2023 Usbenefitstrendreport

insightsfrom
theexperts
US Benefts
Trend Report 2023
Table of Contents
A Letter from Kim 2
Key Takeaways 4
Holistically Mitigating the Efects

of Cumulative Stress 6
Balancing Employee Needs:

Aligning Culture and Benefts for Better Results 18
Maintaining Afordable Benefts: Cost-Efective

Strategies and Solutions to Reign In Rising Costs 32
Plan Benchmarking Data Snapshot 46
About the Data 57
About the Experts 58
2023 NFP US Benefts Trend Report : : 1

A Letter from Kim
In the face of economic uncertainty, The NFP US Benefts Trend Report is a central ele-
ment of our eforts. The insight and solutions we ofer are
employers remain driven by opportunities informed by an understanding of what’s happening in the
world, what employers are trying to accomplish and the
to provide comprehensive beneft solutions barriers in their way. From there, we help employers better
that positively impact their employees’ lives align benefts with employee wants and needs, develop
There are challenges, including ongoing turmoil in the strategies to contain costs and demonstrate a genuine care
labor market, a world working to fully recover from a global for the holistic well-being of their workforce.
pandemic and intense pressure to reduce costs. But there is With data we collected from thousands of employers
tremendous value for employers that take a more proactive across all industries as well as perspectives from our team
approach to caring for and supporting their employees. of experts, this report:
NFP continues to help clients achieve better out- • Examines the challenges employers are facing.
comes by guiding their re-evaluation of what it takes to
• Empowers employers to navigate complexity with
provide afordable, comprehensive beneft solutions.
actionable insights.
We reiterated this commitment earlier this year with the
• Provides recommendations and solutions from a
launch of our Human Capital Solutions business, which rep-
trusted partner.
resents our focus on providing integrated and sustainable
solutions, especially in an environment with no shortage We are taking another step forward to help employ-
of obstacles. ers create personalized beneft oferings that elevate
employee satisfaction, productivity, well-being and
engagement, and the overall success of your organization.
We’re also enhancing competitiveness for organizations
striving to be destinations for top talent.
I want to thank everyone who contributed to the
NFP US Benefts Trend Report. Their passion for serving
clients keeps us moving forward. We thank you for your
commitment to improving the present and look forward to
collaborating with you in the future.
With gratitude,
Kim Bell
Executive Vice President
Head of Health & Benefts
2 : : 2023 NFP US Benefts Trend Report

Key Takeaways
95 %
of workers
are worried about
24
the economic
% situation in the US
63% of employees
of employees feel their would purchase life insurance
with LTC if their employer
benefts completely ofered it to them and the
meet their needs price was right
BUY NOW

55% of workers
aged 18 – 34 consider training
and skill development to be a
critical or important beneft
48 %
of employers
are concerned with increasing
pharmacy costs 39% of workers
and their afordability completely understand
their benefts
74 %
of employers do not ofer
family caregiver leave

1
Holistically
Mitigating the Efects
of Cumulative Stress.
Stress is an inherent part of life
and work and a natural reaction to pressure from challenges. In
a professional, normative work environment, an ideal amount of
stress typically results in happier, more engaged workers. When
healthy employees face healthy stressors such as deadlines,
challenging work responsibilities and interactions with customers
and co-workers, they tend to respond positively and productively.
Stress: A state of mental or emotional strain or tension result-

ing from adverse or very demanding circumstances.
Eustress: Moderate or normal psychological stress, interpreted
as being benefcial.
Distress: Extreme anxiety, sorrow or pain.

Keeping organizational stress at an optimal level is good reducing the workload, extending deadlines or resetting
for business. However, it should be noted that at any expectations. They could further brainstorm with workers
given moment, a wide array of stressors, originating both to help them better prioritize their eforts. Such actions
in and outside of work, are having a cumulative efect could quickly lower stress levels, head of burnout and
on employees. There are social stressors in play, such as depression, and signifcantly lessen the risk of turnover.
difcult friendships or family situations. There are fnancial However, for most people, stress accumulates from
stressors, which afect the vast majority of the working concerns both in and outside of the workplace. When work-
population and remain mostly constant. There are also ers are in chronically stressful situations, the cumulative
health-related stressors from illness or injury. There is even efects can have a signifcant impact on mental well-being.
stress associated with social isolation and loneliness, which As there is no defnitive line separating life priorities and
the Surgeon General of the United States has recently iden- responsibilities from work priorities and responsibilities,
tifed as an epidemic with a mortality impact similar to that stress from things like caregiving, fnances, signifcant life
of smoking 15 cigarettes a day.1 changes or physical and mental ailments integrate with
Although a certain amount of stress is helpful, there is workplace stressors like untenable workloads, inefective
a tipping point where stress can accumulate and become a processes or lack of colleague support.
health and safety issue, and require intervention. In a siloed For employers that don’t take this notion of cumula-
environment like the workplace, if a healthy employee is tive stress into account, any efort to enhance the employee
impacted by poor communication, unattainable deadlines experience through beneft oferings may go unnoticed
or an unreasonable workload, their performance could be against the backdrop of combined personal and workplace
noticeably afected. Attuned managers could intervene by struggles. Therein lies the challenge and the opportunity.
Figure 1: Figure 2:
Why Workers Believe Employers Extent to Which Employees Feel Their
O˜er Beneÿts Beneÿts Meets Their Needs
Retain existing
employees 61% 24%
Attract new 61%

employees 57%
15%
Support employees’
44%
personal lives
Completely
Reward employees 40%
Mostly
Support employees’ Not at all
35%
professional lives
Respondents were asked to select all that apply.

The modern workforce strives
for better balance across their
work and personal lives
Employers have a vested interest in and a duty of care The frst line of defense against this outcome?
to help keep employee stress levels in check, whether that Managers. If managers are not paying attention and the
stress is work or home related. When high stress occurs employee has no outlet to communicate what they’re
within a team and is sustained for any length of time, the experiencing, employees will feel trapped, and the pros-
well-being and efectiveness of the individuals involved are pect of quitting becomes inevitable. Conversely, training
put at risk. Given that stress is a natural human reaction that managers to prioritize communication can help prevent
manifests when we face pressure from changes and chal- burnout and turnover.
lenges, it is no surprise that its efects are expressly salient “Creating a performance management culture of
in the workplace. frequent touchpoints and dialogue can help managers
The modern workforce strives for better balance identify when an employee is struggling,” says Trapenasso.
across their work and personal lives. Employers with a Opening a dialog allows employees to share their strug-
sense of what’s afecting employees outside of work can do gles, providing a valuable forum for employers to listen and
several things to better meet these needs while continuing collaborate to fnd tangible solutions.
to foster a professional culture of engagement and produc- Investing in communication is a win for both parties.
tivity. Updating beneft oferings and well-being initiatives Employees who feel that their employers care about their
to suit the expectations of a post-pandemic workforce well-being and familial responsibilities tend to appreci-
better are just two of them. ate their employer and stay with the organization longer.
What’s more, once a proper communication cadence is
Fight Burnout Through established, managers can focus on balancing the employ-
Candid Communication ee’s needs with organizational expectations and work on
People are the most important determining factor in an ways to improve their overall well-being.
organization’s success, and anything that afects their
health and well-being directly impacts productivity,
engagement and motivation. When demands at work
and home exceed a person’s capacity to respond, stress
can quickly compound, causing problems. As symptoms
like exhaustion and irritability start to weigh down an
employee, their risk for burnout dramatically increases.
Without relief, these conditions can lead to turnover.
According to Maria Trapenasso, SVP, National Practice
Leader, Human Capital Solutions, “Employees today face
many stressors — demanding work schedules, perfor-
mance goals and objectives, taking care of kids and aging
parents, to name just a few. Many of these employees, if
they’re not allowed to share these challenges safely and
transparently with their employer, will either underperform
or burn out trying to keep up with work demands.”

Figure 3a:
Most Attractive Workplace, According to Employees
One that o˜ers its employees a

hybrid work arrangement 31%
One that gives employees the opportunity

to set their own work schedules 27%
One that allows employees

21%
to work fully remote
Any of the above 22%
Figure 3b:
Workplace Flexibility Initiatives Implemented in the Past Year
We o˜er our employees a

hybrid work arrangement 51%
We allow our employees

to work fully remote 23%
We give our employees the opportunity

21%
to set their own work schedules
Other 6%
We did not implement

32%
any permanent changes
“One efective approach our Human Capital Solutions Embrace Flexibility Beyond Hybrid Work
team has recommended to clients is allowing employees to
create fexible work schedules,” says Trapenasso. “When our As fexibility is a big help for struggling employees, demand
team goes into an organization and assesses its workforce for it continues to rise. This is most often seen in the form of
through demographics and other analyses, we get a sense fexible work arrangements that allow employees greater
of what’s important to them, how the entire company control over their schedule, permitting them to work
works together, and how they communicate. This helps to when they’re at their best while still meeting deadlines
inform what type of fexible work arrangement is appropri- and servicing clients. It further allows them to commit to
ate and efcient for an organization.” responsibilities at home as caregivers or heads of house-
Refexively decreasing the workload or ofoading hold while better managing their responsibilities at work.
expectations at the frst sign of burnout is often viewed However, employers should look beyond scheduling when
as the only solution. However, communicating to collab- seeking ways to provide fexibility for employees.
oratively explore potential schedule and workfow timing As Deb Smolensky, SVP, Global Practice Leader,
changes may alleviate the problem by giving the employee Well-Being and Engagement, asserted in NFP’s 2022 Trend
more fexibility. Report, factors impacting employees at home and work
are never mutually exclusive. On the contrary, their impact
is felt concurrently. Therefore, any solution to improve

Figure 4: Figure 5:
Employer Company Support for Employees 2022 Mental Health Services Spending
We understand the importance of

employee work/life balance and are $0 23%
61%
working to create a more employee
centric workplace
$1 - $500 21%
$501 - $1,500 18%

Our organization has considered
creating new initiatives to better 20%
support our employees, but we $1,501 - $3,000 18%
have made very little progress
$3,001 - $6,000 9%
We require employees to be on site, $6,001 - $10,000 3%

and employees want more ˜exibility 19%
that we just are not able to provide
$10,001+ 2%
Unsure 6%
employee well-being must be focused through a holistic an investment shows that an organization cares and is fully
lens of life/work integration. committed to its employees. In addition, the signifcant
While fexible scheduling is a game changer for many, benefts of such a small investment have the potential to
fexibility as an institutional norm goes beyond where pay dividends.
employees work. “When we talk about life-work harmony In addition to opportunities to expand mental health
and implementing measures like fexible work arrangements resources, employee beneft enhancements are being
to keep stress levels down, we also need to consider ofering considered by many employers aiming to meet diversity,
benefts that address personal things like family caregiving equity, inclusion and belonging policy objectives. A few
responsibilities and mental health support,” says Smolensky. areas where employers are investing:
Employers focused on supporting employee needs • Supporting family planning and health through
may note a diference in the prioritization of mental health fertility support benefts and other policies.
spending. As Smolensky observes, “One of the surpris-
• Addressing population health concerns for employ-
ing things in our trend data this year is that about half of
ees living in geographical areas with limited access to
employees reported spending between $500 and $6,000 in
quality care providers.
2022 on mental health services. This is an incredible invest-
ment that employees are making in their mental health. • Designing uniform innovative solutions using current
And at a time when it’s reported that 95% of respondents funding tools like limited scope healthcare reim-
are concerned about the economic situation in the US.” bursement accounts.
Although the NFP survey indicated that 72% of The most efective implementation of these strate-
employers do not plan to add additional mental health gies requires an integrated, non-fragmented approach that
support, it’s clear that this is an opportunity for them to combines HR policies with mental health and well-being
ease employees’ cost burden. strategies. These should be supported by value-based
This could be done by exploring expanded services medical/Rx designs and data analytics with key perfor-
within the current ofering to better support employee mance metrics identifed to validate performance.
out-of-pocket spend. As employees proactively spend
signifcant dollars on mental health services, it’s clear that
they’re willing to invest in the care they need to improve
their well-being. Employers should follow their lead. Such

“Expanding employee assistance programs, provid-
ing greater access to virtual behavioral health, ofering
mental health days, and introducing mental resilience
training are but a few of the levers employers can pull to
help their employees reduce stress,” says Smolensky. “When
the data shows that employees are already investing in
their well-being, employers of choice are taking notice and
Benefts of doing the same.”

