Pulse Survey
BETTER HEALTH
STARTS WITH AN
EMPLOYEE-CENTERED
BENEFITS EXPERIENCE
Sponsored by
SPONSOR PERSPECTIVE
Employers are facing a health care crisis. Health care costs are now the second or
third largest expense for many employers today. Yet costs are continuing to rise by
as much as 20% annually, putting employers at risk of doubling their health care
costs in 10 years. Despite this massive cost increase, employers will gain little to
no additional value for their investment, and employee health and productivity will
worsen. At the same time, with an increasingly diverse workforce and a tight labor
market, benefits are more important than ever when it comes to attracting
and retaining talent.
The problems with health care are exacerbated by a broken health benefits
experience. Employees are struggling to navigate the complicated health care
landscape with little knowledge and support. It’s only further fragmented by a sea of
point solutions that don’t work together, offer little value, and ultimately drive costs
up for both employers and their employees.
It’s time for a paradigm shift—to create an entirely new, employee-centric health
OS—in order to empower employees with their personal health and well-being while
curbing health care costs.
Like SAP for Enterprise Resource Planning and Salesforce for Customer
Relationship Management, an enterprise health care OS acts as a central hub that
allows employers to consolidate their ever-growing number of health and benefit
partners—a platform that prioritizes engagement with benefits and supports
employees in being better health care consumers. One that ultimately helps
employers break the higher cost, worse experience cycle by driving better benefit
utilization and reducing cost.
We started League with a vision for the future of health care: consumer-centric,
personalized, preventive, and always on. We believe that there should be “an app
for that”—a data-driven front door to health care that can empower people to live
happier, healthier lives every day.
Through our Health Benefits Experience platform, we’ve created an opportunity for
employers to provide an entirely new experience for employees—one with the power
to improve health outcomes and drive significant health care savings.
MICHAEL SERBINIS
FOUNDER & CEO
LEAGUE
BETTER HEALTH STARTS WITH
AN EMPLOYEE-CENTERED
BENEFITS EXPERIENCE
INTRODUCTION
Cost control has always been employers’ primary concern when it comes to
employee health benefits, but it hasn’t always been a successful quest. In 2018, for
example, the average annual employer contribution for health insurance premiums
for a single employee totaled $14,069—an 8.1 % increase from $13,049 in 2017.1
Yet forward-thinking employers now are looking beyond costs and beginning to
consider the integral role health benefits play in their overall workforce strategy.
According to a new survey of 238 organizations by Harvard Business Review
Analytic Services, 77% of organizations consider the delivery of innovative
health benefits to be a key factor in a company’s competitiveness. At 57% of these
organizations, the number of health benefits programs is on the rise. FIGURE 1
Employers say offering an attractive health benefits package gives them an
important tool to differentiate their organization from the others competing for
the same scarce talent. Nine out of 10 organizations surveyed say health benefits
serve as an important way to demonstrate that an organization understands and
cares for the needs of employees. “There’s a real war for talent, and we can look at
measurements around that. We will also be looking at employee absenteeism and
engagement,” notes Lisa Park, director of total rewards for KPMG Canada in Halifax,
Nova Scotia. “If these benefits are supporting employee well-being, it should
decrease absenteeism and increase overall engagement.”
Beyond hiring and retaining workers and increasing productivity, however,
employers say a robust employee health benefits package can also help lower health
benefit expenditures—thanks largely to things like proactive health screenings and
wellness programs. Overall improvement in employee safety is another plus.
HIGHLIGHTS
77%
OF RESPONDENTS CONSIDER THE
DELIVERY OF INNOVATIVE HEALTH
BENEFITS TO BE A KEY FACTOR IN A
COMPANY’S COMPETITIVENESS.
57%
OF RESPONDENTS SAY THE NUMBER
OF HEALTH BENEFITS PROGRAMS IS
ON THE RISE.
51%
OF THE ORGANIZATIONS SURVEYED
EXPECT HEALTH BENEFITS TO
BE AN EVEN HIGHER STRATEGIC
PRIORITY THAN THEY ARE TODAY.
