Insights and easy action steps that can help enhance your benefits strategy

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1 New research reveals why value extends beyond employees: accident and critical illness insurance are surprisingly good for business! Insights and easy action steps that can help enhance your benefits strategy ADF# AI-CI521.14

2 Table of Contents The Financial Impact of an Accident or Critical Illness... 3 Three Key Findings Every Employer Should Know to Implement, Communicate, and Maximize Voluntary Accident and Critical Illness Insurance... 5 A Checklist to Implement Voluntary Accident and Critical Illness Insurance Research Methodology In August and September of 2013, MetLife sponsored two online surveys, conducted by GfK to measure the awareness of accident and critical illness insurance and the financial impact that an accident or a critical illness can have on a typical U.S. household. The first survey, the MetLife Accident and Critical Illness IQ Study, featured interviews with 1,000 respondents, ages 25 to 55, including 441 people who work full-time. The second survey, the MetLife Accident and Critical Illness Impact Study, featured interviews with 2,017 respondents (1,017 Critical Illness and 1,000 Accident), ages 25 or older who were affected by an accident or critical illness between six months and five years prior to the survey as follows: Households that experienced any of the following accidents broken/ fractured bones, dislocation, burns, skin grafts, concussion, coma, ruptured disc (with surgical repair), torn cartilage (in knee), lacerations, torn ruptured or severed tendon, ligament or rotator cuff, broken tooth or eye injury counted towards the accident quota Households that experienced any of the following diseases cancer, heart attack, stroke, organ transplant, kidney failure or Alzheimer s counted towards the critical illness quota A key requirement to participate in the study was that the individual for whom the survey questions were intended had health insurance at the time of diagnosis. Additional research conducted in October 2013 by GfK, sponsored by MetLife, included 21 in-depth phone interviews with respondents from the MetLife Accident and Critical Illness Impact Study who had experienced an accident or a critical illness. 2

3 The Financial Impact of an Accident or Critical Illness Americans Are Not Prepared Many people are concerned about experiencing an accident or a critical illness however they may be financially unprepared to address the situation when it occurs. The need is apparent; the average employee s share of health care costs has increased more than 50% over the last five years. 1 With higher premiums and the growth of high deductible health plans, few are immune to the financial burden of paying increased contributions to their medical benefits and many feel the pain of footing a larger share of their health-related expenses. Even with disability benefits alongside medical coverage families may not be prepared for the financial impact when facing an accident or critical illness. Out-of-pocket costs associated with an unexpected health issue can be as high as $4,112 for an accident and $14,444 for a critical illness, according to MetLife survey respondents. 2 Moreover, the lost income from taking time off from work can put a significant burden on a household, as 41% of survey respondents already describe themselves as living paycheck-to-paycheck and fewer than half (46%) have a savings cushion of three months salary. 3 Many people underestimate the financial impact of an accident or critical illness, especially lost income, which averaged $26,900 and $50,600, respectively among MetLife survey respondents. 4 The number of people with health savings accounts/high-deductible health coverage rose to nearly 15.5 in January 2013, up from 13.5 in January 2012 and 11.4 in January 2011; an annual growth rate of approximately 15 percent over the last several years

4 What Benefits Employees, Benefits the Company The case for offering voluntary accident and critical illness insurance alongside existing medical and disability to help employees cope with rising health care costs and lost income gaps is logical and widely accepted. Accident and critical illness coverages can undoubtedly help bridge these gaps, and for many employers this is probably justification enough for adding one or both at annual enrollment. TO AVOID THE 40% EXCISE TAX on high-cost medical plans in 2018, employers are shifting their benefit strategies, with some considering a move toward consumer-driven health plans (CDHP). In a survey by Aon Hewitt, one in 10 employers who offer a CDHP supports employees by offering additional voluntary supplemental medical offerings such as critical illness coverage. This allows employees to determine how they want to manage their risk when enrolling in a high-deductible plan. Nearly half of employers (44%) report plans to consider such an approach in the next three to five years. 6 However, employers may have overlooked a different and important reason for offering accident and critical illness insurance. What is good for employees is also good for the company. New MetLife research reveals that, in addition to helping employees with their personal financial challenges, offering accident and critical illness insurance is a surprisingly effective way to help companies solve their own business challenges. In a recent MetLife employee survey on accidents and critical illness, nearly 6 out of 10 employees reported that they would feel positive about their employers if they offered accident and/or critical illness insurance. 7 Why is this important? When employees are satisfied with their benefits they are much more satisfied with their jobs and loyal to their employer, and more likely to recommend their company as a great place to work than those who are less satisfied. 8 Benefits are the glue that helps vital talent stick with the company. And, MetLife s surveys have indicated that employees see accident and critical illness insurance as valuable offerings from their company. Employees who are very satisfied with benefits are much more satisfied with their jobs, loyal, and would recommend their company as a great place to work. 8 Very satisfied with my job I am very loyal to my employer I would recommend my company as a great place to work 0 Employees who are very satisfied with their benefits 80% Employees who are very dissatisfied with their benefits 4