In a competitive job market where money is tight
Investing in
due to various economic factors, being fexible enough
to adjust budget plans to include such an investment
could mean the diference between providing an okay
Mental Health
employee experience and a superior one that attracts and
retains success.
Address Financial Well-Being Head On

• Builds a strong brand Even during strong economic periods, fnancial concerns
are the primary source of employee stress. Amid one of the
• Retains, attracts and cares most uncertain economic environments in years, those
for employees concerns have proliferated, increasing pressure on work-
ers. Factor in concurrent decreases in mental and physical
• Empowers employees health, and it becomes clear that employees’ overall
wellness – or, more appropriately, their holistic health – is at
• Boosts productivity signifcant risk.
and performance As many employers have been shifting towards a care-
based well-being strategy focused on a committed interest
• Lowers all-around in employees’ holistic health, this downward trend in phys-
healthcare costs ical and mental health is concerning. While the economy’s
battle with infation shows no signs of relenting, employers
• Reduces sickness
should be paying strict attention to the efects that long-
and absenteeism term fnancial instability is inficting on their workers.
Financial stress doesn’t just impact physical and
• Builds a more connected and
mental health, it also impacts work performance and can
compassionate workplace compel employees to make poor or impetuous decisions.
For example, some may feel compelled to alter their
beneft selection toward the lowest-cost medical/Rx plan,
which usually means a signifcantly higher deductible and
out-of-pocket expense. Others may rush through elective
surgeries if they feel they might lose their benefts, which
could cause unintended leave and absence management
costs. Either way, boosting fnancial wellness is more

Figure 6: Figure 7:
2022 Overall Mental Health Employer Plan to Add Additional Support for
Spend Per Employee Mental Health in 2023
Employer is self-funded 9% O˜ering EAP 14%
Expanding visits
$0 - $500 18% 6%
in current EAP
Telebehavioral through
$501 - $1,500 2% 6%
medical insurance
$1,501 - $3,000 1% Telebehavioral 5%

through third-party
$3,001 - $6,000 1% Health Stigma 1%

Reduction Training
$6,001+ <1% Other 6%
70% We do not plan to add 72%

Unsure
additional support
Figure 8:
Employer Concern about US Economy
10% 95% of
27%
Extremely concerned
workers are
40%
Very concerned
worried about
Moderately concerned
the economic
situation in
22%
Slightly concerned
1%
Not at all concerned the US.
Figure 9:
Are Employees Financially Healthy?
The 28% variance

is the largest of all the
perception gaps relative
to employee well-being.
55% of Employees
Say Yes
83% of Employers
Say Yes
(MetLife˜)

Right now, employers have an
unprecedented range of
voluntary options available to
ofer as benefts
important to business than ever. “All employers should be pre-paid legal services can increase employee satisfaction
taking note of the connection between fnancial worries and be the diference maker when someone is deciding to
and mental health,” says Kim Bell, EVP, head of Health and leave or join a team.
Benefts. “Everything is trending in the wrong direction, “We’re seeing new players in the voluntary benefts
and employees are feeling the crunch.” market transforming what personalization can look like as
Younger workers especially have been subject to the well as the future of risk,” says Bell. “For example, we now
pains of living in increasingly chaotic fnancial times. Workers have companies like Armadillo whose focus on the ‘health
aged 18 – 34 have run the gamut of economic stressors since of the home’ provides innovative home warranty services
the Great Recession of late 2007 through 2009. Having sur- for appliances and systems that break down over time.”
vived COVID-19, they’re now subject to the highest infation Other organizations are ofering cutting-edge ben-
rate in 40 years. In the fnancial present, they’re struggling efts in family-building, like Posterity’s initiative into male
with monthly expenses and setting aside money for emer- fertility and Kindbody’s fertility treatments, gynecology
gency savings. With an eye towards the far-of future, they’re and LGBTQ+ services. Forward-thinking organizations like
doing their best to prioritize retirement savings. Tuned focus on hearing care for a world in which noise-in-
“There is a growing expectation that the employer duced hearing loss from earbuds is becoming ubiquitous.
will provide employees with the fnancial tools they need,” Right now, employers have an unprecedented range of
says Bell. “Given the distinct connection between money voluntary options available to ofer as benefts — a low
worries and bottom-line performance, things like produc- cost, high-impact way to support employee fnancial needs
tivity, attendance and engagement, employers need to and life goals.
demonstrate that they genuinely care and have tools Demonstrating this level of holistic care aids in reten-
and resources in place to help employees with their fnan- tion eforts for struggling employees who may otherwise
cial situation.” be looking for a new job and in attracting new talent. When
Ofering diferent points of entry so an employee situated within the framework of an overarching mental
can tailor their voluntary beneft selection to their unique health and well-being strategy, ofering personalized solu-
needs can help reduce some of the stress associated with tions like fnancial well-being and other common-sense
fnancial uncertainty by acting as a safety net. Several voluntary benefts can help employees take control of their
types of benefts are geared directly at long-term fnancial expenses and budget for the short and long term.
well-being, such as accident and critical illness, life insur- In addition, ofering a wide array of voluntary benefts
ance and long-term care, and fnancial planning services. is a good idea to help contain costs. Because zero direct
Other benefts work to target short-term stress, lending out-of-pocket dollars are being spent, employers can ofer
even more personalization for the individual. Things like these in-demand benefts and maintain the delicate bal-
student loan debt repayment, identity theft coverage, and ance of cost-sharing with employees.

Figure 10: Figure 11:
Supplemental Health Plans Enrolled In Supplemental Health Plans O˜ered
Accident 42% Accident 51%
Critical illness 36% Critical illness 46%
Hospital indemnity 33% Hospital indemnity 29%
Other supplemental Other supplemental

15% 31%
option option
None of None of
30% 41%
the above the above
Respondents were asked to select all that apply. Respondents were asked to select all that apply.

Employee Supplemental Health Employer Supplemental Health
Plan Satisfaction Plan Satisfaction
I use beneÿts to the max I will have to review their 21%
and am good about ÿling 52% cost before I can decide
claims when they arise
I will elect them
I could do better at no matter what 59%
utilizing these beneÿts 44%
when claims arise
I won’t be able to enroll
I forget that I in the coming year, the
20%
4% budget is too tight
have beneÿts

Employee Life with LTC Consideration Employer Life with LTC Consideration
Yes - Assuming the price Yes - We believe people are

is right, I would buy this 63% under insured as it relates to LTC 11%
if my employer o˜ered
No - Our employees
No - I am not interested 10% won’t buy this 20%
No - I already have this No - Our employees

6% already have this 6%
Maybe - Before I can make Maybe - Before I can make a

a decision I would have 21% decision I would have 63%
to learn more about it to learn more about it

There is growing consensus that
further shifting the burden of premium
increases onto workers is not tenable

The Employer Dilemma Strategies. “We can even create analyses that allow employ-
ers to verify price diferences across insurance carriers and
While trying to mitigate the efects of cumulative employee payers, hospitals and health systems within their region.
stress, employers are experiencing their own dilemma tack- We can very clearly demonstrate opportunities where com-
ling organizational stress. Although most employers struggle panies can save money without imposing considerable
to rein in the ever-escalating costs of providing health disruption on their employees.”
benefts, there is growing consensus that further shifting the NFP is one of the frst companies to ofer these
burden of premium increases onto workers is not tenable. transparency-based solutions to employers. Since January
“For nearly twenty years, we’ve been trying to mitigate 2023, these tools have opened up ways to negotiate better
rising healthcare costs by ofering high-deductible health pricing, improve performance standards, and hold vendors
plans while telling employees that their out-of-pocket spend more accountable. The hope is that transparency into the
will go up again,” says Heidi Cottle, SVP, Cost Containment cost of care will establish a new frontier where employers
Strategies. “Greater transparency into their spending and will have a direct infuence on their healthcare spend.
negotiated rates would help change that narrative.”
With the emergence of transparency data, employers In summary, cumulative stress is a major concern for
can now utilize tools to target where their dollars are being employers and employees alike. Successfully addressing it
spent and where best to invest them. This is especially sig- requires comprehensive adaptation across the organiza-
nifcant, being that there is a fnite amount that can be spent tion. From how we communicate and manage employees
to stay within budget. Given that the prudent allocation of to how we design and cover costs for the benefts we ofer,
healthcare resources is of utmost importance, claims data data-informed, systematic improvement is required to
should be utilized to help shape the direction of where future efectively address this daunting challenge.
dollars are spent. Data analytics can further follow gaps in Because workers continue to prioritize their mental
care, inform disease management strategies, and identify health, well-being and life-work integration, smart employ-
large claimants that can wreak havoc on a health plan. ers are supporting them both physically and mentally.
One of the main obstacles preventing employers Given this reality, maintaining a positive work culture that
from being fully informed has been limited access to plan/ balances employees’ needs with organizational objectives
provider data. Because of gag clauses and limited-use is paramount to success. Employers who have workfow
agreements, employers had little to go on relative to strategies and, where appropriate, fexible work models in
pricing and quality agreements between health plans and place that are ideally suited to their current workforce and
service providers. That’s all changed now that the various organizational objectives are far more likely to keep the
hospital and payer transparency laws are in efect. adverse efects of workplace stress at bay.
The Consolidated Appropriations Act (CAA), Trans- Ultimately, it comes down to adaptation and com-
parency in Coverage Act (TICA) and the No Surprises Act mitment. To become better suited to this new employment
prohibit group health plans and health insurance issuers environment, employers should shift away from providing
ofering group health insurance coverage from entering strictly professional support in their attraction and reten-
into an agreement with a health care provider, network or tion strategies. Instead, they should consider a broader
association of providers, third-party administrator (TPA), beneft ofering that demonstrates care and promotes
or other service provider ofering access to a network of improved holistic – mental, physical and fnancial – health
providers that would directly or indirectly restrict a plan or and well-being.
issuer from providing provider-specifc cost or quality of
care information or data, through a consumer engagement 1 Ofce of the Surgeon General Our Epidemic of Loneliness and Isolation: The
US Surgeon General’s Advice on the Healing Efects of Social Connection and
tool or any other means, to referring providers, the plan Community, US Department of Health and Human Services, hhs gov, 2023
sponsor, participants, benefciaries, or enrollees, or indi- 2 MetLife The Advantages of Employee Care: Creating Human-Centric
viduals eligible to become participants, benefciaries, or Employee Experiences and Work Environments, 21st Annual US Employee
Beneft Trends Study, MetLife, metlife com, 2023, p 18
enrollees of the plan or coverage. 3, 4
3 Employee Benefts Security Administration No Surprises Act US Depart-
“We can use applied data analytics and really drill ment of Labor, dol gov, 2022
down to individual procedures and services to examine 4 Center for Consumer Information and Insurance Oversight Consolidated
pricing variation across facilities and practitioners, payers Appropriations Act, 2021 (CAA) Centers for Medicare and Medicaid Ser-
vices, cms gov, 2022
and networks” says Heidi Cottle, SVP of Cost Containment