In the past two years, KPMG Canada has completely overhauled the way it delivers
its health benefits to employees, consolidating benefits from more than 20 different
health, fitness, and lifestyle service providers into an enterprise health operating
system that enables workers to access their full range of benefits from a single
online portal. The new system also allows KPMG to more efficiently collect and
analyze data about employees’ benefit usage, engagement, and other factors.
The new benefits system reflects the professional services and accounting firm’s
philosophy that health benefits and their delivery is about enhancing “the full
employee experience,” Park says.
Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
Harvard Business Review Analytic Services
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Employer-Employee Disconnect
FIGURE 1
BENEFITS BEYOND EMPLOYEE HEALTH
Percentage of respondents who agree or disagree with the following statements [TOP 3]
•
AGREE
•
DISAGREE
Health benefits demonstrate that an organization understands and cares for the needs and wants of its employees
92%
5%
Delivering innovative employee health benefits plays a key role in determining my organization’s competitiveness
77%
13%
The number of health benefits programs at my organization is increasing
57%
26%
SOURCE: HARVARD BUSINESS REVIEW ANALYTIC SERVICES SURVEY, JULY 2019
For all these reasons, executive
attitudes toward employee health
benefits are beginning to shift, says
Brian Marcotte, president and CEO at
the National Business Group on Health,
a Washington, D.C.-based nonprofit
organization that represents more
than 400 large, multi state employers’
perspectives on national health
policy issues.
“Before, it was all about controlling
costs, but now, we’re seeing an
evolution toward health benefits
playing a bigger role in overall
workforce strategy. Health benefits
now are all about engaging a productive
workforce,” Marcotte says. “At our
annual summit, we asked employers
what keeps people up at night, and the
number one answer was the ability to
engage people with health benefits.
I fully expected it to be high claims
costs or the cost of special prescription
drugs, but the number one answer was
employee engagement.”
LARGE NUMBERS OF EMPLOYEES LACK THE
KNOWLEDGE THEY NEED TO CHOOSE THE HEALTH
BENEFIT PROGRAM THAT BEST SUITS THEM.
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Harvard Business Review Analytic Services
Several factors are driving
organizations to view their health
benefits as a competitive advantage
and expand the package they offer.
One big factor is the keen competition
for talent in today’s extremely tight
labor market. The U.S. unemployment
rate stood at 3.7 % in July, the lowest in
nearly 50 years. Offering employment
candidates attractive health benefits
can give a potential employer a
competitive hiring advantage, experts
say. Several recent research surveys
indicate that a majority of employees
favor generous health and well-being
benefits over salary increases. For
example, in a 2018 survey conducted
by the American Institute of Certified
Public Accountants, four out of five
respondents said they would choose a
job with benefits over an identical job
that offered 30% more salary but no
benefits.2
Over the next three years, more
than half (51%) of the organizations
surveyed expect health benefits to
be an even higher strategic priority
than they are today. But employees
see things differently. At 63% of
organizations, respondents say
employees don’t know enough about
how to leverage their companyprovided health benefits. More than
half—58%—of organizations report
that employees are unaware of the
health benefits to which they are
entitled.
What’s more, large numbers of
employees lack the knowledge they
need to choose the health benefit
program that best suits them. Well
under half (41%) of organizations report
that employees are qualified to choose
the plan that is right for them. Just
over one-third (35%) consider their
employees knowledgeable about the
quality and cost of health care. Lacking
such awareness, employees fail to fully
exploit the value of employer-provided
health benefits, making it more difficult
to move the needle on employee
engagement.
Practitioners say a big part of the
underutilization problem is the
inherent complexity of health benefits
programs and policies.
Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
Practitioners say a big part of the underutilization problem is the
inherent complexity of health benefits programs and policies.
“Health care is such a complex
and changing subject, and health
insurance is also so complex,”
notes Suzanne Goulden, director
of total rewards and analytics at
the Alexandria, Va.-based Society
for Human Resource Management,
the world’s largest professional
association for human resource
professionals. “There are some things
an employee only needs once in a
while and they may not realize their
health insurance offers it.”
