Want to know what's really going on in employee benefits?


The State of Employee Benefits

Insights and Opportunities Based on Behavioral Data

Key findings from this year’s State of Employee Benefits research provide insights into the continuing evolution of:

  • Group health plan offerings
  • Employee participation and contributing factors
  • Premiums and cost sharing
  • Consumer-directed healthcare accounts
  • And more

Using actual open enrollment data from over 1 million consumers across more than 500 large employers on the BENEFITFOCUS® Platform, the State of Employee Benefits is a one-of-a-kind resource to help benefit professionals and stakeholders understand key trends shaping the future of the industry.

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Health plan choice expands, while participation holds steady.

For the second consecutive year, the percentage of large employers offering high-deductible health plans (HDHP) increased, with a dramatic 10-point bump from 2017 to 2018.


of employers now offer at least one HDHP

PPOs continue to be the plan of choice among employees, while HDHPs are firmly in second place, maintaining over a third of enrollment elections


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What's driving enrollment decisions?

Age remains one of the key contributing factors in employee health plan selection, with millennials more than twice as likely to select an HDHP than the oldest members of the workforce.

2018 Health Plan Participation, When Given a Choice




Employee salary appears to be increasingly influential to plan selection, as the average pay gap between HDHP subscribers and PPO subscribers more than doubled from 2017.

Average salary difference between HDHP and PPO subscribers


increase in salary difference


Employees will pay more up front, but less at the doctor in 2018.

Employee medical premiums climbed again for both HDHPs and PPOs, as employers continue to offload these costs. The greatest increases have been seen in single-coverage plans over the past two years.

For Single Coverage


increase in PPO premiums since 2016

Meanwhile, out-of-pocket costs are down year over year across both plan types, with PPOs seeing particularly significant decreases in average deductibles and out-of-pocket maximums

PPO Cost Sharing





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Employees rely more on consumer directed healthcare accounts.

Participation in health savings accounts (HSAs) and flexible spending accounts (FSAs) among eligible employees surged year over year, with every age group seeing dramatic increases in adoption of both accounts.


year-over-year increase in overall HSA participation



While overall trends in employee account contributions have varied over the last two years, millennials have made consistent gains in HSA savings, while traditionalists have put more and more into their FSAs.


increase in family-coverage HSA contributions since 2016

Average Annual HSA Contribution

Average Annual FSA Contribution

Single Coverage

Family Coverage