Cdph poll final

Sponsored by AETNA June 29, 2011

SHRM Poll: The State of Consumer-Directed Health Plans in the Workplace

The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011 2

Key Findings

How do organizations decide which health care benefits to offer? The most important (“somewhat important” or “very important”) considerations in selecting health care benefits were: 1) adopting new options that help contain costs for the organization (99%), 2) offering a health care benefits plan that provides a broad network of participating physicians and hospitals (98%), 3) adopting new options that help contain costs for employees (98%), and 4) providing 100% coverage for preventive care, including annual physicals and health screenings (95%).

Over the past three to five years, which cost-cutting measures have organizations implemented in relation to health care benefits? As the costs of health care continue to spiral upward, employees and employers are searching for ways to keep these costs under control and as manageable as possible. The top reported cost-cutting measures related to health care benefits was asking employees to share more of the cost of health care benefits (77%). This was followed by switching insurance carriers to find the most competitive rates (47%) and offering consumer-directed health plans (CDHPs) (41%).

Are companies leveraging consumer-directed health plans (CDHPs)? Yes; 42% of organizations offered a CDHP option for employees. Large-staff-sized organizations, publicly owned for-profit companies and firms with multinational operations locations were more likely to offer this plan. Among organizations that offered a CDHP, 75% offered health savings accounts (HSAs) and 47% provided health reimbursement arrangements (HRAs). *

How comfortable are HR professionals with their level of knowledge about CDHPs? In general, HR professionals were not entirely comfortable with their present level of knowledge about CDHPs: only 42% responded either “agree” or “strongly agree” when asked if they were comfortable with their level of knowledge. However, HR professionals from organizations that offered a CDHP were significantly more likely to agree (“agree” or “strongly agree”) they were comfortable with their knowledge level (55%) compared with organizations without this plan in place (34%).

*According to SHRM’s 2011 Employee Benefits Research Report, 35% of companies provided health savings accounts (HSAs) and 21% offered health reimbursement arrangements. The State of Consumer-Directed Health Plans in the Workplace poll specifically examined the relationship between HSAs and HRAs among organizations offering CDHPs.


Key Findings

Do CDHPs help engage employees in their own health and wellness? Among respondents that offered a CDHP, 77% responded either “strongly agree” or “agree” that doing so has helped engage employees in their own health and wellness.

What are the barriers preventing organizations from offering CDHPs? Among companies without a CDHP, the primary reasons for not offering the option were: 1) management wants to maintain the status quo since most employees are satisfied with the current health care benefits plan (49%), 2) management believes CDHPs will not save enough money to merit offering this type of plan (27%), and 3) not have enough information about the benefits of CDHPs (26%).

The State of Consumer Directed Health Plans in the Workplace| ©SHRM 2011

In terms of a total compensation and benefits package, how important are each of the following to employees at your organization?

Vision insurance

Life insurance

Long- and short-term disability

Dental insurance

Employer match for defined contribution plan

Sick days

Prescription drug coverage

Vacation days

Health care benefits

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

21%

16%

15%

5%

8%

11%

1%

1%

1%

54%

52%

48%

39%

31%

28%

14%

11%

5%

24%

32%

38%

56%

61%

62%

85%

88%

95%

Not Very Important / Not At All Important Somewhat Important Very Important

4

Note: n = 836-853. “Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “very important" responses.


In terms of health care coverage, how important are each of the following to employees at your organization?

Online tools with very specific information about health provider cost and quality ratings

Online tools with basic information to help educate employees

A tax-free fund of money to help pay for health care expenses

No referrals for specialty care

100% coverage for preventive care

Low out-of-pocket costs for prescription drug coverage

A broad network of participating physicians and hospitals

Low out-of-pocket costs for health care

0% 20% 40% 60% 80% 100%

34%

32%

22%

13%

2%

1%

2%

1%

49%

50%

50%

49%

31%

24%

21%

21%

18%

19%

27%

37%

66%

74%

77%

78%

Not Very Important / Not At All Important Somewhat Important Very Important

5

Note: n = 806-852.“Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “very important" responses.


How important are each of the following to your organization when deciding which health care benefits to offer to employees?