Typically, employees learn about the
health and other benefits available
to them during an employment
orientation session early in their
tenure with a company. After that,
they may have access to benefit
information via a handbook or online
system, or possibly during a companysponsored wellness event, but the
information frequently recedes into
the background as the employee
becomes more engaged in their work.
Human resources departments can
send out benefit reminders, but
if they’re sent out too frequently,
they become background noise,
Goulden notes.
Often, the only result is relatively
low usage of benefits the company
does provide that could help boost
employee health. Free flu vaccinations
or regular blood pressure screenings
are just two examples of companyoffered health and wellness benefits
an employee might pass up due to a
lack of awareness.
FIGURE 2
LACK OF AWARENESS STRANDS VALUE OF BENEFITS
Percentage of respondents who agree or disagree with the following statements
•
AGREE
•
DISAGREE
Don’t know enough about how to leverage their company-provided health benefits
63%
24%
Are unaware of health benefits to which they are entitled
58%
29%
Can easily leverage their company-provided health benefits
57%
23%
Encounter little to no friction in the process of using their company-provided health benefits
42%
44%
Are knowledgeable about which health benefits plan is right for them
41%
37%
Are knowledgeable about the quality and cost of health care
35%
50%
Actively engage with all of the health benefit programs offered
28%
57%
Typically use the full range of health benefits to which they are entitled
27%
58%
Value health benefits over pay
25%
51%
Fully comprehend the value of their company-provided health benefits
24%
65%
SOURCE: HARVARD BUSINESS REVIEW ANALYTIC SERVICES SURVEY, JULY 2019
This lack of awareness and knowledge
is reflected in fairly low engagement
levels with health benefit programs
overall. Just 28% of respondents say
that employees actively engage with
all of the health benefit programs
offered. Employees use the full range
of health benefits to which they are
entitled at slightly more than onequarter (27%) of organizations. FIGURE 2
Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
Harvard Business Review Analytic Services
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FIGURE 3
TECHNOLOGY OVERLOAD
Number of different touch points organization’s employees interact with to inform themselves
about and leverage their various health benefits programs
A single system does it all
10%
1 to 3 touch points
46%
3 to 5 touch points
21%
More than 5 different touch points
13%
Don’t know
9%
SOURCE: HARVARD BUSINESS REVIEW ANALYTIC SERVICES SURVEY, JULY 2019
Negative Impacts
Low awareness, knowledge, and
engagement often have far-reaching
deleterious effects, resulting in
higher overall health care costs,
poorer employee health, employee
absenteeism, and lower productivity.
ORGANIZATIONS WHERE
EMPLOYEES CAN LEARN
ABOUT AND ACCESS
THEIR BENEFITS
THROUGH A SINGLE
SYSTEM ARE A RARITY.
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But even if an employee is aware
of health benefits and tries to
engage, gaining easy access to the
necessary information is often
difficult. To learn about their full
range of health benefits, employees
at most organizations must use
multiple systems. Organizations
where employees can learn about
and access their benefits through a
single system are a rarity; just 10% of
organizations have a single system.
Almost half (46%) of respondents
use up to three systems, and at 21%
of organizations, employees use
as many as five of them. At 13% of
organizations, employees use more
than five different systems to access
their benefits. FIGURE 3
At KPMG Canada, Park says new
single-access technology was a “key
element” in the company’s health
benefits redesign. “Ensuring that
everything was in one place and
was simple to access was extremely
important,” she asserts, adding that
it was the first step in making the
employee health experience “more
consumerized.”
