6 minute read
What Does the Future Hold for Wellness Benefits?
By Heather Garbers
Wellness benefits are a hot topic in our industry.
They typically pay the member $25-$100 (once per covered person, per year) for completing a covered health screening. Our friends at Sydney Consulting Group have shared that $15 is the average annual rate load to a policy when a $50 Wellness Benefit is offered. In the eyes of the insurer, this is a benefit worth paying as it will hopefully lead to health interventions and earlier stage diagnosis that will help to avoid larger claims for untreated conditions down the line.
Sounds great right? What could be the downside of getting a portion of your premium back each year for completing a health screening, which we should all be doing anyways? Many people successfully use this as a bribe to get their spouses to actually get that annual physical Some in our industry spend more time educating employees on the benefit of these wellness benefits, than on the benefits of the actual supplemental health product they are offering. We also know that Wellness benefits continue to be positioned and marketed in our industry as double dipping tax schemes, which are fraudulent in the eyes of the IRS. You can learn more about these in this article from Aflac, and I encourage everyone to be aware of these, too good to be true, “tax savings” strategies, know how to identify them and avoid them.
Personally, I see the value of offering wellness benefits on supplemental health plans not only based on how they promote preventative treatments and literally save lives, but also how they help with persistency rates. Employees tend to cancel coverage they “do not use” (forgetting that they initially purchased coverage to prepare themselves for an unexpected medical event, which isn’t likely to happen every year), where a $25-$100 benefit for completing a covered health screening results in them “using” the plan each year. Then if a covered event happens, they have a benefit that will help them to remain financially stable and pay for treatment.
On the other hand, we also know that unfortunately, many times wellness benefits go uncollected as employees forget to file their claims. This is improving as carriers and the brokerage community are banding together to make the claim process easier for the member. We are seeing more widespread adoption of auto-filing this benefit based on a census from the employer, claim nudges, and claim integration to be the new standard in the marketplace, but we still have a long way to go. What we do know is that carriers that will auto-file wellness benefits based on completion of corporate bio-screenings or who follow the honor system for filing wellness claims (no EOB required), do see much higher utilization on these benefits.
An even more pressing issue on this topic, is that States are starting to push back on wellness benefits on supplemental health policies. This could be due in part, to frustration with regulating the double-dipping tax schemes out there or that some states view wellness benefits as duplicitous of ACA preventative benefits and thus not necessary (although anyone who has mentioned a health concern during their annual wellness exam can attest to there still being a cost for these visits). California has historically scrutinized wellness benefits and now, Michigan, New Jersey, New Mexico, and Virginia are some of the states starting to take a hard line against approving these benefits on supplemental health plan filings.
What is the future for wellness benefits? Does the current structure meet the needs of today’s consumer? How should, or could, we enhance the standard fixed dollar benefit to provide a more meaningful benefit to the member?
A view on the next generation of Wellness benefits comes from Chubb. Their strategy is to bring new and innovative solutions that embed wellness and advocacy services to better meet the needs of today’s employees and their families. Janet Buzil, SVP, Product Innovation & Delivery, offered to provide us with insights into their Cancer Advocate Plus (CAP) benefit that was released earlier this year, and goes well beyond your typical insurance offering. Not only does CAP encourage a focus on wellness by helping people understand their genetic inclination to cancer, but it also offers a personalized concierge service to help people understand and manage their outcomes.
As all cancer results from a genetic mutation, the CAP program also provides further advanced testing and support services to help identify more effective and timely treatment in the case of a cancer diagnosis, helping to speed and ease the road to recovery. It’s much more than an insurance benefit, it’s breaking new ground in how a comprehensive insurance program, with inherent preventive and treatment services, can improve health and wellness outcomes, while also mitigating the rising costs associated with cancer treatment.
Chubb has also differentiates itself through value-add “wellness benefits” on its supplemental health products, such as:
“Best Doctors” and “Health Champion Resource” services on their Critical Illness plan, which offers personalized and confidential assistance from health professionals, to help insureds find the best medical care and provide access to professional trained financial advisors, claims advocates and medical travel assistance.
Chubb’s Diabetes benefits also help employees to modify their behavior upon a Diabetes diagnosis, with help to pay for smoking cessation, nutrition counseling, and gym memberships.
These alternatives to the traditional fixed dollar benefit can be viable options for the future of wellness benefits in our industry. Services that members can use throughout the year, that impact their wellbeing, that could replace the current fixed indemnity benefit option. Some other ideas that could have value for the member include:
Mental health services
Caregiving support for both the member and loved ones
Genetic testing
At home lab testing for general health, food sensitivity, etc.
Nutrition counseling with discounts on healthy meals
Travel assistance
Marketplace where they can redeem points each year to select the option that best fits their lifestyle and need
As it comes to the future of the current indemnity-based Wellness benefits, only time will tell if the current model remains competitive in the marketplace… or we may have some State DOI’s make that decision for us.
Heather Garbers, SVP Voluntary Benefits, HUB International - is responsible for driving Voluntary Benefits strategy at HUB International (8th largest insurance broker in the world / 9th largest employee benefits broker in the US). In addition to her role at HUB, she is Co-Founder/Editor of Voluntary Advantage - created by the Voluntary Benefits industry, for the Voluntary Benefits industry; was named one of the “15 Women In Insurance You Need to Know” by LifeHealthPro” and was named Voluntary Advisor of the Year by Employee Benefit News.
