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Employers in Central Pennsylvania are increasingly dropping health insurance coverage for spouses, according to an annual survey of more than 130 companies by Conrad Siegel Actuaries.

Thirty-one percent of employers surveyed did not cover spouses who have health insurance available through their own jobs in 2014, the survey said, up from 20 percent in 2012.

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Sixteen percent of employers who did cover those spouses required an average annual surcharge of $1,700, the survey said.

Rob Glus, partner at Conrad Siegel Actuaries, sees that as part of a trend.

"As we continue to see health care costs increase, employers are more prone to reduce benefits rather than passing costs onto employees through payroll deductions,” Glus said. “To a degree, this may be in response to concerns over the impending impact of the Cadillac Tax."

A provision of the Affordable Care Act set to begin in 2018, the Cadillac Tax will impose a 40-percent excise tax on health benefits beyond $10,200 for singles and $27,500 for couples and families.

The survey found that premium sharing was essentially the same as the previous year, with the average percentage of the medical premium that employees paid at 15 percent for single coverage and 21 percent for employee plus dependents.

However, it showed self-funded plans — those in which employers assume more risk by paying the cost of their claims plus an administrative fee — more prevalent than fully insured plans for the first time.

Fifty-two percent of plans were self-funded in 2014, up from 40 percent in 2013. The Affordable Care Act’s health insurers tax on insured plans, which started in 2014 and is not assessed on self-funded plans, may have been a contributor, according to the company.

The survey also showed more companies offering tax-preferred spending accounts such as health savings accounts, health reimbursement accounts, medical expense reimbursement plans and flexible spending accounts in conjunction with qualified high-deductible health plans.

A separate national analysis released this month by the New York-based Commonwealth Fund identified high deductibles as a key factor in underinsurance,which has held steady at about 23 percent of working-age adults since 2010.

Underinsurance is defined, among other measures, as having deductibles equal to at least 5 percent of household income, or having out-of-pocket costs, excluding premiums, equal to at least 10 percent of household income.

“While the number of underinsured people in the United States held constant in 2014, the steady growth in the proliferation and size of deductibles threatens to increase underinsurance in the years ahead,” the Commonwealth Fund said.

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Heather Stauffer covers the health care industry. She can be reached at or 717-481-6022.