Moreover, many of the systems
employees can access are geared more
toward insurance providers and are
more transactional. In other words,
their design isn’t friendly to consumers
or employees. This mismatch can make
for a frustrating and cumbersome
employee experience with employerprovided health benefits. It may also
require the frequent intervention
of HR and benefits professionals to
answer employee questions or expedite
various transactions, taking these
professionals away from more strategic,
higher-value work. Two-thirds (67%)
of organizations say HR staff routinely
answer basic health benefits questions
from employees about coverage, outof-pocket maximums, and co-pays,
among other things. At 64% of
organizations, HR is under pressure
to automate as much as possible as
a way to scale programs and control
costs. This may help explain why,
at 41% of organizations, HR doesn’t
have the time or resources to perform
more strategic activities, like exploring
innovative benefit offerings.
Multiple benefits systems also work
to hamper the efficient collection
and analysis of usage data and
other metrics that employers use
to determine the effectiveness of
various benefit offerings. Currently,
two factors—benefit program costs
and employee engagement—figure
prominently into how organizations
measure the effectiveness of their
employee health benefit programs.
Fifty-nine percent of organizations look
at total spend, 58% study how total
spend changes year to year, and 54%
examine employee engagement with
health benefits programs. Other factors
companies measure include the health
and well-being of employees, hiring
and retention progress, and how their
total spending on health care benefits
compares to that of similar companies.
Forty-one percent of organizations
consider employee satisfaction scores
when measuring the effectiveness of
their health benefits strategy. FIGURE 4
Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
MULTIPLE BENEFITS SYSTEMS HAMPER
THE EFFICIENT COLLECTION AND ANALYSIS
OF USAGE DATA AND OTHER METRICS
THAT EMPLOYERS USE TO DETERMINE THE
EFFECTIVENESS OF VARIOUS BENEFIT OFFERINGS.
Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
Harvard Business Review Analytic Services
5
Reengineering the Health
Benefits Experience
FIGURE 4
MEASURING WHAT MATTERS
Benefits spending still tops the chart
Factors organizations consider when measuring the effectiveness of their health benefits strategy
Total spend
59%
How our total spend changes year to year
58%
Employee engagement with health benefits programs
54%
The health and well-being of our employees
Virtually all organizations are
looking to close the gap between
health benefits spending and the
value employees derive from them,
according to National Business
Group’s Marcotte. To accomplish that
feat, two clear trends are emerging.
The first is a growing emphasis on
making access to health benefits more
consumer-friendly. The second is
“delivering benefits information and
benefits resources in moments that
matter,” he notes.
“We’ve seen a big growth in concierge
services—whether digitally or with
a human touch—which involves
putting all benefit resources behind
a single concierge wall,” Marcotte
explains. “Any question related to
benefits or navigating the system or
managing a decision about a provider
is all provided in a single place where
the employee can go. The goal is to
not drop the consumer during their
health journey.”
43%
Hiring and retention data
42%
How our total spend compares to that of similar companies
42%
Employee benefit satisfaction scores
41%
Absenteeism
18%
We don’t have the necessary data to measure the impact of our health benefits strategy
Imagine a single point of digital access
for health benefits, complete with
recommendations about what to use
next—something similar to Amazon’s
recommendations based on other
customers’ purchases. For example,
an employee in search of maternity
or paternity leave benefits might also
be presented with available child care
benefits, details about the company’s
telework policy, and the location of
lactation sites at the workplace.
4%
SOURCE: HARVARD BUSINESS REVIEW ANALYTIC SERVICES SURVEY, JULY 2019
By amassing data about things like
employee claims and prescription
drug data and using artificial
intelligence to analyze it, employee
benefits systems could also anticipate
workers’ demands, presenting them
with the information they need when
they need it.
“THE INTENT IS TO CURATE INFORMATION AT THE
MOMENTS THAT MATTER.” BRIAN MARCOTTE,
PRESIDENT AND CEO, THE NATIONAL BUSINESS
GROUP ON HEALTH
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Harvard Business Review Analytic Services
“The intent,” Marcotte says, “is to
curate information at the moments
that matter” so employees are aware
of the full breadth of benefits available
to them for a particular circumstance
on their health journey. Today, one
of the biggest challenges employees
face is having to navigate a multitude
of point solutions to get to all of the
Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
benefits that apply. There is no front
door to the full benefits experience.
