Big Increase in Health Care Costs Projected for Employers in 2024

Aon estimates per-employee cost at more than $15,000, up 8.5% from 2023 figures.

Without implementing any employee cost-sharing increases or other cost-saving strategies, employers should expect major health care cost increases in 2024, according to Aon.

Average costs for U.S. employers that pay for their employees’ health care will increase 8.5% to more than $15,000 per employee, the firm predicted.

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Such an increase would nearly double the 4.5% rise in health care budgets that employers experienced from 2022 to 2023. On average, Aon estimated that the budgeted health care plan cost for employers this year is $13,906 per employee.

Aon uses its Health Value Initiative database, which captures information from more than 800 U.S. employers representing approximately 5.6 million employees and $77 billion in 2023 health care spending, to track this data.

These rising health care costs and budgets have the potential to eat into employer budgets for other benefits that employers offer, including financial wellness, student loan benefits, retirement contributions and more, panelists at the PLANSPONSOR National Conference discussed in June.

Rising Drug Costs

Debbie Ashford, Aon’s North American chief actuary for health solutions, said in a press release that even though inflation is subsiding, the cost of health care is still growing, as medical providers push insurers for larger cost increases to cover the higher costs of wages and supplies they endured during the past few years but were unable to pass on to payers.

“Other contributing factors adding pressure on health care cost trends are the proliferation of newly indicated weight-loss drugs, new technologies, [the] severity of catastrophic claims and increasing share of specialty drugs,” Ashford stated.

According to the Business Group on Health—a nonprofit organization that represents large employers’ perspective on optimizing workforce strategy through various health, benefits and well-being solutions—pharmacy costs continue to affect trends and affordability.

The organization’s 2024 Large Employer Health Care Strategy Survey, which gathered data from 152 large employers between June 1 and July 18, found that 91% of employers reported concerns about pharmacy costs. This comes as employers experienced an increase in the median percentage of health care dollars spent on pharmacy, to 24% in 2022 from 21% in 2021.

For 2024, employers said they planned to deploy various pharmacy management strategies, according to Business Group on Health.

In addition, half of employers said cancer was the No. 1 driver in health care costs, and 86% said it ranked among the top three. Last year, cancer overtook musculoskeletal conditions as the top driver of large companies’ health care costs for the first time, according to the survey.

Employers Hesitant to Shift Cost to Participants

Because of the tight labor market, Farheen Dam, Aon’s North American health solutions leader, stated that plan sponsors are hesitant to shift significant costs to plan participants and make benefits less affordable.

Aon’s analysis found that employees in 2023 are contributing about $4,675 for health care coverage, of which $2,682 is paid in the form of premiums from paychecks and $1,993 is paid through plan design features, such as deductibles, co-pays and co-insurance.

While the rate of health care cost increases varies by industry, the professional services industry showed the highest average employer cost increase at 7.5% from 2022 to 2023, while the manufacturing industry had the highest average employee cost increase at 2.9%.

The retail and wholesale industry had the lowest average change in employee contributions, dropping 0.5% from 2022 to 2023.

To help plan sponsors manage their health care spending, Aon developed a Health Risk Navigator, which is aimed at helping employers make better decisions to “optimize reinsurance coverage, improve budget planning and implement targeted care management programs by using machine learning and risk simulation to analyze historical claims and demographic data for each individual employee.”

SEC Reopens Comment Period for RIA Investment Custody Rule

The regulator also announced a new proposal to increase transparency and disclosures for private fund managers such as private equity and hedge funds.

The Securities and Exchange Commission on Wednesday reopened the comment period on a proposed rule to redesignate and amend the current custody rule on how registered investment advisers handle and maintain client assets.

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The comment period had ended on May 8 but will now be open another 60 days from the reopening release’s date of publication in the Federal Register, which generally comes shortly after such SEC announcements. The proposed amendment to what is known as the “custody rule” for adviser-led investing, but would be changed to the “safeguarding rule,” would expand the rule’s application beyond just securities and funds to all assets in a custodian’s custody.

The reopening of the comment period comes after multiple industry associations called on the regulator to extend the chance for comment, with many noting that the rule would unnecessarily widen the umbrella of regulation for many adviser-led asset investments.

Among more than 100 comments in the initial responses, which came from sources such as asset managers, law firms and auditors, many were seeking further clarity or pullback of the amendment. In May, the Investment Adviser Association argued that the amended rule would bring under SEC audit and reporting: digital assets, real estate and physical commodities that could “make those other assets difficult to transact in.” The organization described the rule as “a huge sea change” for custodians, advisers and accountants.

The IAA commended the decision to reopen the comment period on Wednesday, saying the association would “look forward to reviewing the release over the coming weeks, engaging with the SEC on interpretive issues, and helping our members understand and prepare for implementation of the new rules.”

The SEC is seeking to change the rule that sits under the Investment Advisers Act of 1940 and is intended to enhance protections of customer assets managed by registered investment advisers, according to its latest comment. The proposed change was made by the commission on February 15.

“The reopened comment period will allow interested persons additional time to analyze the issues and prepare comments in light of the final rules and amendments … to enhance the regulation of private fund advisers,” it stated.

Private Fund Advisers Rule

In a separate announcement regarding the financial services space, the SEC announced the adoption of new rules and rule amendments enhancing the regulation of private fund advisers, such as private equity and hedge funds, and updating the existing compliance rule that applies to all investment advisers. According to the SEC, the new rules are designed to “protect private fund investors by increasing transparency, competition, and efficiency in the private funds market.”

“Private funds and their advisers play an important role in nearly every sector of the capital markets,” SEC Chair Gary Gensler said in a statement. “By enhancing advisers’ transparency and integrity, we will help promote greater competition and thereby efficiency. Consistent with our mission and Congressional mandate, we advance today’s rules on behalf of all investors—big or small, institutional or retail, sophisticated or not.”

The final SEC rules will require private fund advisers registered with the SEC to provide investors with quarterly statements detailing certain information regarding fund fees, expenses and performance. In addition, the rules will require a private fund adviser to obtain and distribute to investors an annual financial statement audit of each private fund it advises and, in connection with an adviser-led secondary transaction, a fairness opinion or valuation opinion, the regulator wrote.

The rules will also prohibit all private fund advisers from giving preferential treatment to some investors if that special information would have a “material, negative effect on other investors.”

The SEC has given “legacy status” to adviser and investor contracts that already exist, according to the announcement.

In response to the private funds rule, the IAA stated in a letter that it was “pleased to see several important modifications,” but that it still had “significant concerns about the rules.”

The association of investment advisers noted areas into which it would look more deeply, including: considering the legacy rules to ensure current contracts would not be negated; whether the new rule changes or enhances an adviser’s fiduciary duty under prior regulation; the allowance of an adviser to provide a “valuation opinion, in addition to a fairness opinion,” as an option for an adviser-led secondary transaction, which the association said it will review; and continued concerns over the burden on smaller advisers in terms of compliance and reporting.

The new rules will go into effect 60 days after being filed with the Federal Register.

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