A new study released yesterday suggests that although many Americans may want to work a few years longer to improve their retirement security, their health might prevent them from doing so.

Nearly three out of five retirees say they retired earlier than they expected, according to a survey of retirees and pre-retirees conducted by Bank of America Merrill Lynch. Just one in nine pre-retirees, meanwhile, is completely confident in their ability to pay for their health care retirement expenses.

 “The No. 1 retirement wildcard that came out was health disruption. … there are some very big worries out there,” said David Tyrie, head of personal wealth and retirement for Bank of America Merrill Lynch. “When you look at this health disruption, it really is a triple whammy for them. It’s unpredictable, it’s very expensive and it’s the biggest reason folks are retiring early.”

Beyond core financial advice, both retirees and pre-retirees cited “help sorting through health care and long-term care options,” as being most valuable (75%).

“You have a boomer generation that’s living 30 years longer; their biggest concerns are health care. They’re saying they need to start thinking about contingencies,” said Tyrie. “It’s not just about a number or saving for one task. They have to factor in this contingency. Most people have not thought that through and they’re starting to come to the realization that this [health care] does factor into their retirement.”

For employers, he said, this means taking a more holistic view of preparing employees for retirement. “Employers have done a nice job providing savings programs for employees because we need to make sure employees are saving,” he said. “What employers now need to turn to is the fact they have another challenge ahead of them for the boomers, which is to be more holistic about this and not just about the number – how much did you save – but also about the [health care] contingency.”

The study surveyed more than 6,300 Americans age 45 and older and compares pre-retirees’ vision of retirement to current retirees’ real-life experience.

 “We’re finding some interesting changes in terms of what pre-retirees expect retirement to be about versus what those already in retirement are really living and experiencing,” said Andy Sieg, head of global wealth and retirement solutions for Bank of America Merrill Lynch.

For example, pre-retirees think they will most miss the reliable income of a regular job but current retirees actually miss the social connections offered through work more than the reliable income. “This underscores the need to have a much broader, balanced view of all the things that make up a full and satisfying life in retirement,” said Sieg.

Many of those surveyed now view retirement as an opportunity for career reinvention, with 51% of pre-retirees saying they will seek a different line of work in retirement.

 “The idea of working a few extra years, cycling between work and leisure, has gone from being an outlier to being a core assumption in terms of how pre-retirees expect to spend their later lives,” said Sieg. “They’re doing this both for the additional earning power but even more, we think, for the stimulation and satisfaction that comes from work.”

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