⁴One good indicator of the trends in underwriting is the trend for large employer premiums, as opposed to underlying health care costs. Various sources have reported these data for short periods of time (see Hogan, Ginsburg, and Gabel 2000; Strunk and Ginsburg 2003, 2004). Using those data, we can make rough comparisons, though not for the periods in table 1. For 1990 to 1995, the underlying cost increase was an estimated 4.5 percent per year, and large employer premiums grew by an estimated 7.4 percent per year. From 1995 to 1997, the figures are 2.6 percent and 1.3 percent, respectively. From 1998 to 2000, while costs grew at 6.7 percent per year, premiums grew at 5 percent per year. Then from 2001 to 2003, costs grew at 9.0 percent per year, but large employer premiums, by 13.3 percent. Finally, the premium and cost trends equalized in 2006 (Ginsburg et al. 2006, pp. W486–W487). [Return to Text]