MERCER S NATIONAL SURVEY OF EMPLOYER SPONSORED HEALTH PLANS 2013

Transcription

1 MERCER S NATIONAL SURVEY OF EMPLOYER SPONSORED HEALTH PLANS 2013 June 19 th, 2014 Tom Flynn thomas.flynn@mercer.com Mercer, Upstate New York

2 Today s Agenda Highlights from Mercer s 2013 Healthcare Survey ACA Update Trends in Cost Management Exchange Environment and Mercer Marketplace Banks and Financial Institutions 1

3 About Oldest Marking 29 years of measuring health plan trends Largest 2,842 employers participated in 2013 Most comprehensive Extensive questionnaire covers a full range of health benefit issues and strategies Statistically valid Based on a probability sample -- only Mercer and Kaiser survey this way Covers employers of all sizes, all industries, all regions Results project to all US employers with 10 or more employees Employer size groups in presentation Small: employees / Large: 500+ employees / Very large: 5,000+ employees Financial Employers in presentation Banks: <500 employees / Banks: 500+ employees / Financial Services 500+ employees June 19,

4 Our survey headlines Cost Health benefit cost grew 2.1% in 2013 a 16-year low Employers expect a rebound in 2014 ACA Most employers say ACA will increase costs but remain committed to sponsoring health benefits Many take action to counter ACA cost challenges CDHP CDHP enrollment continues to grow, matching enrollment in HMOs Employers use CDHPs to meet cost, choice and compliance goals Health Health management programs stress innovation and engagement As an alternative to traditional cost shifting Choice Widespread interest in private exchanges as a way to add choice While controlling cost and simplifying administration 3

5 ACA CDHP Health Cost Choice 4

6 Medical plan offerings, Large employers Cost PPO/POS HMO CDHP 93% 93% 94% 92% 90% 90% 37% 43% 35% 36% 36% 39% 32% 34% 31% 20% 20% 23%

7 Cost growth slowed again in 2013 with higher increases expected this year Average total health benefit cost per employee rose just 2.1% in 2013 for all employers Cost 20.0% 18.0% 16.0% 17.1% Workers' earnings Annual change in total health benefit cost per employee Overall inflation 14.0% 14.7% 12.0% 10.0% 12.1% 10.1% 11.2% 10.1% 8.0% 6.0% 8.0% 6.1% 7.3% 8.1% 7.5% 6.1% 6.1%6.1% 6.3% 6.9% 6.1% 5.5% 4.1% 5.2%* 4.0% 2.0% 0.0% -2.0% 2.5% 2.1% 0.2% -1.1% % *Projected after plan changes; 7.4% predicted before changes Source: ; Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April) ; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey (April to April)

8 Underlying cost trend still high for all employers Employers plan to hold their actual cost increase to about 5% in 2014 Cost Expected trend before plan changes Trend measured after plan changes 9.8% 9.1% 8.3% 8.2% 6.9% 6.1% 5.5% 4.1% 7.4% Highest spread (5.3%) between underlying cost trend and final employer increase in years 8.0% 5.2%* 7.1% 5.7% 10.4% 7.9% 8.1% 5.8% 2.1% Banks <500 Banks 500+ Financial Services * Projected 7

9 Prescription drug benefit cost growth stabilizes at around 5% Cost increase in primary medical plan for large employers Cost 14.3% 11.5% 9.9% 9.3% 7.6% 7.6% 6.3% 5.1% 5.2% 5.5%

10 Total health benefit cost for active employees up 2.5% in 2013 Large employers Cost Large employers expect an increase in the growth rate for 2014 to 4.9% +2.5% +5.4% +3.6% +8.5% $11,003 $11, % $10, % $10, % +6.1% $9, % $8, % $8,229 $7,832 $7,379 $6, %* $11, *Average increase projected for 2014 after changes; increase of 7.2% predicted before changes 9

11 Cost increase was highest for very large employers, but mid-sized employers experienced the highest cost per employee Cost % +3.7% 2013 $10, % $10, % $11,141 $11,303 $11,254 $10,856 $9,913 $9,991 All employers Employers with employees Employers with 500-4,999 employees Employers with 5,000 or more employees 10