2
Balancing
Employee Needs:
Aligning Culture and Benefts
for Better Results
Over the last few years, the world of
work has undergone signifcant and radical change. This has
forced employers to reexamine how they think about work and
a workforce that’s determined like never before to live and labor
according to their personal values and purpose. Employers are
now expected to personalize benefts in ways not previously
considered. Although the idea of work and the workplace itself
have always been in a steady state of evolution, things have been
moving at a far more rapid clip since March 2020.

Figure 1:
Beneÿts Importance Among Workers
20% 19% 21% 26%

27% 24% 26% 31%
29% 31%
30%
31% 33% 33%
38%
34%
39%
40% 40%
36% 37% 35%
29% 30%
13% 10% 9% 7% 6% 6% 7% 5%
lth serv to
progra sistance
loan re tuition/
develo ional
medica On-site
pment ing/skill
progra h
rams
ices
Ps)
nt
pment
rt
ms
ms
healt
l suppo
Access
payme
ms (EA
progra
Profess
ty prog
Mental
College
ee as
Train
telehea
Disabil
Employ
develo
Critical Important Nice to have Not important
The pandemic upended everything work-related that fexibility, a broader array of employee beneft options and
wasn’t bolted down. In a fash, physical ofces closed. Dig- holistic well-being.
ital channels like Zoom and Teams became surrogates for Ironically, despite all the changes, these priorities
in-person communication. Practically overnight, workers are not all that diferent from pre-pandemic times. Prior to
were forced to adapt to these technologies. In short order, the pandemic, workplace fexibility and a commitment to
“You’re on mute” and “Can you see my screen?” became health and well-being were becoming major factors that
more common but somewhat less human than “Good employees were looking for in a company. The primary
morning” or “How are you doing today?” diference today is that despite economic conditions and
Despite many companies making this transition in recent mass layofs, employees are more likely than ever to
an orderly fashion, employees have continued to battle a leave a job that doesn’t align with what they value. Workers
nexus of overlapping stressors. In addition to occupational have more agency today, and they’re not afraid to make
pressures, workers have been juggling a combination of a change. Although the efects of the Great Resignation
home responsibilities along with other external hazards. appear to be winding down, this type of value-based
Whether it’s the efects of infation outpacing wage growth, disconnect between workers and employers continues to
medical/Rx expenses continuing to escalate, threats to job result in turnover.
security or caregiving responsibilities at home, workers Although some organizations’ values align with
have been worn down these last few years. their diverse employee populations, for many companies,
Today, how people work, where they work and how employer and employee perception of what’s most import-
they value work look completely diferent than they did ant is somewhat out of sync — meaning that if employers
before COVID-19. In response, a re-alignment of personal are going to continue to attract and retain the best talent,
priorities has occurred. Tremendous value and emphasis they need to align their oferings with employee needs or
have been placed on things like life-work integration, candidates will look elsewhere.

Figure 2:
of workers believe it is their

61% employers’ responsibility
to help them achieve their best
quality of life
The New Culture of Care In the past, beneft strategy typically focused on provid-
ing core medical and Rx coverage, ofering a retirement
Workers want to be part of an organization that cares: one plan, and doing everything possible to contain costs. The
that supports them personally and professionally. This motivation behind ofering these bare-bones benefts was
requires employers to approach employee quality care to keep employees physically healthy and free them from
holistically, incorporating elements addressing physical, long-term fnancial worry so they could be present and
mental and social needs. Doing so tends to create a culture productive at work. When included in a total compensation
where happy employees are engaged in their work and statement, employers could demonstrate that they were
have little reason to look for another job. making a far greater investment in their long-term success.
According to MetLife, the #1 reason employers are The pandemic showed that many employers were
investing in benefts this year is that they want to demon- falling short, particularly with providing access to mental
strate care in a unique way.1 This represents a signifcant health and well-being support services. Although employ-
shift from the historical strategic norm. ers have been making signifcant investments in well-being
Figure 3:
Care Is Important to Both Employers
and Employees
Employee Views of Care Employer Views of Care
82% 82%
Believe employers have a Of emloyers think it’s
responsibility to care for important to demonstrate
their workforce care for their employees
62% Want their employers to

care for them
#
1 reason Employers are investing
in beneÿts today
(MetLife˜)

and mental health for several years, there is still progress to
be made.
Compensation still reigns supreme in how employees
measure value, but emphasis has clearly shifted towards
mental well-being and social health in an overall wellness
proposition. Given the strong relationship between the
two, providing support for social and mental health pro-
grams is an efective way to not only afect the perception
of care but to actively demonstrate it.
“We’ve talked about the employee experience at
length for a long time,” says Kim Bell, EVP, head of Health
and Benefts, “but right now, there is a defnite emphasis on
Employer and
well-being and quality care. Today’s employees are looking
for more than pay and traditional benefts. They expect
their managers and supervisors to care for them as indi-
employee per- viduals. And they expect the organizations they work for
to move beyond a one-size-fts-all approach to addressing
their needs.”
ceptions of care From the employee perspective, “better benefts”

increasingly means “personalized benefts.” And when
employers deliver, the view is that they care about their
employees.
To efectively demonstrate care, it Personalizing the employee experience has much to
do with tailoring communication and messaging at every
will be necessary to address the
level, from the interpersonal to the informal, making it a
signifcant perception gap relative relatively complex undertaking. Personalizing benefts,
to employee care. however, is relatively straightforward.
For the most part, adding attractive benefts that
Consider that 87% of employers

appeal to diverse segments of the working population
requires meaningful conversation and an idea of what
believe their organization currently employees want. This can be facilitated through carefully
demonstrates care, while only executed pulse surveys, ongoing benefts discussions
65% of employees agree. and regular benefts-related communication. Leveraging
this information in tandem with reasonable group pric-
Source: MetLife3 ing tends to produce a comprehensive list of reasonably
acquired benefts and perks that employers can implement
with minimal out-of-pocket exposure. Because ancillary
costs and administrative fees are predominantly paid for
by the employees, it’s a cost-efective solution to equitably
meet the needs of a diverse workforce.
Ultimately, incorporating care elements into a holistic
well-being matrix supported by organizational culture,
fexibility and career development can bring an organiza-
tion more in sync with current employee expectations. In
addition, eforts in customization and personalization of
the employee experience and an accompanying beneft
ofering have the potential to boost satisfaction, increase
retention and improve performance and engagement.

Figure 4:
51%
of employees
believe employers
could aõrd to o˜er
better beneÿts
46% 63%
Among Small Among Large
Company Company
Employees Employees
Figure 5:
Employee Satisfaction with Their Beneÿts
18%
22% 60%
Happy
Neutral
Dissatisÿed

Few Workers Fully Understand Employer Perception of Employees
Their Beneÿts Understanding of Beneÿts
Most of it makes sense, but 70%

39%
I don't understand it completely
44% Some of it makes sense,

but it's confusing 23%
13%
Completely understand I understand 6%
3% it completely
Have some questions
Mostly confusing I don’t understand 1%

it at all
Don’t undestand at all
Help Employees Use the Benefts You Ofer access to cost and quality provider information. Employ-
ers who adopt value-based incentives in their health
A more signifcant beneft ofering provides an additional plan designs will achieve greater employee and member
opportunity to leverage more benefts-related education. engagement. This achieves two primary objectives: 1)
Illustrating to employees the value of the benefts improve healthcare literacy; and 2) create a better-in-
they select, how they work together and how to maximize formed consumer. For both employers and employees, this
their use encourages utilization and promotes satisfaction. means an overall decrease in their healthcare spend.
It also aids in retention and recruiting eforts, as the ofer- “Employees don’t typically know how much their
ing demonstrates an investment in employee well-being. benefts cost overall,” says Cottle. “And their idea of quality is
Investing in holistic health, personalized beneft plans and typically based on the interactions they have with their pro-
employee development can help keep talent in-house and vider. This is an opportunity for employers to further show
aid in the art of attraction. This is valuable as more employ- the value of their benefts and how preventive screenings
ers realize there is a diference between fnding someone or higher-quality providers can save them money.”
who can do the job and someone right for the job. With the pandemic in the rearview mirror, much
“In much the same way that we push fnancial literacy of the focus moving forward will be on healthcare price
in our education programs to help employees better their transparency data and how employers can utilize this
situation both today and long-term, we need to continue information to guide employees toward lower-cost,
the push for healthcare literacy,” says Heidi Cottle, SVP higher-quality care. Although the data is extraordinarily
Cost-Containment Strategies. “It leads employees towards complex and difcult to use without the proper tools,
having a better understanding of their benefts, which there are steps that employers can take to better prepare
allows them to make better healthcare decisions, save employees for when this data and the tools to make it use-
money and lead healthier lives.” ful become mainstream.
Poor health outcomes tend to be associated with lower As part and parcel of an overall benefts education
healthcare literacy, which is the capacity to fnd, understand, strategy, employers can draft communications about how
and use information for health-related decisions.4 Low health to use cost and quality transparency data productively and
literacy leads to underutilized preventive care and unneces- point to resources where employees can learn more. They
sary and low-quality care. In other words, without the right should also frame the value of this data relative to cost and
tools to understand basic health information and services, quality and how it impacts the entire beneft ofering. It’s
employees may be more susceptible to illness. For employ- another opportunity to not only efectively communicate
ers, this also means an overall increased healthcare spend. the arc of your personalized benefts but also demonstrate
However, the recent health cost transparency legisla- another layer of the organization’s investment and commit-
tion empowers employers by giving members web-based ment to caring for its employees.