Providing options that give employees control of their health care funds

24x7 access to credible health-related information and tools to educate employees and help them get the most from their health care benefits

Disease management programs for chronic conditions like diabetes and heart disease

100% coverage for preventive care, including annual physicals and health screenings

Adopting new options that help contain costs for employees

Offering a health care benefits plan that provides a broad network of participating physicians and hospitals

Adopting new options that help contain costs for the organization.

0% 20% 40% 60% 80% 100%

15%

14%

10%

5%

2%

2%

1%

43%

43%

44%

29%

23%

21%

13%

42%

43%

46%

66%

75%

77%

86%

Not Very Important / Not At All Important Somewhat ImportantVery Important

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Note: n = 822-840. “Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “very important" responses.


Over the past three to five years, which of the following cost-cutting measures has your organization utilized to contain health care benefits costs?

Nothing

Other

Eliminating some (or even all) of the overall benefits that are offered to employees (i.e., the benefit no longer exists/is completely gone)

Reducing the scope and/or amount of overall benefits offerings from prior levels

Offering consumer-directed health plans (health savings accounts and/or health reimbursement arrangements)

Periodically switching insurance carriers to find the most competitive rates

Asking employees to share more of the cost of health care benefits--whether in the form of higher monthly premiums or out-of-pocket costs (e.g., deductibles, co-insurance)

5%

2%

15%

35%

41%

47%

77%

Note: n = 861. Totals do not equal 100% due to multiple response options.


Based on your experience with your own organization and its employees, do you agree or disagree with each of the following statements?

Our employees take an active role in choosing a health care benefits plan that will work for their unique needs.

It is a challenge to engage our employees in understanding how the health care benefits plan works.

It is a challenge to engage our employees in getting the best value from their health care benefits plan. It is a challenge to encourage our employees to focus on their

health and wellness.

Our employees consider their health care benefits to be an important part of their overall total compensation and benefits package.

0% 20% 40% 60% 80% 100%

44%

25%

23%

6%

43%

47%

44%

26%

13%

29%

33%

68%

Somewhat Disagree / Strongly Disagree Somewhat Agree Strongly Agree

8

Note: n = 827 - 846.“Not sure” responses were excluded from this analysis. Percentages may not total 100% due to rounding. The figure is sorted by “strongly agree" responses.


Do you agree with the following statement: “I am comfortable with my level of knowledge about consumer-directed health plans (CDHPs).”

Strongly Disagree

Disagree

Agree

Strongly Agree

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

15%

43%

35%

7%

Note: n = 821. “Not sure” responses were excluded from this analysis.


Does your organization currently offer consumer-directed health plans (CDHPs)?

Yes; 42%

No; 58%

Note: n = 838. “Not sure” responses were excluded from this analysis.


Does your organization currently offer consumer-directed health plans (CDHPs)?

1-99 employees = 32%100-499 employees = 41%

500-2,499 employees = 38%

2,500-24,999 employees = 60%25,000 and above = 63% Larger organizations > smaller organizations

Comparisons by organization staff size:Compared with smaller organizations (2,499 employees or fewer), larger organizations (2,500 or more employees) were more likely to offer a CDHP.

Publicly owned for-profit = 55%

Privately owned for-profit = 40%Nonprofit = 39%

Government = 33%

Publicly owned for-profit organizations > privately owned for-profit organizations, nonprofit organizations

and government agencies

Comparisons by organization sector:Publicly owned for-profit organizations were more likely to offer CDHPs than privately owned for-profit organizations, nonprofit organizations and government agencies.

Multinational operations = 54% U.S.-only operations = 39% Multinational operations > U.S.-only operations

Comparisons by operations location:Organizations with multinational operations were more likely than organizations with U.S.-only operations to offer a CDHP.


Does your organization currently offer any of the following consumer-directed health plans (CDHPs)?

Health reimbursement arrangements (HRAs)

Health savings accounts (HSAs)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

47%

75%

Note: n = 344. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis.


Does your organization currently offer any of the following consumer-directed health plans (CDHPs)?

Multinational operations = 59% U.S.-only operations = 44% Multinational operations > U.S.-only operations

Health reimbursement arrangements (HRA) comparisons by operations location:Organizations with multinational operations were more likely than organizations with U.S.-only operations to offer HRAs.