12 Total health benefit cost per employee Includes medical, prescription drug, dental and vision Cost % $10,558 $10,779 $11, % $11,277 $11, % $11, % $10,812 $10,069 All National Employers Large National Employers Northeast Employers Upstate NY Locally, total health benefit costs are approximately 5%-10% lower than large national and Northeast employers Represents 500+ employees 11

13 Average total health benefit cost* per employee 2012 % Change 2013 $10,102 $10,522 $9,815 $10,196 $10,860$11,042 $10,558$10, % +3.9% +1.7% +2.1% Banks <500 Banks 500+ Financial Services 500+ National All *Total health cost includes medical, dental, Rx and specialty benefits

14 In addition to employer size and geography, other factors affecting total health benefit cost for large employers include Cost $11,042 $11,114 $11,342 $11,460 $12,024 $12,311 $8,710 Wholesale / Retail Financial services Services Health care Manufacturing Transp. / Comm. / Utility Government $10,658 $11,134 $9,946 $11,277 $12,197 $12,845 $13,286 $8,457 PPO HMO HRA-based CDHP HSA-eligible CDHP All large employers Average EE age 45 or higher Dependent coverage election >65% 75% or more EEs in unions 13

15 Other factors.. Cost $10,214 $11,776 $11,199 $11,812 $11,081 $11, ,000-4,999 5,000-9,999 10,000-19,999 20,000 or more Number of employees $10,540 $11,019 $11,875 $12,091 South Midwest Northeast West 14

16 Cost shifting has been considerably higher for small employers Average PPO deductible for individual, in-network coverage Cost $1,663 Small employers Large employers $1,410 $1,452 $1,016 $1,113 $1,192 40% increase since % increase $501 $511 $565 $587 $666 $684 3% increase 21% increase since

17 Payroll contributions slightly lower for local employers Average monthly employee contribution bank employers Cost PPO HMO CDHP/HSA Single coverage $127 $108 $119 $78 $82 $57 $459 $421 $389 $448 $367 Family coverage $231 Banks <500 Banks

