What CEOs May Not Know About Their Employee Health Plans
Approximately 50% of Americans receive healthcare benefits from employers, a benefit that 86% of employees surveyed for MetLife’s 20th Annual U.S. Employee Benefit Trends Study 2022 said was a “must have.” Corporate benefits managers are responsible for the increasingly difficult job of evaluating and selecting benefits plans that strike the right balance between comprehensive coverage and financial cost to their organization.
In recent years, the trend in benefit design has leaned toward plans with high deductibles and lower premiums, which shift more out-of-pocket costs to employees. The use of cost-saving strategies that control patients’ access to healthcare services, known as “utilization management” or “UM” has also increased dramatically. And formularies, the list of drugs covered by a health plan, have become more restrictive and include more pricing tiers, which can result in greater expense for employees who need certain medicines.
All this cost-shifting has helped employers keep their benefit costs under control, but what has it done to employees? According to the Kaiser Family Foundation, nearly half (46%) of insured adults report difficulty affording their healthcare out-of-pocket costs. In fact, a recent survey by Bankrate, a personal finance company, found that 56% of Americans would be unable to pay for a $1,000 emergency, such as an unexpected car repair or emergency room visit.
