What Employees Don’t Know About Their Health Care

Study reveals gap in knowledge among America’s workforce

By SHRM Online staff Feb 17, 2015

Employees need to know so much in order to effectively use their health care plans that it can be overwhelming, research findings by BambooHR reveal.

The firm, an online HR software provider for small and medium businesses, recently asked more than 1,000 U.S.-based employees for their thoughts on their health care insurance. The feedback showed that employees care deeply about the quality of their insurance but feel confused about its coverage and costs, and are unsure about new requirements imposed by the Affordable Care Act (ACA). Among the findings:

77 percent of employees don’t understand how the ACA will affect their tax filings.

63 percent don’t know all of the times they are able to switch plans (during open enrollment or when a life-changing event occurs).

48 percent don’t know what the penalty is for not having insurance that meets ACA requirements.

27 percent don’t know if their insurance plan is ACA-compliant.

Aspects of employer-provided health coverage that employees said they did not understand or were uncomfortable using included:

How the out-of-pocket maximum works (55 percent of employees).

Submitting claims (54 percent).

What the premium covers (49 percent).

How the deductible works (44 percent).

In-network versus out-of-network providers (39 percent).

Cost of their monthly premium (33 percent).

Relatedly, employees said they were not satisfied with their:

Out-of-pocket maximums (69 percent).

Coverage percentages (64 percent).

Deductible amounts (60 percent).

Monthly premiums (55 percent).

Options within the network (52 percent).

All of these aspects (25 percent).

A large majority (70 percent) of employees view increased health care costs as a pay cut, but the majority of them don’t blame the company:

48 percent of respondents resent the government for increased costs.

16 percent resent their employer.

“These results illustrate that employees care about their insurance but could use a more detailed overview and stronger guidance regarding year-to-year changes,” according to BambooHR.

What can employers do to increase employees’ understanding and satisfaction with their health care benefits? The firm advised the following:

Find out what your employees don’t know. Send out a survey to see what they need help with. Then, hold an educational meeting to fill those knowledge gaps.

Find out which parts of their plan employees aren’t happy with. Figure out what your employees will appreciate and incorporate those features next time you select a plan. For example, do employees want a health savings account match, or would they prefer to have gym membership reimbursement?

The December 2014 study collected responses from 1,029 U.S.-based full-time employees.

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