As workers struggle against the impact of the pandemic, employers expand mental health benefits


As the covid-19 pandemic passes into its second year, the path ahead for American workers remains unstable, with many continuing to work from home as policies to keep jobs evolve. In his 2021 Employer Health Benefits Survey, published Wednesday, KFF found that many employers have increased mental health and other benefits to provide support for their workers during times of uncertainty.

Meanwhile, the percentage of employers offering health insurance to their employees has remained stable and increases in health insurance premiums and out-of-pocket health expenses have been moderate, in line with the rise in wages. The deductibles remained substantially unchanged compared to the previous two years.

“With the pandemic, I’m not sure employers wanted to make any major changes to their plans, because so many other things have been disrupted,” said Gary Claxton, senior vice president of KFF and director of the Health Care Marketplace Project. (KHN is an editorially independent program of the foundation.)

Reaching a dispersed workforce is also a challenge, with on-site activities like employee benefit fairs being reduced or eliminated.

“It’s hard to even communicate changes right now,” Claxton said.

Many employers have reported that since the start of the pandemic they have made changes to their mental health and substance use benefits. Nearly 1,700 non-federal public and private companies completed the full survey.

In companies with at least 50 employees, 39% made such changes, including:

  • 31% increased the ways employees can tap into mental health services, such as telemedicine.
  • 16% who offered employee assistance programs or other new mental health resources.
  • 6% who expanded access to online mental health service providers.
  • 4% who reduced the cost sharing for such visits.
  • 3% who increased coverage for offline services.

The workers are using the services. 38% of the largest companies with 1,000 or more employees reported that their employees used more mental health services in 2021 than the previous year, while 12% of companies with at least 50 employees said their employees had increased use of mental health services.

Thundermist Health Center is a federally qualified health center serving three communities in Rhode Island. The center’s health plan offers employees an HMO and a preferred provider organization and 227 workers are enrolled.

When the pandemic hit, the health plan reduced the fees for behavioral health visits from $ 30 to zero.

“We wanted to encourage people to ask for help who were feeling stressed or worried,” said Cynthia Farrell, Thundermist’s associate vice president of human resources.

Once the pandemic is over, if the health center re-adds a ticket, it won’t be more than $ 15, he said.

The pandemic has also changed the way many companies have managed their wellness programs. More than half of those with at least 50 workers expanded these programs during the pandemic. The most common change? Expansion of online consulting services, reported by 38% of companies with 50-199 employees and by 58% of companies with 200 or more employees. Another popular change has been the expansion or modification of existing wellness programs to meet the needs of people who work from home, reported by 17% of smaller companies and 34% of larger companies who have made changes.

Enhancing telemedicine services has been a popular way for employers to make services more accessible for workers, who may have worked remotely or whose doctors, including mental health professionals, may not have seen patients of person.

In 2021, 95% of employers offered at least some health care services through telemedicine, up from 85% last year. These were often video appointments, but a growing number of companies have allowed telemedicine visits by telephone or other means of communication, as well as have expanded the number of services offered in this way and the types of providers who can use them.

About 155 million people in the United States have employer-sponsored health care. The pandemic hasn’t changed the percentage of employers offering coverage to their workers – it has mostly remained stable at 59% over the past decade. Size does matter, however, and while 99% of companies with at least 200 employees offer health benefits, only 56% of those with fewer than 50 employees do.

In 2021, the average premiums for both family and single covers increased by 4%, to $ 22,221 for households and $ 7,739 for single covers. Workers with family coverage contribute an average of $ 5,969 to their coverage, while those with single coverage pay an average of $ 1,299.

The change in the annual premium was in line with the growth in workers’ wages of 5% and inflation of 1.9%. But over the past 10 years, average increases in premiums have substantially outpaced increases in wages and inflation.

Workers pay on average 17% of the premium for single coverage and 28% of that for family coverage. The employer pays the rest.

Deductibles remained stable in 2021. The average deductible per individual coverage was $ 1,669, up 68% over the decade but not much different from the previous two years, when the deductible was $ 1,644 in 2020 and $ 1,655 in 2019 .

Eighty-five percent of workers now have a deductible; 10 years ago, the figure was 74%.

Healthcare spending slowed during the pandemic as people delay or avoid nonessential care. Half of large employers with at least 200 workers reported that workers’ use of health care was about what they expected in the last quarter. But nearly a third said usage was below expectations, and 18% said it was above it, according to the survey.

At Thundermist Health Center, fewer people sought health care last year, so the self-funded health plan, which pays for employee claims directly rather than using insurance for that purpose, fell below expected spending, Farrell said. .

This proved to be good news for the employees, whose contribution to their plan hasn’t changed.

“This year was the first year in a long time that we haven’t had to change our rates,” said Farrell.

The survey was conducted between January and July 2021. It was published in the journal Health affairs and KFF have also released more details in its full report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the three main operational programs a KFF (Foundation of the Kaiser family). KFF is a gifted nonprofit organization that provides information on health issues to the nation.


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