Figure 8:
The misÿt of beneÿts o°ered versus

what is valued may contribute to
28% only 28% of workers saying
they make maximum use
of their beneÿts.
Figure 9:
Percentage of Employees who Understand
Their Beneÿts by Age
55 years + 52%
18-24 years 22%
Meanwhile, 35% of those 18 – 24

are mostly confused by their beneÿts,
or don't understand them at all.
Figure 10:
About Half of Employees Don’t Think
Employers Communicate Beneÿt Costs Well
Communicates
Communicates Well Neutral Poorly
Explanation of 53% 38% 9%

Employee Cost Paid
Communicates
Communicates Well Neutral Poorly
Explanation of
43% 42% 15%
Employer Cost Paid

Percentage of Employees who Importance of Training/Skill Development
Consider Training/Skill Development Programs According to Employees
Programs Critical or Important by Age
Critical 10%
55%
Important 40%
48%
Nice to have 31%

18-34
36%
35+ Not important 19%
have this beneÿt
Prioritize Human Development to As employers took notice, it became clear that simply
Fill Talent Gaps throwing money at the problem would not solve it. They
needed talented workers to stay at their organization, not
Of all the things an employer can do to show they care jump ship at the frst sign of an incremental salary increase.
about employees, investing in a person’s professional jour- Despite contending with the disruptions and workfow
ney will always be viewed positively. inefciencies caused by the ongoing skilled labor short-
The even better news is that investing in employee age, the need for a new approach and strategic solutions
development is a win-win. Around half of workers already became evident.
indicate that training and skills development programs are Today, companies are fundamentally changing
critically important for an organization to ofer. With the their strategy to boost retention and attraction, angling
demand for new hard and soft skills constantly evolving, these eforts towards personal development. Despite the
helping employees develop them shows commitment. An thinning of the traditional talent pool, there are ways to
employee who believes that their employer is interested in close the skills gap across a workforce. By approaching
helping them progress through their career by upgrading the problem holistically and considering not only salary
their knowledge and competencies has the potential to and benefts but also career development – personalized
feel fully immersed in their work. learning, training and upskilling programs – employers are
Beyond employee satisfaction, an evolving labor reshaping organizational culture to embody one where
market may be another reason for employers to consider a professional learning and development take precedence.
robust training and skill development ofering. “What we’re talking about when we’re looking at
The threat of illness and layofs coerced millions of career development and upskilling is really the idea of
baby boomers to retire early during the pandemic and human development,” says Deb Smolensky, SVP, Well-Being
threw the labor market out of sync. As they took their and Engagement. “From developing soft skills like intra-
skillsets and decades of expertise with them, a talent gap and interpersonal communication to building of existing
emerged, putting companies competing to fll open roles technical expertise, employees are prioritizing their
at a disadvantage. In the chaos, a worker’s labor market professional and personal development.” Smolensky con-
took shape, complicating the process of flling these tinues, “They’re also laser-focused on their holistic health.
vacant roles. As salaries and benefts for new hires rose in What they really need is for their employer to show that
response, one cohort of in-demand workers, the so-called they want to see them succeed. And part of that is to help
job-hoppers, started moving from one employer to the them understand what their strengths are, develop those
next, increasing salary with each leap. strengths and then align them with their workfow.”

Figure 13:
Workers’ Interest in
Upskilling Opportunities
71%
Paid Upskilling
vs. 34%
Unpaid Upskilling
46%
Upskilling Outside
vs. 65%
Upskilling During
Work Hours Work Hours
(Gallup˜)
As the battle for top talent wages on, transferring in their careers is essential to meet worker expectations.
existing workers into gaps and enhancing their skills, rather Accommodations may need to be made to avoid disrupting
than only hiring externally, is good for employers. In addi- day-to-day workfow, and expectations on the time it takes
tion to saving the time and resources it takes to acclimate to fll a skills gap may need to be tempered, but for employ-
someone new to an organization and its culture, it also ers interested in retaining and developing talent, skills
helps to create fexible and agile employees ready to take development programs present an opportunity to support
on new responsibilities. employees who are invested in developing their careers.
Ofering an upskilling and professional development
training program designed to help employees advance

An inclusive environment
recognizes there are
diferent paths to success

Clear the Path for Diverse Talent For example, employees from a minority or marginalized
group may not advance as quickly or have access to some
Development programs seamlessly fall in line with diver- opportunities because of the unique challenges under-
sity, equity, inclusion and belonging (DEIB) initiatives. represented employees often face. Therefore, training,
Although DEIB is often siloed from the management of educating and developing workers with personalized tools
upskilling programs, coordinating the two when develop- tailored to their needs is another lever employers can pull
ing professional development initiatives can help set an to demonstrate that they are invested in their people and
organization apart from the pack. care about their careers.
As managers need to be trained to identify can- “When we talk about making equitable investments
didates who have the talent to fll a particular role, they in training and development for our diverse employee
should also be trained to manage their biases in this populations, what we’re really talking about is removing
selection process. This is true not only for the professional barriers,” says Wheeler. “A lot of times, when we hear the
development of talent already on staf but for the entire word ‘equity,’ our minds go to an image of some people
candidate pool at large. standing in front of a fence. A couple of them have boxes
“Companies that fall prey to social stereotypes and to stand on so they can see over the fence, and we call that
confrmation bias in their hiring and development prac- equity. But while everyone is so focused on who gets what
tices tend to create a sort of ‘homologous reproduction,’” box, what we really need to do is get rid of the fence.”
says Pamela Wheeler, Chief Diversity and Inclusion Ofcer Clearing the path so that diverse candidates can bet-
at NFP. “This tendency to put people in a new position ter reach success is the mark of an organization committed
simply because their ethnic background, gender, age or to advancing diversity and equity. Building a diverse team
education is similar to who was there before prevents orga- and tapping into employee perspectives to identify the
nizations from hiring and developing the diverse talent barriers present in your own organization is a vital frst step.
they need to be competitive today.” Removing those barriers and positioning people to do their
Difering perspectives allow for a greater diversity best work lays the foundations for a system that generates
of thought and problem-solving capacity. A diverse team success across all demographics of an employee popula-
that has the same goal in mind and collaboratively lever- tion. Such an investment celebrates the value of diferent
ages its variety of views can foster innovative approaches kinds of people and ultimately expands the scope and
to familiar problems. This can lead to novel solutions and reach of a business. The more diverse a team is, the more
coordinated team eforts that better serve a client’s needs. types of people they can reach. As they reach more people,
With each new approach and voice raised, the potential to they increase brand awareness, convert more customers
reach more audiences, convert more customers and garner and clients and generate more sales.
more moral and social capital increases. Organizations with diverse teams enjoy improved
“A diverse workforce that looks like America is better fnancial performance, increased organizational engage-
suited to reach all of America,” says Wheeler. To do business ment, decreased organizational costs and decreased
with all of America (and beyond), you need a diverse group attrition and turnover costs.6 However, upskilling, training,
on your team to successfully serve an equally diverse group and development programs alone can’t give people every-
of clients. thing they need to be their best at work. They also need to
Just as there is more than one type of person who can be able to integrate their obligations at work and those at
do a specifc job, there needs to be more than one narrow home in a healthy way. Providing benefts that thoughtfully
path to success for that position. With many factors in play address the need for time away from work is also an essen-
– personal, societal and organizational – fostering an inclu- tial component of fostering organizational diversity.
sive environment that recognizes there are diferent paths
to success is critical. An inclusive environment recognizes
that everybody’s path to success is somewhat diferent.

Care Beyond the Workday Through Most organizations ofer paid time of for certain life
events, so employees have the fexibility to take care of
Leave Policies
personal responsibilities. Paid time of has long been an
There will always be unexpected disruptions that throw attraction and retention tool employers have utilized to
things out of sync. Workers are already spending much reward their workers. Although traditional PTO policies
of their waking existence trying to balance obligations at provide employees with time for sick leave, vacation or
home and work. When something unexpected happens that other reasons, the primary beneft is that employees can
disrupts this balance, addressing it can instantly take prece- take time of without having to worry about lost wages.
dence over everything else. At that moment, employees truly “When we give employees the ability to take time of
need time of from work to focus on these pressing needs. from work, we’re giving them the fexibility they need to
manage their life,” says Maria Trapenasso, SVP, Human Cap-
ital Solutions. “That is why having efective leave programs
While roughly half of employers ofer in place is essential. It demonstrates to employees that
maternity (45%) and parental (49%) leave, we’re invested in their well-being and overall life satisfac-
tion even when they’re not at work.”
74% of employers still do not ofer
A well-designed leave management strategy should
family caregiver leave. address the diverse individual needs and concerns of
employees across the organization. This includes consider-
ing dimensions like familial responsibilities, childbearing
Figure 14:
needs and concerns, aging parents and circumstances at
Bereavement Leave Amount home, among others. These inherent challenges are forcing
employers to become more creative when formulating
3 days 57% their leave programs. Because these programs ofer paid
time of for certain life events, one potential tweak that
5 days 18% employers can do to provide a richer beneft without add-
ing too much additional cost is expanding the defnition of
Length varies based
18% who is covered under these programs.
on individual need
At some point, all workers need time away from their
Unlimited days 1%
jobs. Regardless of whether it’s to recharge and rejuvenate,
due to illness or injury, or to manage complicated and
Not o˜ered by cumbersome obligations at home. They need to know that
5%
my organization
if something comes up, their job will not be at risk while they
work to address the issue. Workers can’t be available around
the clock, and there has to be fexibility when life intervenes.
Bereavement Leave Allowances
When employers show they care for their
For designated employees, by listening to them and doing their best to
family members 88%
deliver what they value most, outcomes improve.
For any Beyond fexibility and health, employees want career
32%
close relation development and advancement opportunities. They want
For miscarriage meaningful, purpose-driven work that matches their skills
or failed IVF 24%
with their workfow. They want personalized total rewards
For the death
and accessible benefts that have a direct impact on their
7%
of a pet lives. They want an organizational culture that incorporates
what matters most to them professionally and personally.
Other 4%
And they want to know that their employer is genuinely
interested in seeing them succeed in all areas of their work
Respondents were asked to select all that apply. and life.

