Examining Form 5500 data submitted by 1,480 multiemployer health plans, the average benefit costs for the plans increased about 5% from 2018 to 2020, reaching $12,298 per participant per year (PPPY), according to The Multiemployer Health Plan Landscape: A 15-Year Look (2006-2020), recently released by the International Foundation of Employee Benefit Plans. Benefit cost levels are influenced by various factors, including the types of benefits offered (medical, prescription drug, dental, vision, etc.) and the design of those benefits as well as the demographics of the population utilizing the benefits (average family size, morbidity, age, gender, etc.).

Health Plan Benefits

For the plan year 2020, 79% of multiemployer health plans offered dental and vision benefits in addition to health benefits; 61% of plans also included life insurance benefits. Only 2% of plans offered only medical/prescription drug (only health) benefits. The highest prevalence of dental coverage (94%) was found in the service industry, and the highest prevalence of vision coverage (90%) was found in the transportation industry.

Retiree Coverage

The percentage of plans covering retirees varies by industry and region. In general, the larger the number of active participants in a health plan, the more likely the plan is to also cover retirees. The percentage of multiemployer health plans covering retirees in the 2020 plan year was 73%. Most construction industry plans (80%) covered retirees, while just over half of service industry plans (52%) covered retirees.

Plan Funding

The funding, or income, of multiemployer health plans can be broken into four primary components: employer contributions, worker/retiree contributions, investment income and other income. Employer contributions have accounted for at least 80% of the total income during every calendar year for the 15-year period covered in the report (80.9% in 2020). Participant contributions have been anywhere from 4.6% to 6.5% in any given year (4.6% in 2020), with the remaining total income coming from investment/other income (14.6% in 2020).

• The median employer contribution PPPY was $12,065 for the 2020 plan year, up from $11,762 reported for 2018. That’s almost a 3% increase.
• The average plan’s PPPY worker/retiree contribution was $813. Compared to $792 in the 2018 plan year, that’s also an increase of almost 3%.

Assets as Months of Expenses

Despite shifting demographics and impacts due to the COVID-19 pandemic, which varied dramatically by industry, the total number of participants covered by multiemployer health plans remained relatively unchanged over the 15-year period, and the financial condition of many multiemployer health plans improved.

In the 2020 plan year, 65% of the multiemployer health plans in the study had assets in excess of 12 months of expenses, compared to under 60% in the 2018 plan year. Over the 15-year period, the percentage of plans with assets worth between zero and six months of expenses decreased from over 27% to under 16%, while the percentage of plans with assets worth more than 24 months of expenses increased notably from 16% to 33%.

Learn More About Multiemployer Health Plans

The Multiemployer Health Plan Landscape: A 15-Year Look (2006-2020) is the sixth multiemployer health plan benchmarking report produced in partnership with Horizon Actuarial Services, LLC, and the International Foundation of Employee Benefit Plans. The comprehensive report examines data from Form 5500 annual reports filed by multiemployer health plans with the U.S. Department of Labor. As required by the Employee Retirement Income Security Act (ERISA) to satisfy annual reporting requirements, Form 5500 collects data on the plan demographics, benefit costs, income and plan cash flows of employee benefit plans filed by group health plans.