5 Three Key Findings Every Employer Should Know to Implement, Communicate, and Maximize Voluntary Accident and Critical Illness Insurance Offering accident or critical illness insurance alongside other benefits during enrollment is a great place to start to help meet employee and company needs. However, simply adding them to the enrollment ballot will not by itself lead to financial preparedness, satisfaction, or loyalty. Employees must recognize the advantages of these offerings before they open their wallets. They will want to know how the products work, how their families can benefit from them, and how they fit with their other benefits. Therefore, it is important that employers raise awareness and demonstrate value. The following three key findings are easy to address and can help boost employee recognition of accident and critical illness insurance as desirable and valuable benefits. Employers who are planning to add these benefits should consider putting these recommendations into action to facilitate participation in and satisfaction with the coverages. At the same time, employers who already offer the benefits would do well to assess these findings to help enhance their current programs, especially if participation is lower than expected; a sign that employees may not be taking full advantage of the options that they have available to them. 1 Provide Choice. Employees Value Choice of Voluntary Benefits Offering a wide variety of voluntary products increases the power of the voluntary benefits program to drive employee loyalty. 9 In fact, 59% of employees surveyed reported they would value a greater variety of benefits to choose from and 62% want a scenario where benefits are geared to their individual circumstances. 10 Further, nearly 40% of surveyed employees say I am willing to bear more of the cost of my benefits in order to have a choice of benefits that meets my needs. 11 Nearly 6 out of 10 employees surveyed reported that they would feel positive about their employers if they offered accident or critical illness insurance. 12 5

6 Diverse Needs Indicate a Variety of Solutions Accident and critical illness insurance may be relevant for employees at different ages and life stages, so it is important to offer both. In general, younger people and employees with children at home are more likely toward be drawn to accident coverage while employees at midlife and beyond the years where serious illnesses, such as strokes and heart attacks become more commonplace may lean to critical illness coverage. Of course, a family history of serious illness may influence these guidelines, as would adult participation in riskier sports activities. Older adults also become more vulnerable to accidents. In these instances owning accident and critical illness insurance could be desirable. Recognizing the importance of providing both options, more carriers are offering integrated implementation to make adding them even easier. Together, accident and critical illness insurance help address gaps left by existing coverage and help meet diverse protection needs. Scenarios that may indicate an employee s preference for accident and/or critical illness coverage Gen X and Gen Y * Younger and Older Boomers ** Employees age <49 Accident N/A Employees age 49+ N/A Critical Illness Not confident that rainy day funds/savings could cover out-of-pocket expenses from a typical accident Accident Accident Not confident that rainy day funds/savings could cover out-of-pocket expenses from a critical illness Critical Illness Critical Illness Medical coverage is a high deductible plan Accident Critical Illness Medical plan has a low deductible Accident Critical Illness Owns Long-term disability insurance Accident Critical Illness Owns Short-term or no disability insurance Accident Critical Illness Employee is currently healthy Accident Critical Illness Employee has a family history of serious illness Critical Illness Critical Illness * Gen X b , Gen Y b ** Older Boomers b , Younger Boomers, b

