Workforce trends such as the tight labor market, the growth of the “gig economy” and a need to meet the requirements of multiple generations in the workplace have spurred organizations to move beyond traditional health benefits to offer supplementary and innovative health care perks. Coverage for autism treatments and bariatric surgery, transgender-inclusive benefits and fertility benefits are among the nontraditional health benefits organizations are adding, the 2018 Employee Benefits Survey showed.
By offering innovative benefits, organizations are seeking to stand out among competitors in their recruitment and retention efforts. The growth of the gig economy is also forcing them to revisit the concepts of worker and workplace. And the presence of four generations in the workforce has highlighted a need for flexibility in benefits.
Other Types of Health Care Offered
- More than four in five (82.1%) responding organizations provide mental health benefits. Other International Foundation research shows that this most commonly entails outpatient and inpatient treatment sessions and prescription drug therapies.
- A similar proportion (79.1%) offer chiropractic coverage.
- Three in four (75.1%) respondents provide vision benefits including coverage for glasses, contact lenses and preventive screenings.
- More than three in five (64.0%) offer orthodontia coverage, which is insurance coverage for the repositioning of teeth and jaws.
- About three in five (57.9%) cover autism treatments, which most often includes speech therapy, occupational therapy, physical therapy and/or medications.
- Less than one-half (47.0%) cover bariatric surgery, which is performed on the stomach or intestines to induce weight loss.
- More than two in five (44.6%) offer hearing benefits—a benefit more commonly available in public employer and multiemployer sectors, compared with single employer/corporations.
- A similar proportion (42.8%) of responding organizations provide retiree health care benefits, a benefit also more commonly offered in the public employer and multiemployer sectors.
- More than one in four (28.4%) responding organizations offer critical illness/cancer insurance. In this limited form of health insurance, an insurer agrees to pay a lump-sum benefit if the policyholder is diagnosed with a specific condition such as cancer, heart attack, stroke, Alzheimer’s disease or kidney failure, or if the beneficiary has an organ transplant.
- More than one in six (17.1%) respondents cover genetic testing services. These services most often take the form of a DNA analysis to identify inherited diseases/traits but are also being used to identify medication response (also known as pharmacogenetic testing).
- One in nine (11.7%) responding organizations offers long-term care insurance. Long-term care insurance covers the costs associated with the long-term care for persons who are unable to care for themselves as a result of a chronic illness, disability or mental impairment.
Transgender-Inclusive Benefits
Much attention has been paid to the inclusion of transgender benefits—such as gender reassignment/affirmation surgery—in worker health benefit offerings. Organizations are adding these benefits for recruitment and retention purposes and also to portray a workplace with an inclusive company culture. Overall, more than one in four (27.3%) responding organizations offer at least one transgender-inclusive benefit, and the number of organizations offering them has grown substantially. When respondents were asked about these benefits in the 2016 edition of the study, only 11.9% of respondents offered them. In the past two years, prevalence of coverage has more than doubled among both small and large organizations.
- More than one in four (25.4%) responding organizations cover mental health counseling as part of their transgender-inclusive benefits.
- A similar proportion of respondents (24.4%) cover prescription drug therapies, including hormone replacement therapy.
- Physician visits are covered by about one in four (23.9%) respondents, followed closely by coverage for laboratory tests (22.7%).
- Gender reassignment/affirmation surgery is covered by 22.4% of organizations.
- One in eight (12.9%) also cover birth gender preventive care on a post-transition basis. This preventive care often includes prostate or gynecological exams.
- Smaller proportions of respondents (3.0%) offer coverage for cosmetic surgery, including facial feminization and Adam’s apple reduction.
Fertility Services
Respondents from single and public employers were also asked about covered fertility services. These benefits are related to the biological inability to carry a pregnancy to full term.
- Coverage for in vitro fertilization (IVF), the process of combining sperm and eggs outside the body and placing them inside the uterus, is offered by one in six (16.5%) responding organizations. This coverage is extremely valuable, since IVF cycles are very expensive, and multiple cycles are often required for success.
- Less than one in seven (13.5%) responding organizations cover fertility medications for their workers.
- One in nine (11.1%) responding organizations offers genetic testing services to determine infertility issues.
- A similar percentage (10.8%) cover non-IVF fertility treatments. These medications are typically used to help induce ovulation in women who have ovulatory dysfunction or to help women increase the chances for pregnancy in a given cycle.
- A small proportion (7.1%) of responding organizations cover visits with counselors, including geneticists and surrogacy counselors.
- Finally, coverage for egg harvesting and freezing services is offered by 5.7% of respondents.
Want to learn more? Members and nonmembers may purchase and download the 2018 Employee Benefits Survey at www.ifebp.org/BenefitSurvey2018.
Justin Held, CEBS
Senior Research Analyst at the International Foundation
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