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Employee Health Benefits Costs Strolled Higher: Milliman

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Knowing what COVID-19 will do to group health insurance costs in 2021 is hard, but the level of increases between 2019 and this year was moderate.

Christopher Girod and other actuaries at Milliman estimate, in a new look at current health costs, that health benefits costs for workers at the kinds of benefits-conscious employers that hire Milliman strolled, at a leisurely pace, up about 4.1% this year.

The average total cost is about $6,553 for individual coverage, and $28,653 for coverage for a family of four, according to the Milliman actuaries.


  • A copy of the latest Milliman medical cost analysis is available here.
  • An article about government health expenditure figures is available here.

Years ago, the Milliman analysts computed separate cost estimates for indemnity coverage, health maintenance organization coverage, and preferred provider organization (PPO) plan coverage.

The analysts now assume that PPOs have won: They focus on calculating costs for a PPO plan that covers 84% of the actuarial value of a standard essential health benefits package. Based on the Affordable Care Act “metal level” system, the standard Milliman plan used in the calculations is somewhere between a good gold plan and a great platinum plan.

Here’s what Milliman actuaries say the 2020 cost breakdown looks like individual coverage:

  • The employer’s premium payments: $3,907
  • The employee’s share of the premiums: $1,598
  • The employee’s out-of-pocket spending on deductibles, co-payments and coinsurance amounts: $1,048

Here’s what’s happened to the cost breakdown for coverage for a family of four:

  • The employer’s premium payments: $16,368
  • The employee’s share of the premiums: $7,703
  • The employee’s out-of-pocket spending on deductibles, co-payments and coinsurance amounts: $4,582

— Read Health Insurance Rates Could Be Weirdly Stable: Actuarieson ThinkAdvisor.

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