KPMG Canada’s new system
consolidates what previously were
20 distinct benefit programs into a
single benefits package, and allows
employees to choose—up to a certain
benefit amount—which programs
are valuable to them. Employees
then self-select what they want and
need at any given point from benefits
covering child and elder care, health
and wellness, financial well-being, and
other services.
“Given the multi generational
workforce, different employees have
different needs at different points in
their lives,” Park says. “We focused
on well-being in general and provide
programs for wherever you are in life,
and let them choose. It’s really about
holistic wellness.”
CONCLUSION
Toward a More Holistic Health
Benefits Experience
As employers embrace workforce
strategies that emphasize the
connection between health benefits
and broader business goals such as
employee recruitment and retention,
experts anticipate two positive
results. First, employees will realize
significantly greater value from the
health benefits their employers offer,
and second, employers will streamline
benefits packages, better tailoring
them to reflect services employees
need and use regularly. The anticipated
result, Marcotte says, is an increase in
overall employee wellness plus better
management of companies’ health
benefits spending.
Increased use of tools and technologies,
notably data analytics and artificial
intelligence, can help employers close the
gap between health benefits spending and
overall employee well-being.
programs and benefits that best
suit them while helping employers
manage costs.
A single user access point, or
“front door,” resonates with survey
respondents. Some 78% of respondents
at organizations with single access
points report that employee
engagement with their health benefits
either already has increased or will
increase. At the same time, 86%
of organizations agree that better
matching employees to health benefits
and programs that best suit them helps
control costs at their organization.
Given the competitive repercussions
that organizations feel health benefits
packages can cause, it behooves them
to make sure not only that employees
are taking advantage of what the
company is paying for, but that the
company is also designing a program
that workers will engage in. It’s at that
point that financial and health wellbeing for all involved will converge.
Increased use of tools and
technologies, notably data analytics
and artificial intelligence, can help
employers close the gap between
health benefits spending and overall
employee well-being. Implementing a
single, consumer-like access point to
all employee health benefit programs
would help employees identify the
Endnotes
1 https://www.kff.org/report-section/2018-employer-health-benefits-survey-section-6-worker-and-employer-contributions-for-premiums/
2 https://www.aicpa.org/press/pressreleases/2018/americans-favor-workplace-benefits-over-extra-salary.html
Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
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METHODOLOGY AND PARTICIPANT PROFILE
A total of 238 respondents drawn from the HBR audience of readers (magazine/
enewsletter readers, customers, HBR.org users) completed the survey.
SIZE OF ORGANIZATION
ALL RESPONDENTS’ ORGANIZATIONS HAD 500 EMPLOYEES OR MORE.
18%
500 – 999
EMPLOYEES
33%
11%
1,000 – 4,999
EMPLOYEES
38%
5,000 – 9,999
EMPLOYEES
10,000 OR MORE
EMPLOYEES
SENIORITY
70%
SENIOR
MANAGEMENT
19%
EXECUTIVE
MANAGEMENT/
BOARD MEMBERS
KEY INDUSTRY SECTORS
OTHER INDUSTRIES WERE LESS THAN 7% OF THE TOTAL
21%
HEALTH CARE
13%
11%
FINANCIAL SERVICES MANUFACTURING
8%
7%
EDUCATION
GOVERNMENT/
NOT-FOR-PROFIT
JOB FUNCTION
OTHER FUNCTIONS WERE LESS THAN 5% OF THE TOTAL
18%
HR/TRAINING
12%
GENERAL/
EXECUTIVE
MANAGEMENT
9%
ADMINISTRATION
9%
FINANCE/RISK
7%
SALES/BUSINESS
DEVELOPMENT/
CUSTOMER
SERVICE
6%
5%
5%
OPERATIONS/
MARKETING/PR/ PROFESSIONAL
PRODUCTION/
COMMUNICATIONS SERVICES
MANUFACTURING
5%
STRATEGIC
PLANNING
Figures may not add up to 100% due to rounding.
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Pulse Survey | Better Health Starts with an Employee-Centered Benefits Experience
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