was the top strategic priority, rather than cost-cutting measures.
Steering to high-value care

More than a third of very large employers (36% of those with 20,000 or more employees) offer a telephonic healthcare navigation or advocacy service to help members find the right provider based on quality and cost, and 17% offer a digital navigation tool.
Specialty drugs

Large employers reported that spending on specialty drugs rose by nearly 10% in 2022, and still higher increases are expected as more breakthrough gene and cellular therapies enter the market. Over a third of large employers (34%) say they will add or enhance stop-loss protection in anticipation of an increase in very large claims.
Behavioral health a priority

Many employers – especially very large employers – are prioritizing mental health in their program strategies. Some are taking steps to reduce stigma: A Mercer survey conducted earlier this year found more than a third of large employers are training managers to recognize behavioral health issues and direct employees to existing resources.

Explore the findings 2022

Health benefit cost per employee rose 3.2% in 2022
Change in total health benefit cost per employee compared to CPI

Annual change in total health benefit cost per employee:

1993 8.0%
1994 -1.1%
1997 0.2%
1998 6.1%
2002 14.7%
2005 6.1%
2008 5.5%
2010 6.9%
2013 2.1%
2014 3.9%
2015 3.8%
2018 3.6%
2019 3.0%
2020 3.4%
2021 6.3%
2022 3.2%
2023 5.4%

Overall inflation

Beginning in 2020, survey results are based on employers with 50 or more employees. *Projected.

Source: Mercer's National Survey of Employer-Sponsored Health Plans, Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation, 1993-2022 (April)

Mercer National Survey of Employer-Sponsored Health Plans

Average per-employee cost tops $15,000 in 2022
Average total health benefit cost per employee

All employers (50 or more employees)
2021 $14,542
2022 $15,013
+3.2%

Employers with 50-499 employees
2021 $14,896
2022 $15,278
+2.6%

Employers with 500 or more employees
2021 $14,393
2022 $14,948
+3.9%

Mercer National Survey of Employer-Sponsored Health Plans

Employers prioritize enhancing benefits for A&R
Most important strategies for the next 3-5 years, among employers with 500 or more employees

Enhancing benefits to improve attraction and retention
Important 40%
Very Important 44%

Managing high-cost claimants
Important 31%
Very Important 47%

Expanding behavioral healthcare access
Important 37%
Very Important 36%

Improving health care affordability
Important 39%
Very Important 29%

Managing cost for specialty drugs
Important 33%
Very Important 33%

Enhancing benefits/resources to support women's reproductive health
Important 34%
Very Important 21%

Addressing health inequities/social determinants
Important 29%
Very Important 16%

Increasing use of virtual care throughout the health care journey
Important 31%
Very Important 12%

Steering to high-value care (ACOs, COEs, etc.)
Important 25%
Very Important 11%

Mercer National Survey of Employer-Sponsored Health Plans

Navigation and advocacy services help members find the right care, based on quality and cost
Employers with 20,000 or more employees

Provide services beyond the health plan's standard customer service

A digital-only service (Alight, Healthcare Bluebook)
2021 13%
2022 17%

A telephonic advocacy service (Grand Rounds, Transcarent, Castlight)
2021 36%
2022 36%

Considering adding
2021 14%
2022 22%

Not considering
2021 43%
2022 33%

Mercer National Survey of Employer-Sponsored Health Plans

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National Survey of Employer-Sponsored Health Plans

Explore the findings 2022

Let’s get started