• Report
  • July 13, 2016

2016 Employee Benefits Survey Trends

Children's hospitals of all types are evolving their employee benefits to promote wellness according to the Children's Hospital Association's 2016 Employee Benefit Survey.

With data from 38 member hospitals representing more than $1.7 billion in spend, this survey helps inform decision makers and support strategic planning at freestanding and system-affiliated children's hospitals.

The trends are derived from responses to nearly 300 benchmarking questions developed by a CHA member task force. In addition to the key findings below, CHA provided a full report of survey findings to hospitals enrolled in CHA's Insurance Services program.

Key findings

Children's hospitals continue to offer competitive benefits
On average, hospitals surveyed require employees to contribute between 15 percent and 25 percent of the premium equivalent, which is less than the national average1. Yet, wide variance exists. Contributions for single coverage ranged from "free" for several EPO/HMO plans to 77 percent of the total cost for one PPO.

On-site services continue to grow
  • Almost 35 percent have an on-site clinic
  • More than 40 percent offer wellness coordinators or coaches to help employees manage their health
  • Roughly 80 percent offer biometric screening and a self-reported health assessment to help employees understand their health risk
  • More than 90 percent have some form of a wellness program

Contribution strategies

Did children's hospitals increase their employees' share of premiums?

In 2015, fewer hospitals surveyed increased their employee share of premium. Between 2012 and 2014 there was approximately a 20 percent increase with only a 5 percent increase between 2014 and 2015.

Are children's hospital employee benefit plans in danger of an excise tax?

For 2018, 33 percent of surveyed hospitals' plans are in danger of an excise tax compared to the national average2 of 10 percent. In 2019, 40 percent may be subjected to the excise tax.

Of the surveyed hospitals responding to a question about the "Cadillac Tax," 45 percent indicated they expected to reach the limits of $10,200 for single coverage and $27,500 for a family by 2019. Against a national average of 10 percent of firms expecting to reach this threshold, it is clear hospitals surveyed have generous benefits, and that some meaningful, and potentially painful, benefit reductions are likely.

*Note: For 2018, 66 percent did not respond and for 2019, 60 percent did not respond to this question.

How much do children's hospitals contribute to employee HRA/HSA accounts?

2009-2015 CHA average HRA/HSA employer contributions compared to 2015 national average1

For employees in high deductible plans, the hospitals are making above-average contributions to employees' accounts.

What are employee contributions as a percent of total cost?

It is evident hospitals surveyed have very competitive programs, with contributions that are generally below national benchmarks1.


How many children's hospitals offer an employee disease management program?

Hospitals surveyed are only slightly lower than the national average1 for chronic disease management programs. Of these programs, 40 percent are carved-out to vendors.

How do children's hospitals' wellness initiative programs compare to the national average?

Among hospitals surveyed that offer health benefits, 91 percent offer various wellness and health promotion activities. Biometric screening programs are 17 percent higher than national average2 while HRA and obesity management programs are 5 percent lower than national average.

Do employees who use tobacco pay more?

(National average: Towers Watson4.)

Do children's hospitals offer on-site employee care services?

Of hospitals surveyed, 34 percent have some type of on-site clinic for employee use. This lags behind the national average1 of 2 percent.

Cost containment

Have children's hospitals added a specialty pharmacy fourth tier?

Because drug costs are on the rise again, a small number of surveyed hospitals added a fourth tier for specialty pharmacy to increase employee awareness. Most hospitals cap the maximum per-prescription out-of-pocket at $250.

Do children's hospitals charge more if employee spouses have access to other coverage?

Between 2012 and 2014 spousal surcharges increased 6 percent (of hospitals charging a spouse). While in 2016, the number reduced by 4 percent, which is still higher than the national average1 of 15 percent.

Do children's hospitals provide a domestic discount for dependent children?

Hospitals surveyed are offering fewer discounts for employees, which may be attributed to the hospitals offering a consumer-drive health plan (CDHP) plan. (National average: 2012 Sullivan Cotter3.)

More information

Contact Insurance Services, (913) 262-1436.


  1. 2015 Mercer National Survey of Employer-sponsored Health Plans, Mercer
  2. 2015 Employer Health Benefit Survey, Kaiser Family Foundation
  3. 2012 Employee Benefit Practices in Hospitals and Health Systems, Sullivan Cotter
  4. 2015 Emerging Trends in Health Care Survey, Towers Watson