Employee Decision Making Process Perception
My employer values my opinion and

they use my feedback to make decisions 27%
The leadership in my company makes 25%

most decisions, and let me know
My company provides me with clear,

honest and authentic communication
My company o˜ers the opportunity

21%
18%
to join an employee focus group 17%
My company does not communicate

10%
with me in an e˜ective manner
Figure 18: of employees say

Organization Decision Making Process their employers
We have transparent leadership
consider their
communication and employee
involvement on decisions
35% feedback when
We value our employees’ opinion making decisions
32%
and use their feedback to make
decisions that a˜ect them that a˜ect them
Leadership makes most decisions 27%
and we then inform employees
We have employee focus groups

and working groups that help 4%
inform organization changes
Other 1%
When things like organizational culture, well-being

initiatives, benefts and total rewards, and career develop- 1 MetLife The Advantages of Employee Care: Creating Human-Centric
Employee Experiences and Work Environments, 21st Annual US Employee
ment are equitable and in alignment, organizations reap Beneft Trends Study, MetLife, metlife com, 2023
the rewards. These include higher job satisfaction, less turn- 2 Ibid , p 23
over, better teamwork, more efective communications, 3 Ibid , p 25
bigger contributions to the organization and more pro- 4 Marilyn McDonald and Laura Shenkman “Health Literacy and Health Out-
ductive negotiations, along with more diversity, equity and comes of Adults in the United States: Implications for Providers,” Internet
Journal of Allied Health Sciences and Practice, vol 16, issue 4, nsuworks
inclusion. Conversely, when these aspects are unbalanced nova edu/ijahsp, 2018
or out of alignment, employers must pivot their eforts and 5 Gallup ”The American Upskilling Study: Empowering Workers for the Jobs
commit to a course that better meets workers’ expectations of Tomorrow,” Amazon/Gallup, gallup com, 2021
and aligns personal values alongside the organization’s. 6 Paul Ingram and Yoonjin Choi “What Does Your Company Really Stand
For?” Harvard Business Review, hbr org, 2022

3
Maintaining
Afordable Benefts:
Cost-Efective Strategies and Solutions to
Reign In Rising Costs.
Second only to compensation,
holistic healthcare and well-being benefits are a critically
important component of a total rewards package. Done correctly,
they can demonstrate an investment in employees’ overall health
both today and well into the future. They can diferentiate an
organization in a sea of competition and determine the success of
any attraction, retention and engagement efort. The right ofering
can motivate talented employees, reduce turnover and increase
satisfaction. Above all, they can help keep employees healthy,
happy and better suited to bring their best to work every day.

The cost of care can lead people to
delay care or avoid it altogether
However, as costs continue to rise, employers see competitive benefts package in the battle for talent means
signifcant increases in their beneft expenditures. Plan cutting costs in other areas.
sponsors are clamoring for solutions to control and/or Especially for many mid-market-sized employers,
lower their overall spend, which in most cases is signif- staying within budget means adjusting beneft design. The
cantly increasing and impacting their bottom line. Because resulting cost-containment measures are, by design, then
it’s not just overall cost, employers must also recognize that borne by employees in the form of slower wage growth
addressing escalating medical and pharmacy increases and increased premiums and deductibles. Coupled with
requires an active strategy that focuses on reducing the reductions in workforce, employees wind up working
unit cost of care. harder, while paying more for less coverage.
For HR beneft professionals, it’s a double-edged With an economy hovering near the brink of reces-
sword. Not only are they tasked with keeping an eye on the sion, where infation and cost of living remain high,
costs associated with plan design and overall ofering, but employee salaries simply can’t keep up. At the same time,
they must ultimately consider whether employees can rea- employers working to create the types of competitive ofer-
sonably aford the beneft packages they’re being ofered ings that today’s employees are demanding are fnding it
to help them win the war for talent. increasingly challenging to stay within budget.
From premiums to deductibles, if an employee either Managing these costs despite an economic down-
can’t aford their benefts or if they’re underinsured, the cost turn is a priority for everyone involved. With no respite in
of care can lead people to delay care or avoid it altogether. sight for the foreseeable future, many frustrated employers
With about half of insured US adults saying it is seek new tools and solutions to mitigate the rising costs
somewhat or very difcult to aford healthcare and/or associated with beneft oferings, while at the same time,
out-of-pocket costs,1 employees are feeling the fnancial ensuring employees can reasonably aford to enroll and
squeeze. And it’s afecting their utilization. engage with their benefts.
This is especially impactful for lower-wage workers
with fewer resources. Avoiding care can harm physical
health, and eventually worsen an employee’s fnancial situ-
ation, leading to more expensive conditions down the line.
Employers also need help adapting to the increased costs
associated with providing benefts. From rising prescrip-
tion drug prices and high-cost claimants to health system
consolidation and administrative expenses, ofering a

Figure 1: Figure 2:
Impact of Economic Concern on Impact of Economic Concern on Voluntary
Beneÿt Election Beneÿt Election
Yes - I will have to choose I will have to review their

27% cost before I can decide 64%
lower cost plans
No - I will stick with the same I will elect them

17% 19%
plans no matter the cost no matter what
Maybe - I will decide what to I won’t be able to enroll

choose once I see the plans 47% in the coming year, the 8%
and how much they cost budget is too tight
I don’t know/unsure 8% None of the above 9%
Figure 3a:
Among Covered Workers with a General Annual Deductible, Distribution of General
Annual Deductibles for Single Coverage, Reduced by any HRA/HSA Contributions, 2007-2022
2007 - 57% 27% 14% 3% $0 (or less) - $499
2008 - 49% 30% 17% 4% $500 - $999
2009 - 44% 30% 19% 7% $1,000 - $1,999
2010 - 42% 29% 22% 8%

$2,000 or more
2011 - 37% 34% 20% 9%
2012 - 35% 31% 23% 11%
2013 - 32% 33% 23% 11%
2014 - 25% 35% 28% 12%
2015 - 21% 37% 28% 15%
2016 - 20% 35% 28% 17%
2017 - 18% 33% 33% 16%
2018 - 15% 30% 35% 19%
2019 - 15% 32% 32% 22%
2020 - 13% 31% 36% 20%
2021 - 15% 29% 33% 23%
2022 - 10% 28% 38% 24%
NOTE: Account contributions include an employer's contribution to an HSA or HRA. These estimates include workers enrolled in HDHP/SOs
and other plan types. Average general annual deductibles are for in-network providers.
Tests found no statistical di˜erence from distribution for the previous year shown (p < .05).
(KFF°)

Figure 3b:
Among Covered Workers with a General Annual Deductible, Distribution of General
Annual Deductibles for Single Coverage, 2007-2022
2007 - 58% 22% 14% 4% 1% $1 - $499
2008 - 45% 26% 21% 6% 2% $500 - $999
2009 - 40% 27% 22% 8% 3% $1,000 - $1,999
2010 - 38% 25% 23% 10% 3%

$2,000 - $2,999
2011 - 35% 24% 25% 11% 5%
$3,000 or more
2012 - 32% 24% 26% 11% 7%
2013 - 24% 30% 28% 12% 6%
2014 - 20% 30% 30% 13% 7%
2015 - 14% 31% 34% 13% 8%
2016 - 14% 24% 36% 16% 10%
2017 - 12% 24% 40% 13% 11%
2018 - 11% 22% 39% 16% 12%
2019 - 10% 21% 38% 17% 14%
2020 - 9% 22% 40% 16% 13%
2021 - 11% 22% 36% 15% 16%
2022 - 8% 19% 41% 16% 16%
NOTE: Average general annual deductibles are for in-network providers. In 2022, 88% of covered workers are enrolled in a plan with a general annual deductible.
* Distribution is statistically di˜erent from distribution for the previous year shown (p < .05).
(KFF°)
Double Down on Personalization in eting costs and their employer’s bottom line, it’s important
Times of Economic Stress that employers maintain morale by pairing benefts with
ongoing communication.
“Today, everything is expensive,” says Kim Bell, EVP, head However, communication needs to be an inclusive
of Health and Benefts. “And it’s hitting employees hard. two-way street. If there are any major disconnects, for
They’re worried about infation and the cost of living while example, a lack of pride or interest in the company’s mis-
keeping an eye on their savings. For a lot of workers, one sion, employee well-being could further sufer, no matter
unexpected event, an illness or injury, a legal matter or a the employer’s efort. “In addition to being transparent
critical home repair, could create an out-of-pocket cost that and making sure everyone is attuned to what’s happening
could seriously undermine their livelihood. Without some across the organization, it’s imperative that communica-
kind of safety net, many employees are vulnerable.” As a tions be collaborative,” says Bell. “If you’re trying to boost
result, afordable, personalized benefts that work for your morale, you have to listen to employees’ feedback. Their
employee population are more important than ever. insights can help address simmering problems before they
Employers and employees alike are keen to avoid have a chance to boil over.”
a scenario where the efects of a slowing economy afect Although there is a relatively small cost attached
work performance and increase stress levels. Although to the front end of voluntary benefts, ofering them
employees can’t help but experience some additional can provide a high level of personalization and security.
anxiety with concerns about dwindling savings, skyrock- Focused communication to help employees understand

Figure 4:
Employee Financial Indicators are
Trending in the Wrong Direction
55%
of workers say they are
living paycheck to paycheck,
up from 43% in 2022
55%
say they are in control of
their ÿnances, down from
61% in 2022
52%
say they have a three-month
savings cushion, down from
62% in 2022
(MetLife°)

Figure 5:
Alterations Due to Potential Economic Downturn
38%
Stañg levels 49%
13%
43%
Employee compensation 47%
10%
50%
The amount or kind of
41%
employee beneÿts o˛ered 9%
75%
Coverage levels for property
21%
and casualty insurance
4%
77%
Real estate holdings 17%
6%
Not at all likely to change Some what likely to change Very likely to change
how voluntary benefts such as accident, critical illness, should have an expected engagement metric that was
hospital indemnity, identity theft, disability coverages, established during the frst year of adoption. In many cases,
long-term care and the like fgure into their fnancial this should have been followed by maintenance metrics
well-being is key to adoption. Utilizing cost comparisons (minimum active engagement plus new hire engagement)
and education on unnecessary exposure to fnancial risk in subsequent years. If these were backed by performance
can demonstrate how voluntary benefts are an inexpen- standards and guarantees, now would be the time to
sive way to mitigate the out-of-pocket costs for medical review them. Comparing the percentage of plan partici-
care and household budget expenses. pants who were engaged against the benchmark should
help clarify which benefts are valued.
Measure, Adjust and Communicate If the consensus is that a particular beneft is probably
the “Why” best eliminated, it presents an ideal opportunity to com-
Employers are challenged with providing benefts that municate with plan participants. Ongoing pulse surveys
employees value and utilize while keeping costs under con- ofer one of the best ways to secure actionable employee
trol. “If you don’t understand what your workforce wants,” feedback, especially if an organization is experiencing
says Maria Trapenasso, SVP, National Practice Leader, signifcant turnover. Taking the time to ask employees
Human Capital Solutions, “you are wasting money. Figuring what they think about the benefts they’re being ofered
out and focusing on what benefts employees are using can gives employers a chance to gain a deeper understanding
save an organization a ton of money.” of what’s meaningful to them. By the same token, it also
Constructing a data analytics baseline to track ofers employers the opportunity to establish a mutually
engagement within the programs that are currently being accountable agreement with employees that engagement
adopted by plan participants is a necessary frst step to is required to maintain a beneft ofering. Essentially, this
solve this problem. Weighing those benefts that have amounts to a level of personalization capable of meeting a
gained the most traction with employees against those worker’s unique needs.
that are either underutilized or essentially ignored should “Many employers invest in a variety of beneft options
lend some insight into potential beneft modifcations. for their employees from health and welfare, well-being,
In tandem, review agreements made with partners student loan assistance, adoption and fertility benefts to
and vendors. At the point of negotiations, all programs various paid leave programs,” says Trapenasso. “Our Human