18 ACA CDHP Health Cost Choice 17

19 Key Elements of Health Care Reform for Employers 2010 Change in tax treatment for over-age child coverage Early retiree medical reinsurance Accounting impact of change in Medicare retiree drug subsidy tax treatment Medicare prescription drug donut hole beneficiary rebate Break time/private room for nursing moms No lifetime dollar limits on essential health 2011 benefits 1 Restricted annual dollar limits on essential health benefits, phased amounts until Child coverage to 26 (grandfathered plans may limit to children without access to other employer coverage, other than parent s coverage) 1 No pre-existing condition limitations for enrollees up to age 19 1 and no rescissions 1 No health FSA/HRA/HSA reimbursement for nonprescribed drugs Increased penalties for non-qualified HSA distributions Additional standards for non-grandfathered health plans, including preventive care in-network with no cost-sharing, appeal and external review, provider choice, and non-discrimination rules for insured plans 3 Income-based Medicare Part D premiums Pharmaceutical importers and manufacturers fees start Medicare, Medicare Advantage benefit and payment reforms Insurers subject to medical loss ratio rules Employers to distribute uniform summary of 2012 benefits and coverage (SBC) to participants 60-day advance notice of mid-year material modifications to SBC content Form W-2 reporting for health coverage (track in 2012 for W-2 form provided in early 2013) 4 Coverage for additional women's preventive care services Health insurance exchange coverage Individual coverage mandate 5 Financial assistance for exchange coverage of low- and middle-income individuals State Medicaid expansion (only in some states) Child coverage to age 26 for any covered employee s child 2 No annual dollar limits on essential health benefits 2 (generally banning stand-alone HRAs for active employees) No pre-existing condition limits 2 No waiting period over 90 days 2 $2,500 (indexed for inflation) per plan year health FSA contribution cap (plan years on or after January 1, 2013) Comparative effectiveness research (PCORI) fees first due for calendar year plans (and 11/1 and 12/1 plans) Annual dollar limits on essential health benefits cannot be lower than $2 million Employers notify employees about exchanges by Oct. 1, 2013 Medical device manufacturers fees start Higher Medicare payroll tax on wages exceeding $200,000/individual; $250,000/couples Change in Medicare retiree drug subsidy tax treatment takes effect Health Insurance exchanges initial open enrollment period (Oct. 1 March 31) Wellness limit increase allowed 2 Health insurance industry fees Additional standards for non-grandfathered health plans, including limits on in-network out-of-pocket maximums, provider nondiscrimination, and coverage of routine patient costs of clinical trial participants Small market, non-grandfathered insured plans must cover essential health benefits with limited deductibles (initially $2,000/individual, $4,000/family), using a form of community rating Insurers must apply guaranteed issue and renewability to non-grandfathered plans of all sizes Employer shared responsibility Temporary reinsurance fees first due in early/late 2015 Additional employer and insurer reporting and disclosure (reporting due in early 2016) Auto enrollment some time after 2014 (effective date TBD) 40% excise tax on high cost or Cadillac employer-sponsored health coverage Footnotes 1. Applies to all plans, including grandfathered plans, effective for plan years beginning on or after Sept. 23, 2010 (Jan. 1, 2011, for calendar year plans). 2. Applies to all plans, including grandfathered plans, effective for plan years beginning on or after Jan. 1, Applies to non-grandfathered plans, effective for plan years beginning on or after Sept. 23, 2010, except that insured plan discrimination ban is delayed until regulations issued. 4. A temporary exemption applies to certain categories of employers. 5. A temporary exemption applies to employees of employers with noncalendar-year plans, as well as individuals who enroll in an Exchange plan by March 31, Other exemptions may also apply. 18

20 Group Health Plan Mandates & Employer Requirements in 2014 New Plan Design Requirements Maximum 90 day waiting period Final rules hot off the presses! No pre-existing condition limitations for all enrollees No lifetime or annual dollar limits on essential health benefits Limits on in-network, out-of-pocket maximums (NGF) In 2014, $6,350 for an individual, $12,700 for family coverage In 2015, projected to be $6,750 for an individual, $13,500 for family coverage Expansion of wellness incentives Coverage of routine patient costs for items and services furnished to clinical trial participants (NGF) Provider nondiscrimination (NGF) Taxes/Fees Patient-Centered Outcomes Research Institute (PCORI) fee Transitional Reinsurance Fee Health Insurer Fee Communications SBCs (on-going) W-2 reporting of health care costs (ongoing) Exchange Notice (Oct. 2013) 19

21 Transitional Reinsurance Fee To stabilize individual insurance marketplace, and to provide revenue to federal government Paid by contributing entities, which includes self-insured and fully-insured major medical plans For 2015, might only apply to plans providing 60% minimum value In our latest survey, nearly half of the respondents haven t yet decided how they will pay ACA s reinsurance fee of $63 per member 39% 43% Begins in 2014 and sunsets in 2016 Mechanism for payment is not yet known 17% 1% Fee PMPY $63.00 $44.00* $25.00** Will pay fee outright Will build it into rates and share cost with employees Will handle some other way Haven't decided yet *Based on HHS estimate issued in Dec **Mercer estimates calculated based on 200,000,000 estimated covered lives Source: 20

22 Transitional Reinsurance Fee Paid annually by the contributing entity Insured plans: insurance providers (carriers may build this fee/tax into renewal pricing) Self-insured plans: the plan sponsor, although plan administrator may transfer the fee on behalf of the plan sponsor Fee paid in two (unequal) installments: one in first quarter and one in last quarter of calendar year following applicable fee year Important dates and deadlines: By November 15 In December 30 days after HHS notification In December Contributing entities submit to HHS average number of covered lives HHS notifies contributing entity of amount due 1 st installment payment due to HHS (Jan. following the Dec. notification) 2 nd installment payment due to HHS (Dec following 1 st installment) 21

