6 Open Enrollment Trends for 2020

Employers prioritizing employee well-being, employee choice and integration of new technologies

Stephen Miller, CEBS By Stephen Miller, CEBS September 30, 2019

Workers and their families will be making important decisions in the coming weeks about their health care and other employee benefits for 2020. As they do, they may notice that their benefit options and the enrollment process have changed.

While most employers are not planning major changes to their benefit plans, "they continue to increase efforts to improve quality, access and convenience by providing workers more plan choices," said Brian Marcotte, president and CEO of the nonprofit National Business Group on Health (NBGH), which represents large employers.

Changing Benefits Landscape

NBGH identified six trends for open enrollment, drawing on its annual Large Employer Health Care Strategy and Plan Design Survey, conducted in May and June, with responses from 147 self-insured multistate and global employers that offer coverage collectively to more than 15.6 million employees and their dependents. The results show that employees are likely to encounter:

1. Modest cost increases

Employers expect the total cost of health benefits covering employees and their dependents to rise by 5 percent in 2020—after employers take cost-controlling steps—to an average of $15,375, including premiums and out-of-pocket costs. Most large employers will continue to cover almost 70 percent of the costs.

2. More health plan choices

Many employers have been reducing the number of plan choices over the past few years, moving employees into high-deductible health plans (HDHPs) that can be paired with a health savings account. In 2018, 39 percent of employers offered only HDHPs. Next year, however, only 25 percent will offer an HDHP as the only option. Employers are reintroducing choice, largely driven by employee feedback for more plan options. Most often, employers are adding a preferred provider organization plan in addition to an HDHP.

3. Additional virtual care options

To help improve access and enhance the employee experience, most large employers will provide employees with additional virtual care services beyond those traditionally offered through telehealth. More than three-quarters (82 percent) will provide mental health services to employees virtually, and 60 percent will provide weight management programs virtually.

Digital solutions for musculoskeletal care management, prenatal care and coaching, sleep management, diabetes management, and cardiac care management show the greatest potential for growth over the next several years.

4. Greater access to health care support tools

More than 3 in 4 large employers (78 percent) plan to offer medical-decision support tools, in which medical specialists evaluate the appropriateness of a diagnosis based on a patient's submitted records, and second-opinion services that can advise whether a less-invasive, alternative treatment is available. Seventy-three percent will offer virtual solutions to help with claims assistance. About 60 percent will offer full-service, high-touch concierge programs that help employees navigate the health care system, reflecting the need to simplify the consumer experience.

5. Expansion of mental health benefits

Almost half of large employers will conduct campaigns next year to reduce the stigma surrounding mental health conditions and treatment. More employers will offer online resources (69 percent), manager training to help recognize mental health issues and direct employees to appropriate services (47 percent), onsite mental health counselors (33 percent), and online behavioral therapy for mental health issues (28 percent).

6. Increased focus on quality

Employers are increasing their focus on health care quality and value with the use of centers of excellence (COE)—treatment centers deemed to offer high-quality, cost-effective care. More than 1 in 4 large employers (27 percent) will expand their COE offerings to address additional conditions or procedures, including in orthopedics. Nearly half of large employers will have COEs in place in 2020 for musculoskeletal conditions. In addition, a growing number of employers are turning to COE models for fertility and maternity programs. Many employers are expanding incentives to boost employee use of COEs.

Self-insured employers increasingly are designing their health plans around high-performance networks of doctors and hospitals and adopting advanced primary care strategies, such as contracting with primary care physicians' offices to coordinate services provided by health care specialists.

[SHRM members-only toolkit: Managing Health Care Costs]

Changes to Employee Benefit Strategy

Faced with rising costs and employees who often don't understand or value their benefits, U.S. employers are revisiting their benefit strategy, according to consultancy Willis Towers Watson.

Employers want to place greater emphasis on employee well-being, broader benefit packages and use of new technologies to support employee decision-making, according to the firm's 2019 Benefits Trends survey, conducted during May and June 2019 with responses from 400 large and midsize U.S. companies.

The top benefit strategy challenges employers expect to face over the next three years are:

  • Rising benefit costs (82 percent).
  • Difficulties communicating benefit choices to employees (53 percent).
  • Differing wants and needs of a multigenerational workforce (50 percent).

"Employers are looking for ways to better connect with employees to meet the benefit needs of a diverse workforce and to get the most value for their benefit spending," said Jennifer DeMeo, senior director of retirement at Willis Towers Watson.

When asked about their highest priorities, according to the survey, employers cited:

  • Incorporating employee well-being into their benefit programs, including physical, emotional, financial and social well-being programs (80 percent).
  • Aligning benefit provisions with employee wants and needs (64 percent).

"Most employers are giving their employees choice across their core and voluntary benefits," said Julie Stone, managing director of health and benefits at Willis Towers Watson. However, she noted, "there is still much opportunity to enhance employee engagement, including widespread adoption of new decision-making technologies," by tailoring benefit communications to various segments in the workforce.

Informed Choices

Leston Welsh, head of products at Prudential Group Insurance, similarly believes that "the next big opportunity for employers is to think about how to tailor [benefits] communications for populations most likely to need them, such as new employees, employees in new roles, employees who received a raise or promotion, and those likely to experience a life change."

Just 35 percent of working adults chose the same benefits in 2019 that they chose in the prior year, according to Prudential's August survey of 2,000 adults enrolled in at least one insurance benefit through their employer. Those who took on a new job or an elevated role or received a raise were more likely to select new benefits.

In most cases, the 65 percent who chose new benefits credited their employer for using a variety of communication methods to keep them informed.

Of those who chose the same benefits, 74 percent said they did so because they believed those benefits were still appropriate for them. However, those who selected new benefits were more likely to say their benefits reduced their financial stress (79 percent) than those who selected the same benefits as the previous year (62 percent).

Related SHRM Articles:

Simple Open-Enrollment Tips That Can Make a Big Difference, SHRM Online, September 2019

Does AI Have a Place in Open Enrollment?SHRM Online, September 2019

Related SHRM Resource:

Open Enrollment Guide & Resources



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