Figure 6:
Employer Communication About Beneÿts
7.59 Avg 7.43 Avg 7.69 Avg 7.51 Avg 7.42 Avg 7.67 Avg
24% 23% 28% 23% 23% 25%
14% 15%
15% 16% 16%
14%
19%
20% 18% 18%
18% 20%
13% 13%
13% 13% 14%
14%
9% 13% 9% 9%
10% 8%
8%
9% 8% 8% 10% 9%
6%
5%
our mation
of b sage
are a eneÿts
you w to use
ben yer
neÿ r
you pay fo
eÿts
ÿts
ble
ts
eÿts
ts
neÿ
o
ene
vaila
for y empl
u
ben
ual/
r be
r be
tb
abo d infor
you
Ho
Wha
our
Accr
pays st your
Cost
ut y
n
to ÿ
Co
re
Whe
1 2 3 4 5 6 7 8 9 10
Communicates Communicates
exceptionally exceptionally
poorly well
Capital Solutions team benchmarks these kinds of total would like to see in the future has no value. This can lead to
rewards oferings and conducts employee satisfaction sur- a loss of trust and, in worst-case scenarios, turnover.
veys to understand what employees really want and need. Therefore, communication must be deliberate, which
With that information, we help build a unique strategy that means that the results need to be analyzed and interpreted
ofers value and contains costs.” in a timely manner. “Many employers will engage a third
As invaluable as this information is to employers, it’s party to assist with the survey process and communication
equally so to the employees themselves. Any time this type strategy. This is a service that NFP has deep experience
of benefts survey is conducted, the results must be shared with,” says Trapenasso.
with workers. When employers receive valuable feedback By announcing an overview of the detailed results
and don’t act on it, employees know it, and they can easily and the planned course of action, HR can then discuss it
become disenchanted. The perception tends to be that with their workforce and set expectations for next steps.
their efort was meaningless and, worse yet, that their opin- This tends to result in a connection between employers and
ion about existing beneft programs and those that they employees that fosters trust and instills a sense of safety.

Figure 7:
Company Beneÿt Communication
6.63 Avg 6.40 Avg 7.02 Avg 7.40 Avg 6.20 Avg 7.17 Avg
11% 11%
20% 26%
11% 11% 28%
34%
18% 16%
20% 12%
21%
13% 18%
24%
18%
24% 11%
22% 19%
11% 7%
16%
10%
15% 11% 11%
8% 14%
14% 6%
10% 7%
5% 7% 5%
r be use
of b /usage
ilab ts
ene r
neÿ r
ur b oye
fo
ts
ÿts
le
ÿts
ts
our rmatio
are beneÿ
eÿt
neÿ
you u pay
you w to
ene
r yo r empl
ben
ava
r be
l
rua
o
Ho
at
t yo
abo nd inf
Wh
Acc
pay st you
Cos
ut y
to ÿ
s fo
Co
ere
Wh
1 2 3 4 5 6 7 8 9 10
Communicates Communicates
exceptionally exceptionally
poorly well
Manage Costs by Optimizing Benefts to become better healthcare consumers. An example of

this might be the adoption of earned deductible incentives
Employers should err on the side of caution when deter- using three-tiered beneft structures that incentivize plan
mining the degree to which cost optimization strategies are participants towards lower cost and higher quality provid-
adopted and implemented. As beneft value and cost are not ers. As part of an overall health literacy strategy, along with
always in lockstep, maintaining a balance between large cost access to clinical care navigation tools, this methodology can
reductions and highly valued benefts is essential. Applying potentially ofset expenses more efciently than increasing
a variety of actuarial, data analytics and predictive modeling deductibles and raising employee premiums.
in conjunction with new network transparency tools coupled Constructing a future-forward plan design that
with a sound survey strategy should provide great insight increases access to employee well-being and mental
into any cost-containment discussion. Furthermore, by creat- health services requires a more nuanced approach. This
ing key performance indicators, employers can beneft from is especially true when it comes to clinical mental health
ongoing insight into the performance of any plan changes services. Many therapists don’t take insurance. As a result,
and incrementally modify the program as appropriate. most of the costs associated with therapy come directly out
Beyond the fundamental level, maintaining the of pocket. But for workers struggling with a mental health
holistic health and mental well-being of plan participants is issue who can’t aford to see an out-of-network therapist,
critical to any organization’s ongoing success. To achieve the the system works against them.
physical health aspect of this, cost and risk-sharing strategies “For that smaller 20% – 30% of employees that are
may need to require a structure that incentivizes employees struggling with mental health issues, fnding a therapist can

Figure 8: Figure 9:
Plan to Add Additional Support for Company Mental Health Resources O˜ered
Mental Health in 2023
O˜ering EAP 14% Third party employee assistance 57%
Expanding visits
in current EAP 6% Telebehavioral support 31%
Telebehavioral throught
6% Carrier assistance program 22%
medical insurance
Telebehavioral throught Education and development

5% courses 14%
third-party vendor
Health Stigma Third party choice

8%
Reduction Training 1% telebehavioral
Manager mental
6%
Other 6% health training
In-o˜ce mental
We do not plan to add health therapy 3%
additional support 72%
On-site therapy 2%
Psychedelic
therapy coverage 1%
Other 5%
None of the above 26%
be particularly challenging,” says Deb Smolensky, SVP, Global When framing a beneft as being underutilized and
Practice Leader, Well-Being and Engagement. “With a typical cost-prohibitive, it’s a good idea to be able to ofer another
EAP program, we’re giving employees about three visits, beneft or perk in its place. Increasing access to virtual care
which can be just long enough to determine whether a thera- is a cost-efective solution that can help in this.
pist is a good ft. For a small win and an opportunity to provide Although the practice of telemedicine was not
high-quality care at very low to no cost, why not expand that unheard of, the pandemic drove home the practicality
to nine visits, so people can get the care that they need?” of virtual visits, especially for mental health. The num-
In theory, EAPs and the entire benefts ofering ber of patients who adopted remote care services such
should serve the interests of employees. Consequently, as wellness visits, medication consultations and mental
if elements of these programs are not serving employee health counseling exploded exponentially during the
interest and are a drag on the employer’s bottom line, then early months of the pandemic. By today’s standards,
these underutilized benefts should be eliminated. The telemedicine is commonplace and preferable for work-
process of determining which benefts are ripe for the cut is ers that prioritize convenience. Generally speaking, it
delicate and should not be taken lightly. ofers employees greater access to comparable in-person
“In this environment, companies are laying of work- services. However, appointments are typically billed at a
ers, they are dealing with higher interest rates, and they are lower rate, which can help plan sponsors and employees
tightening their belts,” says Smolensky. “Being transparent maintain afordability. As such, providing 24/7 access to a
throughout the process, from focus groups to conversa- comprehensive scope of services creates a cost-efective
tions with leadership and, ultimately, breaking the news alternative to unnecessary ER or urgent care visits.
to employees, is so important. Leading with empathy and While crafting communications on the value of
informing your workforce why the changes were made can telemedicine, it’s an excellent opportunity to emphasize
go a long way to a smooth transition.” the fnancial well-being programs a company has in place.

Half or more of employers
fnd it important to control
their Rx spend when
designing Rx benefts

Figure 10:
Increasing Pharmacy Cost Concerns
Yes, concerned with increasing

costs and aõrdability 48%
No, not concerned with increasing

12%
costs and aõrdability
Other. Somewhat concerned with

40%
increasing costs and aõrdability
As a distinct component of holistic well-being, fnancial Actions to consider include:

well-being directly impacts an employee’s health and abil- • Pharmacy consultants can provide expertise to
ity to bring their best to work. Educating them on money navigate Rx trends, educate you on the option and
management and minimizing their exposure to fnancial manage your overall Rx spend.
risk can help them gain greater confdence and get the • Manufacturer assistance programs are available to help
most out of their paychecks. employees manage costs for essential prescriptions.
“By tying this message into a team efort, one where
• Analyzing pharmacy claims data can inform strategic
both organization and individuals alike are tightening their
planning, fnd gaps in care and focus the eforts of
belts in the face of worldwide economic uncertainty, it cre-
appropriate vendors to engage in Rx cost contain-
ates a sense that we’re all in this together,” says Smolensky.
ment solutions.
“Creating that sense of alignment and getting everyone
• Rx plan design strategies, including cost sharing
to think about budgeting and doing what it takes to stay
between employer and employee, multi-tiered
fnancially fexible can really help give companies and their
network channels can create meaningful savings by
employees the tools and wherewithal to get through these
improving consumerism, creating pathways for drug
difcult times.”
competition and evolving with the changing market.
In light of these trends, it should come as no sur-
prise that half or more of employers fnd it important to • Engaging your employees on their perspectives
control their Rx spend when designing Rx benefts (49%). regarding prescription drugs can help to inform plan
But about half of employers (45%) are unsure if improving refnements:
healthcare literacy will decrease Rx usage/cost. • Are they willing to change drugs to a lower cost
With an astonishing 86% of employers not currently option (if available)?
utilizing a pharmacy consultant, NFP sees many collab- • Are they willing to be fexible in their purchase
orative opportunities employers can take advantage of method (retail, mail order, retail 90)?
to achieve favorable results. “In addition to education
• Would a digital tool that assists with Rx decision
campaigns, there are a variety of actions for employers to
making be valuable?
consider that can have a direct and positive impact on their
prescription drug spend and member experience,” said • Are they open to switching to biosimilars,
Nelly Rose, VP, Clinical Pharmacy for NFP. “I appreciate the when appropriate?
complexity of the challenge, but with the right expertise
and guidance, better outcomes for employers and employ-
ees are possible.”