23 Employer Shared Responsibility Employer Mandate Minimum Essential Coverage Eligibility Minimum Value Affordable Contributions Eligible employersponsored plan 30 hours / week 60% 9.5% of household income (individual only) $2,000 Non-offering employer payment $3,000 Offering employer payment 22

24 Employer Shared Responsibility a refresher How the payment will work in Did you average 100 or more full-time and full-time equivalent employees in 2014? No You will not be subject to a shared responsibility payment. (Aggregate controlled group members) Yes 2. Do you offer a health plan to substantially all (70%) full-time employees (FTEs) and their dependent children (not spouses/domestic partners)? (Disaggregate controlled group members) Yes 3. Does the health plan offered to FTEs satisfy standards for both: (1) affordability (employee-only contribution for plan 9.5% of an employer affordability safe harbor or employee s household income), and (2) minimum value (60%)? Yes 4. Do you have any FTEs to whom you do not offer a health plan? No You will not be subject to a shared responsibility payment. You will pay: $2,120* x (total # FTEs first 80 FTEs) Applies if at least one FTE receives taxsubsidized benefits for exchange coverage. No $2,120 Non-offering Employer Payment You will pay the lesser of: $3,180* x FTEs receiving tax-subsidized benefits for exchange coverage or $2,120* x (total # FTEs first 80 FTEs) No $3,180 Offering Employer Payment Yes Notes Box 1: Beginning in 2016, applies to employers with 50 or more full-time and fulltime equivalents. Employers must meet certain rules to use 100 (vs. 50) count for Box 2: Beginning in 2016, the percentage increases to 95%. Non-offering employer payment: Beginning in 2016, the total number of FTEs will be reduced by 30, not 80. * Includes 2015 HHS-projected premium inflation adjustment. Payments will increase annually to reflect the projected average national increase in health insurance premiums. 23

25 The 30-hour Rule Two Methods for Determining Full-time Status Full-time employees are those working on average at least 30 or more hours per week Two options to measure who is a full-time employee: Monthly method Look-back method Must use same method for all employees, except: Salaried/hourly Collectively bargained/non-collectively bargained, or covered by different CBAs Different US states Different members of controlled group may use different methods 24

26 The typical employer plan still meets the ACA s plan value requirement of 60% of covered expenses with room for further cost shifting ACA Large employers Median cost sharing* amounts for: In-network services 60% plan PPO HMO HSA-eligible CDHP Deductible $2,000 $500 $500 $1,500 Hospital coinsurance/copay 50% 20% $ Out-of-pocket maximum $6,000 $2, $3,000 * Cost sharing for individual, in-network coverage Local large employers offer a lower median PPO deductible ($300) 20% coinsurance and a lower PPO out-of-pocket maximum ($1,000) 25

27 The typical employer plan still meets the ACA s plan value requirement of 60% of covered expenses with room for further cost shifting ACA Small employers Median cost sharing* amounts for: In-network services 60% plan PPO HMO HSA-eligible CDHP Deductible $2,000 $1,000 $2,000 $2,500 Hospital coinsurance/copay 50% 20% $ Out-of-pocket maximum $6,000 $3, $4,000 For detailed plan design benchmarks contact Mercer * Cost sharing for individual, in-network coverage 26

28 Employers success in bringing cost growth under control will be challenged by health reform ACA ACA impacts are pushing cost up.. But large employers remain committed to sponsoring healthcare Likely or very likely to terminate medical plans within the next five years 23% 34% 19% 22% % 6% < 50 EEs EEs 500+ EEs.. And are taking action to hold costs down: Resetting benefit value Contribution strategy changes Workforce adjustments Consumer-directed health plans New focus on employee choice More sophisticated health management programs Market innovations creating more efficient health care delivery 27

29 Most large employers say reform will boost health spending in 2014 beyond normal cost increases due to higher enrollment and fees ACA Expected impact due to higher enrollment and fees in 2014 Expect increase of 3% or more due to higher enrollment and fees, by industry Don t know 34% No increase in health spending 9% 18% Increase of less than 3% 51% 41% 36% 35% 35% 35% 28% Increase of more than 10% 13% 16% 10% Increase of 5-10% Increase of 3-4% 28