How easy or difficult is it to explain the concept of consumer-directed health plans (CDHPs) to employees?

Very Difficult

Somewhat Difficult

Somewhat Easy

Very Easy

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

11%

38%

44%

8%

Note: n = 342. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis. Percentages do not total 100% due to rounding.


Do you feel equipped to explain consumer-directed health plans (CDHPs) as a health insurance option to the following groups?

Yes, feel equipped to explain CDHPs to employees

Yes, feel equipped to explain CDHPs to management

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

86%

90%

Note: n = 322-323. Organizations that did not offer consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis.


Has your insurance carrier provided you with the information you need to help educate the following groups about consumer-directed health plans (CDHPs)?

Yes, insurance carrier provided information needed to help educate employees

Yes, insurance carrier provided information needed to help educate management

81%

82%



Do you agree that offering a consumer-directed health plan (CDHP) has helped engage your employees in their own health and wellness?

Strongly Disagree

Disagree

Agree

Strongly Agree

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

6%

17%

53%

24%



Which of the following best describe your organization’s reasons for not offering consumer-directed health plan options?

Other

Management has difficulty understanding CDHPs.

Health care broker/consultant has not brought up CDHPs as an option for my organization.

Do not have enough information about the benefits of CDHPs.

Management believes CDHPs will not save enough money to merit offering this type of plan.

Management wants to maintain the status quo since most employees are satisfied with current health care benefits plan.

2%

17%

20%

26%

27%

49%

Note: n = 456. Organizations that offered consumer-directed health plans (CDHPs) and “not sure” responses were excluded from this analysis. Totals do not equal 100% due to multiple response options.


Demographics: Organization Industry

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Industry PercentageManufacturing 19%Health care and social assistance 15%Professional, scientific and technical services 13%Finance and insurance 10%Educational services 7%Public administration 5%Retail trade 4%Arts, entertainment and recreation 3%Construction 3%Information 3%Wholesale trade 3%Accommodation and food services 2%Religious, grantmaking, civic, professional and similar organizations 2%Utilities 2%Transportation and warehousing 2%

n = 861. Totals do not equal 100% due to multiple response options. * = Less than 1%.


Demographics: Organization Industry (continued)

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Industry PercentageAdministrative and support and waste management and remediation services 1%Agriculture, forestry, fishing and hunting 1%Mining 1%Real estate and rental and leasing 1%Repair and maintenance 1%Management of companies and enterprises *Personal and Laundry Services *Other services, except public administration 10%

n = 861. Totals do not equal 100% due to multiple response options. * = Less than 1%.


Demographics: Organization Sector

Government sector

Publicly owned for-profit organization

Nonprofit organization

Privately owned for-profit organization

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

10%

19%

20%

51%

21

n = 859.


Demographics: Organization Staff Size

1 to

99

emplo

yees

100

to 4

99 e

mplo

yees

500

to 2

,499

em

ploye

es

2,50

0 to

24,

999

emplo

yees

25,0

00 o

r more

em

ploye

es0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

25%

39%

18%13%

5%

22

n = 859.


Demographics: Other

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n = 860.

U.S.-based operations only 83%

Multinational operations 17%

Single-unit company: A company in which the location and the company are one and the same

41%

Multi-unit company: A company that has more than one location

59%

Corporate (companywide) 73%

Business unit/division 16%

Facility/location 12%

Is your organization a single-unit company or a multi-unit company?

Are HR policies and practices determined by the multi-unit corporate headquarters, by each work location or both?

Does organization have U.S.-based operations (business units) only or does it operate multinationally?

n = 861.

n = 503. Percentages do not total 100% due to rounding.


SHRM Poll: The State of Consumer-Directed Health Plans in the WorkplaceSponsored by AETNA

Response rate = 14% Sample composed of 861 randomly selected HR professionals form

SHRM’s membership database with the job title of manager and above

Margin of error is +/- 4% Survey fielded June 8th - June 20th, 2011

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Methodology

For more poll findings, visit www.shrm.org/surveys

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Cdph poll final

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