7 2 Raise Awareness and Counteract Confusion. Worried but Unaware of the Remedy Employees definitely think about the prospect of accidents and critical illnesses. In fact, 50% of respondents are worried about the impact of an accident. 13 And, six in ten (60%) are worried about the financial impact of a critical illness on their families. 14 However, half of the worried respondents (50%) are unaware of the potential solution provided by critical illness insurance. 15 Clearly, when bringing these benefits on board, the top priority should be to ensure that benefit communications raise employee awareness that solutions are available. Turn Misconceptions into Clarity A crucial issue revealed by the MetLife research is that employees too often confuse accident and critical illness insurance with traditional health coverages such as medical and disability insurance, even among those who claim awareness or believe they already own accident or critical illness insurance. In the MetLife survey, only 38% selected the correct definition for accident insurance. 16 And, 60% of the surveyed employees who claim to be aware of critical illness insurance were unable to identify the correct product definition from a prompted list. 17 Even more disturbing, is that 44% of those who believed they own the product confused it with medical insurance. 18 As employees are being asked to take more responsibility for choosing and paying for their benefits, there is an increased potential for confusion. They must become smart benefit consumers instead of benefit recipients. Employers must not only effectively communicate the differences between voluntary supplemental benefits and the other medical and disability coverages they offer, but they also need to show how the range of benefits complement each other and act together to strengthen the total safety net. Using preferred and effective methods and channels to inform and educate employees is important. Many carriers and brokers understand these education challenges and are ready to help with proven communications and tools and supportive on-site expertise. When the correct definition is provided, surveyed employees find the benefit concepts very appealing: 76% find accident insurance appealing and 74% find critical illness insurance appealing. 19 7

8 Underestimating the Scope and Value The MetLife study also reveals that many employees seriously underestimate the scope, flexibility and ease of use of these benefits. For example, 85% and 83% of respondents were not aware of everything covered under accident and critical illness coverage, respectively. 20 This kind of misunderstanding impacts the perceived value of a product. Indeed, the overly narrow interpretation could even lead to the perception that it is not worth the price. Appreciating the full worth of a product helps put premium costs in perspective. As such, increasing awareness and understanding of how these products work is key to implementing a successful program. If I had coverage so that I could have paid somebody to come in and help with my house, help with my personal care, have a few extra dollars to pay somebody to mow my lawn and stuff like that, go to grocery store for me, run errands for me then I wouldn t have been stuck with an $11,000 bill, it would have covered that. Male, suffered a stroke. 3 Alert Employees to Risk and Resource Realities. Protection? Who Needs It! As with many risks in life, employees would often prefer to bury their heads in the sand. When it comes to accidents nearly one in five (19%) reported that I don t worry about stuff that may or may not happen. 21 As for critical illnesses, 16% of surveyed employees reported that I am healthy enough that I don t need to worry about critical illness right now. 22 Yet, approximately 1.6 new cases of cancer are expected every year alone. 23 Employee education about these risks should not use scare tactics but there is a need for a reality check. Employees frequently believe that financial risks from accidents and critical illnesses are sufficiently covered by other insurances that they carry. However, a key lesson learned by those who experienced an accident or critical illness was that their existing policies left them with surprising out-of-pocket gaps and lost income to fill. It has cut our income enough that we had to make a lot of changes in things just everyday things things we can t buy for the kids, clothes just, you know, having to cut back on everyday expenses. Makes it harder to get through the month, that s for sure. Female whose husband had a heart attack. 8

9 Understanding the Potential Financial Cost of an Accident or Critical Illness Potential out-of-pocket costs for an accident or critical illness include medical expenses due to co-pays and deductibles and non-medical expenses such as travel, childcare, and house-hold help. The MetLife survey shows that those who experienced an accident reported average out-of-pocket costs of $1,226, rising to maximum costs of $4,112 for an accident where the financial burden was major or devastating. 24 However, it is important to remember that accidents can occur frequently especially with several children in the family. Out-of pocket costs are often higher for a critical illness, where survey respondents reported a total average of $7,071 rising to $14,444 when the financial impact was described as major or devastating. 25 Accident and critical illness insurance are positioned as remedies for meeting these out-of-pocket costs. But the survey had another important finding. By far the biggest financial burden as a result of an accident or critical illness came from lost income. On average, those experiencing an accident estimated their total financial burden to be around $5,000, respondents reporting a major or devastating accident experienced costs that were nearly six times as much. 26 For accidents, the average loss of income was $3,900 rising to $26,900 when the accident had a major or devastating financial impact. 27 Alternatively, those who experienced a critical illness reported lost income of $22,200 rising to $50, The role of lost income in accident and critical illness scenarios illustrates why it is especially important to help employees understand that the protection afforded by accident and critical illness insurance is not just about compensating for out-ofpocket costs, but also helps offset the impact of lost income. Given that most medical plans will not cover 100% of health-related expenses and long-term disability benefits only cover up to 60% of lost income, employees are left with at least a 40%+ income gap to fill; accident and critical illness insurance can be ideal supplements to help bridge this gap. Lost income is often the biggest contributor to the financial impact of an accident or critical illness. 29 Accident Critical Illness Minor/ Somewhat Major/ Devastating Minor/ Somewhat Major/ Devastating Out-of-pocket non-medical expense $239 $1,087 $1,047 $2,009 Out-of-pocket medical expense $987 $3,025 $6,024 $12,435 Lost income $3,900 $26,900 $22,200 $50,600 Total $5,126 $31,012 $29,271 $65,044 9