30 But the shared responsibility requirements are just the beginning Majority of large employers in danger of getting hit with excise tax by 2022 ACA Percent of employers that would be subject to the excise tax if they made no changes to their current plan and almost a third said avoiding the tax influenced health plan decisions for 2014 Avoiding the excise tax influenced health plan decisions for % 46% 49% 52% 55% 31% 69% Source: 2011 National Survey of Employer-Sponsored Health Plans Excise tax did not influence 2014 decisions 29

31 Taking steps now to avoid the excise tax in 2018 Large employers ACA For nearly a third of employers 31% concerns over the 2018 excise tax influenced decisions for 2104 Introduced a CDHP or took steps to increase enrollment in an existing CDHP 19% Added or expanded health management programs 12% Dropped a higher-cost health plan 11% Unbundled dental and medical plans 4% Other change(s) 12%

32 Employers taking bolder action to steer spouses to other coverage and changing contribution strategies Special provisions concerning spouses with other coverage available ACA Large employers Small employers Large Employers employees % 8% % 7% 6% 4% 3% 2% Spouses with other coverage are not eligible Spouses with other coverage must pay surcharge Spouses with other coverage are not eligible Spouses with other coverage must pay surcharge Small employers vs. Large Managing growth in enrollment by changing contribution strategies 18% 13% 12% 10% Raise employee contribution percentage for dependent coverage Raise employee contribution percentage for employee-only coverage 16% 18% Other change

33 Planned response to Employer Shared Responsibility 30 Hour Eligibility Requirement ACA Majority of large employers expect to make all employees eligible for current full-time plans and a third expect to add a lower-cost plan for all employees Actions that large employers not currently covering employeess working 30+ hours/week are likely to take: Make all associates eligible for current, FT plan(s) 69% Use a "segmentation strategy (different benefits offered across eligible population) 10% Add a lower-cost plan and offer it to all employees 33% Make no changes to eligibility and pay the penalty 9% 38% of local employers plan to add a lower-cost plan option 32

34 ACA CDHP Health Cost Choice 33

35 CDHPs becoming mainstream and central to meeting the challenges of health care reform CDHP offerings expected to accelerate Large employers CDHP Why? Provide a low-cost plan to newly eligible employees Encourage employees to use the health care system wisely Reduce excise tax exposure By 2016, 64% of large employers expect to offer a CDHP % of employers offering CDHPs % of covered EEs enrolled in CDHPs By 2016, 63% expect to offer a CDHP 63% 32% 36% 39% 20% 8% 23% 10% 13% 15% 18%

36 CDHPs becoming mainstream and central to meeting the challenges of health care reform Larger employers still mostly offer Even CDHPs small as an option but more are planning to employers offer them alone Percent of employers offering CDHPs Percent of covered employees enrolled in CDHPs 55% 38% 31% 19% 15% 21% Employers with employees Employers with 500-4,999 employees Employers with 5,000 or more employees 35

37 Expect to offer an account-based CDHP in next three years As only type of plan offered for at least some employees Alongside other medical plan choices for all employees 50% 48% 30% 30% 32% 24% 21% 14% Banks <500 Banks 500+ Financial Services 500+ National All

38 CDHPs typically pass the 60% test but cost about 20% less than PPO and HMO coverage CDHP Medical plan cost per employee $10,196 $10,612 $8,482 PPO HMO HSA-eligible CDHP (Includes employer contributions to HSA accounts) 37

39 Employee enrollment in CDHPs equal to HMOs for the first time Large employers percentage of all covered employees enrolled in each plan type CDHP % 18% 18% % 65% 18% 16% % 67% 20% 13% % 69% 19% 11% % 69% 21% 9% % 69% 23% 7% Traditional Indemnity PPO/POS HMO CDHP 38