Importance of Controlling Rx Spend Using a Pharmacy Consultant
22% No, outside consulting assistance

86%
Extremely important not currently utilized
Slightly important
Yes, use of outside consulting
27% 14%
Neutral assistance currently in place
Slightly unimportant
Extremely unimportant
39%
4%
8%
While it takes time to fnd the right solution, the trends When analyzed, these data sets provide unprec-
mentioned above make it clear that doing nothing isn’t edented insights that can help tremendously in these
a viable option. “If you’re serious about containing costs, current economic conditions. Employers can now compare
and you’re committed to providing employees with the Rx and contrast real-time healthcare costs by geographical
support they need, it’s critical to explore changes in your location, provider, network and the claim’s payer. Because
approach,” says Rose. transparency legislation is relatively new, the reliability of
the publicly posted hospital and payer data continues to
Take Advantage of Modern Data improve each day.
and Reporting “Using multiple data sets of qualitative and quanti-
Employers must take advantage of their data to signif- tative research allows us to normalize, map and deliver an
cantly reduce costs and provide benefts more afordably. accurate and reliable analysis,” says Cottle. “Empowering
Through the legislative changes initiated by the Consoli- the employer and consumers with this data will transform
dated Appropriations Act, 2021 (CAA), employers now have the industry. However, interpreting it requires prudence
a fduciary responsibility to establish a process for evaluat- with a clinical risk management lens. We are delivering real
ing medical and Rx plans ofered to employees. Awaiting value in this area.”
agency guidance on the employers’ responsibilities, the Although there is tremendous potential that these
Centers for Medicare and Medicaid Services (CMS) indi- new data sets will lead to the creation of a new purchasing
cate that data disclosure to plan participants will remain model in healthcare, one in which the true cost of care is
a cornerstone of compliance. Because of this, employers married with quality and outcome data, employers are only
should be adopting strategies that apply data analytics and just now making progress towards that goal. Currently, the
transparency metrics to all renewal evaluations. petabytes of data are practically unusable for any entity
“If you can’t measure it, you can’t manage it,” says outside a data aggregator. However, tools that can deliver
Heidi Cottle, SVP, Cost Containment Strategies. “The release clear, accurate and user-friendly cost information are
of this transparency data could not be more timely. For the being built. And there is employer interest in discovering
frst time, employers and consumers now have visibility variations in pricing mechanisms for both in-network and
into the true cost of healthcare. However, the raw data size, out-of-network services.
which currently exceeds two petabytes, makes the data “We need to remove barriers to accurate analyses and
actionable for only a limited number of early innovators, provide employers the clearest snapshot of their healthcare
including the team at NFP.” spend. When we benchmark that information meaningfully,

Employer Interest in Digital Prescription Employer Trust of New-to-Market Biosimilars
Purchasing Tool
Yes, a digital tool will help Yes, I trust new-to-

76% 43%
with decision making purposes market biosimilars
No, I do not trust

No, I do not ÿnd digital tools biosimilars at this time 19%
24%
helpful when making decision
I don’t know/Unsure 38%
we can verify and validate if they’re getting the best market market will emerge. In turn, market competition will drive
pricing on their healthcare plan,” says Cottle. reasonability in pricing and the unit cost of care at a proce-
dural level. Furthermore, as more actionable information
As healthcare prices continue to escalate on quality and outcomes becomes available, clarity on the
year-over-year, employers must combat them with com- total cost of high-value care will emerge.
prehensive solutions that mitigate disruption to plan
1 Alex Montero, Audrey Kearney, Liz Hamel and Mollyann Brodie “Americans’
participants and make them more afordable without
Challenges with Health Care Costs,” KFF, kf org, 2022
compromising quality. In a challenging economy with out- 2 Ibid
rageous infation, no one action is likely to move the needle 3 Ibid
on an organization’s overall healthcare spend. However, 4 MetLife The Advantages of Employee Care: Creating Human-Centric
visibility into the cost of care is a signifcant move in the Employee Experiences and Work Environments, 21st Annual US Employee
Beneft Trends Study, MetLife, metlife com, 2023, p 17
right direction.
Educating employees on fnancial wellness, with sup-
porting transparency data brings visibility to and enhances
the perceived value of employer-sponsored benefts. Data
continues to validate that a happier employee is a more
productive employee, which puts them in a position to
better focus on their work while improving their holistic
health. Together with other small eforts aimed at increas-
ing value and lowering risk, incremental changes to a
beneft ofering are more sustainable and can be just as
benefcial as a large shift.
The efects of healthcare pricing transparency
continue to develop as visibility grows. As employers, and
eventually individual consumers, become actively engaged
in making their own healthcare decisions, engagement and
adoption will increase.
As a by-product of plan participant engagement, a
greater level of accountability in the healthcare delivery

Plan Benchmarking
Data Snapshot
The costs associated Figure 1:

Prevalance of Medical Plan Types
with providing employer-sponsored insur- O˜ered by Employers
ance have risen steadily for both employer
27%
and employee. Given the persistence of HMO
infation, these costs are expected to con- PPO

66%
tinue to rise. With wage growth cooling, it

43%
will be incumbent on employers to explore HDHP
comprehensive solutions targeting the POS

19%
unit cost of care to better manage overall 8%

EPO
healthcare spend.
Figure 2:
Median Annual Total Premium by
Plan Type & Coverage Tier
$7,251 HDHP HMO PPO

Employee $7,509
$8,526
$15,464
Employee
+ Spouse $16,488
$18,452
Employee $13,664
+ Child(ren) $14,589
$16.074
$21,453
Family $22,368
$25,408

Median premium costs have risen steadily over the
Costs by last three years, with PPOs and HMOs slightly out-
pacing HDHPs. The year-over-year percent increase
Plan Type & for median total annual premiums across HMOs,
Coverage Tier PPOs and HDHPs varies between 4.68% and 6.03%
(Figure 3).
Figure 3: Figure 4:
Year-Over-Year % Increase in Median Employee Median Annual Total Premium (PPO)
Annual Total Premium by Plan Type
$25,408
4.68% Family $23,892
HMO
$23,019
6.03%
PPO
$16,074
Employee+
$14,967
Child(ren) $14,497
HDHP 5.28%
$18,452
Employee +
$17,363
Spouse $16,712 2022
2021
$8,526
Employee
$7,996
Only $7,819 2020
Figure 5: Figure 6:
Median Employee Annual Total Premium (HMO) Median Employee Annual Total Premium (HDHP)
$22,368 $21,453
Family $20,893 Family $20,142
$20,162 $19,794
$14,589 $13,664
Employee+ $13,175 Employee+
$12,667
Child(ren) $12,434 Child(ren) $12,439
Employee + $16,488 Employee + $15,464

$15,194 $14,643
Spouse Spouse
$14,573 $14,180
2022 2022
$7,509 $7,251
Employee 2021 Employee 2021
$7,073 $6,807
Only Only
$6,741 $6,639
2020 2020

Employee Over the last couple of years, the diference in
yearly employee contributions in terms of plan
Contribution type and coverage level has experienced mini-
by Plan Type & mal variance for HMOs and HDHPs. Despite the
fact that overall premium costs are increasing,
Coverage Tier the median annual employee contributions for

family HMOs and HDHPs slightly decreased in
2022 (Figures 10 and 11).
Figure 7:
Median Annual Employee Contributions by
Plan Type & Coverage Tier
$1,206 HDHP
Employee $2,011
$2,192 HMO
$4,633
Employee PPO
$7,200
+ Spouse
$7,280
$4,020
Employee
$6,284
+ Child(ren)
$6,136
$6,717
Family $10,340
$10,504

Figure 8: Figure 9:
Year-Over-Year % Increase Median Annual Median Employee Annual Contributions (PPO)
Employee Contributions by Plan Type
HMO $9,796
6.61% Family $9,408
$8,638
PPO 10.27%
$5,849
Employee+ $5,270
Child(ren) $4,980
HDHP 0.51%
Employee + $6,871
Spouse $6,582
$5,977
Employee $2,178 2022

$1,905
Only $1,777
2021
2020

Median Employee Annual Contributions (HMO) Median Employee Annual Contributions (HDHP)
$9,020 $6,793
Family $9,031 Family $6,844
$7,669 $6,542
$5,385
Employee+ $5,230 $3,869
Child(ren) $4,464 Employee+
$3,780
Child(ren)
$3,628
$6,225
Employee + $6,166
Spouse $4,666
$5,405 Employee + $4,654
Spouse
$1,737 $4,557
Employee 2022
$1,605 2022
Only
$1,445
2021 $1,221
Employee
Only $1,196 2021
2020 $1,208
2020

Median deductibles for both individuals and
Deductibles & families were highest for HDHP plans, then PPO
Out-of-Pocket plans and last HMO plans. Median out-of-pocket

expenses for both individuals and families were
Costs highest for HDHP plans, then PPO plans and last
HMO plans.

Percentage of Employers Implementing Median Annual HMO Deductible
Various Contribution Strategies
Deÿned $1,500 In-Network

Contribution 3.20%
Individual
Health Out-of-Network
$0
Wellness 2.35%
Banding
Salary
Banding 1.54%
$3,000
Family
$0

Median Annual PPO Deductible Median Annual HDHP Deductible
$1,500 In-Network $3,000 In-Network

Individual Individual
Out-of-Network Out-of-Network
$3,000 $5,000
$3,000 $6,000
Family Family
$7,000 $10,000

Median Annual HMO Out-of-Pocket Median Annual PPO Out-of-Pocket
Maximum Amount Maximum Amount
$5,500 In-Network $4,500 In-Network

Individual Individual
Out-of-Network Out-of-Network
$0 $9,000
$11,250 $9,700
Family Family
$0 $20,000
Figure 18:
Median Annual HDHP Out-of-Pocket
Maximum Amount
$5,000 In-Network
Individual
Out-of-Network
$10,000
$10,000
Family
$20,000

Figure 19:
Percentage of Employers O˜ering
Beneÿts to Part-Time Employees
2.71%
Medical 2.17%
2%
2.71%
Dental 1.90%
1.33%
Part-Time
2.44%
Vision 1.63%
2%
Benefts STD 1.63%

2.08%
2%
Although few employers ofer 2.08%

LTD .81%
part-time employees benefts, they 2%
remain a great bargaining tool for 2022
attracting and retaining talent, 2.35%

2021
Life 2.17%
increasing job satisfaction and 1.33%
2020
improving fnancial stability
Figure 20:
Percentage of Employers
O˜ering Part-Time Beneÿts
Medical 2.71%
Dental 2.71%
Vision 2.44%
STD 2.08%
LTD 2.08%
Life 2.35%

About two out of every three employers ofer at least one dental
plan. As an additional layer of fnancial security for employees,
Dental it remains a good value obtainable at a low cost. While out-of-
Benefts pocket spend for dental coverage remains mostly fat, it’s an
invaluable tool that positively impacts employee health and
can additionally aid in reining in other plan-related spending.

Percentage of Employers O˜ering One Median Annual Employee Dental PPO (DPPO)
or More Dental Plans Contributions by Coverage Tier
Employee $198
One Plan Employee

$482
33% + Spouse
Two Plans
46% Employee
$544
Three or + Child(ren)
More Plans
Family $838
3% Not O˜ered
18%

Median Annual Employee Dental HMO (DMO) Median Annual Total Premium (DPPO)
Contributions by Coverage Tier
$1,420
Family $1,426
Employee $171 $1,440
Employee
$360 $997
+ Spouse Employee+
$967
Employee Child(ren)
$301 $993
+ Child(ren)
Family $561
$887
Employee +
Spouse $852
$866
2022
$431
Employee $419 2021
Only
$424
2020

Median Annual Employee Contributions (DPPO) Median Annual Employee Total Premium (DMO)
$838 $1,392
Family $839 Family $1,380
$811 $1,407
$544 $967
Employee+ Employee+
Child(ren) $538 $939
$525 Child(ren)
$960
Employee + $482 $858

$468 Employee +
Spouse $827
$449 Spouse
$845 2022
2022
$198 $412
Employee 2021
$180 Employee
Only 2021 $405
$160 Only
$412
2020
2020
Figure 27:
Median Annual Employee Contributions (DMO)
$767
Family $766
$761
$518
Employee+ $495
Child(ren)
$493
$466
Employee +
$439
Spouse
$427
$191 2022
Employee
Only $170
2021
$152
2020

Although the majority of employers do not ofer short- or
long-term disability plans, doing so provides yet an addi-
Disability tional layer of fnancial security for employees. Furthermore,
Benefts ofering these benefts can demonstrate care and support

while aiding in attraction, retention, and recruiting eforts.