10 The biggest lesson learned by those who incurred a devastating or major financial impact from an illness or accident? Not thinking through the financial impact such an event could have on family and/or savings. Where Will the Money Come From? Most surveyed employees are financially unprepared to cope with the cost of an accident or critical illness, especially one that lasts for a long time and affects their ability to earn a living. For example, when asked how they would find the money to pay for a critical illness, only 30% are confident that their rainy day funds are sufficient to cover most family emergencies. 30 Thirty-three percent expect to pay for extra expenses out of pocket and 52% plan to tap into savings and investments. 31 Yet, these plans might have holes in them given that 40% also describe themselves as living paycheck-to-paycheck and only about a third (36%) have a savings cushion of three months salary on hand. 32 In fact, one in four admit that they do not have any idea where the money would come from. 33 My illness drained our savings account that we had and will have an impact for years to come. Female, 34, cancer, 3 to 5 years ago Few employees anticipate having to change their lifestyle or go into debt in the event of an accident or critical illness. Yet, the reality, as shown in the MetLife survey, counters this assumption especially for a critical illness. Of those who reported the financial impact as major or devastating, 63% described themselves as now living paycheck-to-paycheck, 61% reported withdrawing from their savings and retirement accounts, 42% reported running higher credit card balances, 43% said they had missed bill payments, mortgages and loan payments admitted borrowing from friends and family. 34 If employees have a clear appreciation of the true potential financial impact an accident or critical illness can have, they can realistically determine if their own rainyday funds and other resources are adequate to see them through such a challenge and help them assess their need for voluntary supplemental health coverage. In the MetLife survey, few respondents owned accident or critical illness insurance at the time of their incident. Those that did however were certain that it was helpful and they primarily used it for out-of-pocket medical expenses and paying household bills. Buying a supplemental insurance plan. I wish I had it before the heart attack, it would have A Checklist to Effectively paid for itself. Male, 54 heart attack 6-11 months ago 10

11 A Checklist to Effectively Implement Accident and Critical Illness Insurance ü Offer both accident and critical illness insurance during enrollment Work with a carrier that has experience in delivering a range of voluntary benefits that can easily integrate into existing benefits. ü Select simple plan designs with popular features Ensure the plans are simple to understand and use, with the key features that are available in the market today. ü Implement a robust enrollment strategy that leverages a proven communication and education approach Ensure your carrier has proven enrollment expertise and can provide effective tools and flexibility to adapt to your needs, culture and employee demographics. ü Ensure exceptional customer service and claims handling A straightforward and hassle-free claims process is very important at a time of stress. Look for carriers that deliver a simple, integrated claims process and are recognized for excellent customer service. To download or share a copy of this whitepaper, please visit 11

12 End Notes 1 aspx 2 3 The 12thth Annual MetLife Study of Employee Benefits Trends, Annual census by America s Health Insurance Plans (AHIP) of U.S. health insurance carriers, The census does not include coverage associated with health reimbursement arrangements (HRAs), which are most commonly offered in the large-group market. 6 Aon Hewitt Health Care Survey, The 12th Annual MetLife Study of Employee Benefits Trends, The 12th Annual MetLife Study of Employee Benefits Trends, The 12th Annual MetLife Study of Employee Benefits Trends, The 12th Annual MetLife Study of Employee Benefits Trends, American Cancer Society Stewardship Report The 12th Annual MetLife Study of Employee Benefits Trends, The 12th Annual MetLife Study of Employee Benefits Trends, METLIFE, INC. L (exp2015)(All States) PEANUTS 2014 Peanuts Worldwide 12 Metropolitan Life Insurance Company 200 Park Avenue New York, NY

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