Midsized Businesses Grapple with Healthcare Coverage Options

For 2012, the survey projected that the average reported annual cost of medical and pharmacy coverage will be $11,204 per employee for active coverage. Two-thirds of employers will increase employees' share-of-premium contributions for single-only coverage for 2012, and 73% will increase them for employees with dependent coverage.

"It is clear from our research that employers remain committed to providing employer-sponsored benefits for the foreseeable future," Randall Abbott, senior healthcare consulting leader at Towers Watson, said in the report. "2012 will ultimately be a defining year— the year some employers head down a path of bold and decisive actions, while others will wait and see. Whether choosing to pay or play, employers will need a strategic view for the future."

Cost shifting is expected to continue well beyond 2012. By 2013 or 2014, the survey showed that 23% of employers are considering significantly reducing their subsidization of coverage for spouses and dependents, and 19% are considering spousal waivers and surcharges when other coverage is available.

Now, only 5% of employers have, or plan to encourage, performance-based payments to providers based on the health status of plan participants by 2012, but an additional 26% are considering the implementation of this strategy for 2013 or 2014.

Robert Zirkelbach, press secretary for America's Health Insurance Plans, told HealthLeaders Media that the healthcare reforms will place a tremendous burden on the nation's businesses, in part because the emphasis is on expanding coverage and not containing costs.