Percentage of Employers O˜ering One or Percentage of Employers O˜ering One or
More Short-Term Disability Plans More Long-term Disability Plans
2% 1%
One Plan One Plan
34%
29% Two Plans Two Plans
Three or Three or
68% 61% More Plans
More Plans
Not O˜ered Not O˜ered

4%
1%

Short-Term Disability Plan Premium Cost Share Long-term Disability Plan Premium Cost Share
Arrangement by % of Employers Arrangement By % of Employers
100% 100%
Employer Employer
Paid Only 17% Paid Only
22%
Employee 5% Employee
Costs Share 1% Costs Share
6% Only Only
1%
Core & Buy Core & Buy
Up Plans Up Plans
71% 77%
Not Not
Reported Reported

Life Voluntary beneft oferings like life insurance can also aid in
attraction, retention and recruiting eforts. With the majority
Insurance of plans being 100% paid by the employer, it is an easy win for
organizations looking to demonstrate an investment in the
Benefts long-term well-being of employees and their families.

Percentage of Employers O˜ering One or Life Insurance Premium Cost Share Arrangement
More Life Insurance Plans by % of Employers (Multiple of Salary)
4% 100%
4% Employer
One Plan Paid Only
1%
Two Plans
Employee
Costs Share
47% 44% Three or Only
More Plans
Not O˜ered Core & Buy

Up Plans
2% 6% 91%
Not
Reported
Figure 34:
Life Insurance Premium Cost Share
Arrangement by % of Employers (Flat Amount)
4% 100%
8% Employer
Paid Only
3%
Employee
Costs Share
Only
Core & Buy

Up Plans
85% Not
Reported

Other Ofering a wide array of voluntary benefts can provide
additional layers of fnancial protection and protect
Voluntary employees from gaps in health coverage. They can further
be personalized to the needs of the individual and are
Benefts generally paid for by the employee.
Figure 35: Public Multiemployer

Corporations Overall
Types of Voluntary (Employee-Pay-All) Employers Plans
n=373 n=424
Benefts Ofered n=51 NA
Accident insurance 55.0% 47.1% NA 54.0%
Automobile insurance 13.7% 9.8% NA 13.2%
Critical illness or cancer insurance 52.3% 39.2% NA 50.7%
Hearing insurance 1.1% 9.8% NA 1.7%
Hospitality indemnity insurance 29.2% 29.4% NA 12.0%
Identity theft insurance 33.5% 25.5% NA 32.5%
Legal services plan 35.1% 27.5% NA 34.2%
Pet insurance 35.1% 21.6% NA 33.5%
Student loan repayment assistance 5.1% 3.9% NA 5.0%
Vision insurance 54.0% 41.2% NA 49.3%
Other 0.0% 3.9% NA 0.5%
None 11.0% 5.9% NA 10.4%
Respondents were asked to select all that apply. (International Foundation of Employee Beneft Plans)
About the Data
The 2023 NFP US Benefts Trend Report (and the associated

fgures) draws on data from NFP’s annual Benefts Trend
Survey, annual Leave Management Survey, Benefts at
Work Survey and client benchmarking database. Rounding
conventions have been applied for readability. All other
sources are as referenced throughout.
For full information on the methodology for each NFP
survey, contact marketing@nfp.com.

About the Experts
Kim Bell
Kim is executive vice president, head of Health and Benefts at NFP, where she directs
the overall strategy and operations for NFP’s national employee benefts practice. With
more than 30 years of experience in the employee benefts industry, Kim is an infuential
thought leader in the corporate benefts space. She graduated from Indiana Universi-
ty’s Kelley School of Business with a Bachelor of Science in fnance and has a Master of
Science degree in management from Indiana Wesleyan University. Kim also holds the
Certifed Employee Benefts Specialist® (CEBS) designation from the International Foun-
dation of Employee Beneft Plans.
Maria M Trapenasso
Maria M. Trapenasso Maria is senior vice president, national practice leader of Human Capital
Solutions for NFP. Maria leads the HR consulting practice and ofers NFP’s clients strategic
guidance on HR related functions such as organizational harmonization, leave management
and employment practices. Her expertise is in the areas of HR audits and compliance, and she
assists clients in implementing comprehensive total rewards programs. Maria has over 28
years of Human Resources experience working in various industries and she holds a Senior
Certifed Professional designation from the Society of Human Resources Management, and a
Leave Management Specialist certifcation from DMEC. Maria has been a professional mem-
ber of SHRM and the National Association of Female Executives since 1998. Maria also holds a
NY State Insurance license for Health, Life and Accident Insurance.
Deb Smolensky
Deb is senior vice president, Well-Being and Engagement practice leader. In addition,
Deb serves as a subject matter expert for the insurtech, fntech and digital health verticals
of NFP Ventures. She consults with a variety of clients, including numerous Fortune 500
companies, to develop programs and practices that empower employees and leaders to
lead healthy, productive lifestyles through innovative and highly engaging solutions. Deb
holds a bachelor’s degree in accounting from Illinois State University as well as a multitude
of certifcations and designations in organizational health and productivity.

E Heidi Cottle
Heidi is senior vice president, Cost Containment Strategies, collaborating with ofces to
develop strategies driven by data analytics, medical/clinical risk management programs and
service/vendor assessments. With 30+ years of experience in the health and welfare mar-
ket, Heidi has specialized insights on medical/Rx cost containment and emerging trends in
traditional and non-traditional strategies. Heidi was also a fnalist for the 2019 World Health
Congress “Innovator of the Year” award, a refection of her engagement in digital transforma-
tion eforts designed to enhance the client experience. Heidi holds over 30 health and welfare
licenses, credentials and certifcations in the U.S. and its territories to support a holistic view
of the market.
Pamela Wheeler
Pamela is chief diversity and inclusion ofcer and is an accomplished leader with nearly
three decades of experience improving diversity, equity, inclusion and belonging (DEIB)
outcomes for employees, clients, partners and communities. She works with leaders across
NFP, building from the DEIB foundation in place to move the organization forward with
deliberate action, measurable results and continuous refnement. Prior to NFP, Pamela
consulted with National Football League Operations on DEIB eforts and led the Women’s
National Basketball Players Association, where she accelerated DEIB in a number of areas for
the players. She earned a BA from Dartmouth College and a JD from Boston University.
Nelly Rose
As vice president of Clinical Pharmacy, Nelly supports NFP Rx Solutions with clinical insights
and new initiatives while also providing strategic analysis for drug trends and utilization.
She works directly with members to support and educate on clinical programs and
drug interventions. Nelly received her Doctor of Pharmacy degree from St. Louis College
of Pharmacy.

insightsfrom
theexperts
NFP is committed to sharing insights that help clients make

informed decisions regarding their most signifcant challenges.
By delivering ideas, expertise, and perspective on opportunities
in the marketplace, NFP is driving improvements to solutions
that help clients meet their goals.
For the latest on the 2023 US Benefts Trend Report,

visit us online at www.nfp.com.

About NFP
NFP is a leading property and casualty broker, benefts con-
sultant, wealth manager, and retirement plan advisor that
provides solutions enabling client success globally through
employee expertise, investments in innovative technologies,
and enduring relationships with highly rated insurers, vendors
and fnancial institutions.
Our expansive reach gives us access to highly rated insurers,

vendors and fnancial institutions in the industry, while our
locally based employees tailor each solution to meet our
clients’ needs. We’ve become one of the largest insurance bro -
kerage, consulting and wealth management frms by building
enduring relationships with our clients and helping them
realize their goals
The information contained herein is for informational purposes

only. NFP Corp. and its subsidiaries do not provide legal or tax
advice. Please consult an attorney or tax professional before imple-
menting any particular strategy to determine the application of
laws, regulations, or policies to your specifc circumstances.

NFP.com

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insightsfrom

A Letter from Kim 2

Holistically Mitigating the Efects

Balancing Employee Needs:

Maintaining Afordable Benefts: Cost-Efective

Plan Benchmarking Data Snapshot 46

About the Data 57

About the Experts 58

2023 NFP US Benefts Trend Report : : 1

2 : : 2023 NFP US Benefts Trend Report

4 : : 2023 NFP US Benefts Trend Report

2023 NFP US Benefts Trend Report : : 5

Stress: A state of mental or emotional strain or tension result-

6 : : 2023 NFP US Benefts Trend Report

Attract new 61%

Respondents were asked to select all that apply.

8 : : 2023 NFP US Benefts Trend Report

2023 NFP US Benefts Trend Report : : 9

One that o˜ers its employees a

One that gives employees the opportunity

One that allows employees

Any of the above 22%

We o˜er our employees a

We allow our employees

We give our employees the opportunity

We did not implement

Respondents were asked to select all that apply.

10 : : 2023 NFP US Benefts Trend Report

We understand the importance of

$501 - $1,500 18%

We require employees to be on site, $6,001 - $10,000 3%

2023 NFP US Benefts Trend Report : : 11

Benefts of doing the same.”

Address Financial Well-Being Head On

12 : : 2023 NFP US Benefts Trend Report

Employer is self-funded 9% O˜ering EAP 14%

$1,501 - $3,000 1% Telebehavioral 5%

$3,001 - $6,000 1% Health Stigma 1%

$6,001+ <1% Other 6%

70% We do not plan to add 72%

Respondents were asked to select all that apply.

The 28% variance

2023 NFP US Benefts Trend Report : : 13

14 : : 2023 NFP US Benefts Trend Report

Accident 42% Accident 51%

Critical illness 36% Critical illness 46%

Hospital indemnity 33% Hospital indemnity 29%

Other supplemental Other supplemental

Figure 12: Figure 13:

Figure 14: Figure 15:

Yes - Assuming the price Yes - We believe people are

No - I already have this No - Our employees

Maybe - Before I can make Maybe - Before I can make a

2023 NFP US Benefts Trend Report : : 15

16 : : 2023 NFP US Benefts Trend Report

2023 NFP US Benefts Trend Report : : 17

18 : : 2023 NFP US Benefts Trend Report

20% 19% 21% 26%

Critical Important Nice to have Not important

20 : : 2023 NFP US Benefts Trend Report

of workers believe it is their

62% Want their employers to

2023 NFP US Benefts Trend Report : : 21