Most employees don't think they should be required to participate in wellness programs to qualify for employer-provided health insurance, according to a recent survey released by the National Business Group on Health. Moreover, they don't think employers should charge employees more for health coverage if they don't meet specific health goals.

Employees oppose the linking of their health plan to wellness program participation, with 62% opposing charging employees more for health coverage if they do not participate in wellness programs.

Over 80% of employees favor offering a financial reward to employees who meet specific health goals, meanwhile, but only 29% favor charging employees more for health coverage if they don't meet health goals. Sixty-eight percent oppose requiring employees to participate in a wellness program in order to qualify for health insurance.

"You can give them more, but you can't charge them or take it away from them, according to these employees [in the survey]," noted Helen Darling, president, NBGH, during a press briefing.

However, the survey of 1,545 employees at companies with 2,000 or more employees also found nearly four-in-10 (39%) rank biometric screenings as a very important health benefit program, followed by exercise programs (31%) and onsite fitness centers (31%). Interestingly, 35% of employees don't consider any of these programs to be very important.

The survey also shows employees aren't particularly knowledgeable about the investment their employers make in health care. Just four-in-10 can estimate their employer's contribution to their health care premium, and most of those are, at best, only somewhat confident in their estimate.

"Employers need to help employees understand how rich the benefit is that they're providing," said Darling.


Health plan satisfaction

Over 60% of employees are very satisfied with their health plan, according to the survey. "Despite higher premium costs and higher out-of-pocket costs, compared to three years ago, 35% had higher satisfaction levels with their health coverage, and 53% had similar satisfaction," said Darling. "They're paying more, but they're as satisfied or more satisfied."

One-third of employees are not confident in their ability to shop for any insurance on their own, while 53% aren't confident they could purchase the same or better insurance on their own.

In a related NBGH survey, meanwhile, large U.S. employers expect their health care costs to increase by 7% next year. The survey, based on responses from 82 of the nation's largest corporations, was conducted in June prior to the Supreme Court's decision to uphold the Patient Protection and Affordable Care Act.

The majority (60%) of employers plan to increase the percentage of the premium paid by employees in 2013, although most indicated that it would be by less than 5%. Additionally, 40% plan to increase in-network deductibles, while roughly one-third will increase out-of-network deductibles (33%) and out-of-pocket maximums (32%).

While many employers continue to adopt cost-sharing provisions, survey respondents now consider consumer-directed health plans and wellness initiatives to be more effective at stemming cost than shifting costs to employees. According to the survey, 43% cited a CDHP as the most effective cost control tactic, followed by wellness programs (19%). Less than one-in-10 (9%) respondents reported increased employee cost-sharing as the most effective tactic. Last year, cost shifting was cited as the most effective measure.

The survey also reports that employers plan to sharply increase the incentive amount for maintaining a healthy lifestyle or participating in a wellness program. Among employers offering incentives, the median amount employees can earn will jump 50% from $300 this year to $450 next year. The median incentive amount that dependents can earn is expected to increase from $250 this year to $375 in 2013.

Employers were also asked what changes they made or are planning to make as regulations from the Patient Protection and Affordable Care Act continue to come into effect. Half of all respondents indicated they no longer have any annual benefit limits in place, while nearly one-third )32%) reported that they did not make any changes to their annual limits this year. Among employers making changes for 2013, the most common benefits requiring adjustments to annual limits were mental health and substance abuse (9%) and rehabilitative services and devices (9%).

More than half of employers (51%) believe some retirees might find state health insurance exchanges to be a viable option for health insurance.


Sound off!

Here's what readers are saying about the NBGH employee survey data:

"'Over 80% of employees favor offering a financial reward, but only 29% favor charging more if they don't meet health goals' ... this is a shell game, and whoever hasn't learned to frame his/her messaging accordingly should suffer the wrath of his/her employees. The interesting fact is a good percentage of employees value wellness and 'rank biometric screenings as a very important health benefit program, followed by exercise programs and onsite fitness centers.' These are facts upon which we should be building." - posted by Kenneth W

"In a free-market economy, this would not even be a discussion. Risk would be factored in amongst many other items to determine what a person would pay for their own health care, i.e., that which they had to research and pay for with their own money. Get the employers out of it, allow real competition between companies on a nationwide basis, and you will have an efficient, fairly priced and innovative health system." - posted by msmox

"This is one reason why health care cost so much - insulation from pricing/cost and third-party payment. These numbers shouldn't surprise anyone, but employers shouldn't heed these numbers, either. Employers' messages needs to morph to 'you want to be unhealthy, that's your business, so do it on your dime. If you want our help, subsidy and programs, then you will comply with X,Y & Z.'" - posted by daplus4

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