40 Employers working to build enrollment in CDHPs further Large employers CDHP 21% HSA-based CDHP enrollment rises over time % choosing CDHP when offered w/other medical plans 24% 29% Employer HSA funding drives enrollment... % choosing HSA when offered with other medical plans... but extensive communication is also important % choosing HSA when offered with other medical plans 28% 30% 20% 21% Employer HSA contribution of $800+ Employer does not have contribution to HSA When HSA communication is extensive When HSA communication is limited 39

41 CDHPs as full replacement Large employers CDHP Expect to offer a CDHP as full replacement 3 years from now 14% 16% Small Employers Large Employers 22% Very Large Employers 6% of large local employers expect to offer CDHP as full replacement within 3 years 32% of large banks Nationally 40

42 ACA CDHP Health Cost Choice 41

43 Health management is now the norm, addressing a full range of needs Percent of employers offering program Health Small employers Large employers 82% 80% 80% 78% 66% 22% 47% 34% 42% 51% 30% 51% 35% 36% End-of-life case management Case management Disease management Nurse advice line Health advocate Lifestyle management Health assessment REACTIVE Addressing the continuum of health needs PROACTIVE 42

44 Fewer employers are willing to offer only their health plan s standard services Large employers Health 66% 54% More employers are contracting with specialty vendors and purchasing optional services from their health plans % 26% 24% 23% Through health plan standard services only Through health plan some optional services Contract with one or more specialty vendors 43

45 Large employers are banking on health management to control costs in the long-term Health % 52% 62% 64% Becoming the norm More employers are driving engagement through financial incentives, most often cash or contribution reductions Large employers Very large employers 52% Large employers offering incentives Large employers not offering incentives 51% Large employers using incentives report higher participation rates 32% 26% 14% 26% Health assessment completion rate Lifestyle management program participation rate* Validated biometric screening rate *Average % of identified persons actively engaged in program 44

46 Employers looking for new ways to engage employees Group activities and technology-based tools offered Health Offerings of these activities and tools by local employers exceed national norms Large Employers Upstate NY Employers Worksite biometric screening event 53% 58% Business unit / location group challenges 45% Business unit / location group challenges 45% 52% Onsite weight loss programs (such as Weight Watchers) Web-based portal with activity / incentive tracking 40% Onsite exercise or yoga classes 39% Personal challenges 33% Peer-to-peer support 21% Mobile apps for activity tracking / peer interactions 15% Onsite weight loss programs (such as Weight Watchers) 40% 70% Web-based portal with activity / incentive tracking 40% 36% Onsite exercise or yoga classes 39% 52% Personal challenges 33% 36% Peer-to-peer support 21% 21% Mobile apps for activity tracking / peer interactions 15% 6% None of these 22% None of these 22% 9% 45

47 Employers looking for new ways to engage employees Group activities and technology-based tools offered Health Offerings of these activities and tools further broken down by size. Banks <500 employees Banks 500+ employees Worksite biometric screening event 35% 53% 59% Business unit / location group challenges 43% Business unit / location group challenges 45% 44% Onsite weight loss programs (such as Weight Watchers) Web-based portal with activity / incentive tracking 30% Onsite exercise or yoga classes 17% Personal challenges 39% Peer-to-peer support 17% Mobile apps for activity tracking / peer interactions 13% Onsite weight loss programs (such as Weight Watchers) 17% 40% 44% Web-based portal with activity / incentive tracking 40% 47% Onsite exercise or yoga classes 39% 21% Personal challenges 33% 38% Peer-to-peer support 21% 9% Mobile apps for activity tracking / peer interactions 15% 12% None of these 30% None of these 22% 18% 46

48 Incentives used for specific programs Large employers Health Large employers Very large employers Provide incentive for completion of health assessment* 45% 61% Median maximum value of incentive (of any type) $150 $204 Provide incentive for participating in validated biometric screening 31% 42% Median maximum value of incentive (of any type) $150 $250 Provide incentive for participating in lifestyle management* 31% 47% Median maximum value of incentive (of any type) $150 $200 Require employees to take more than one action to earn incentives (when incentives are offered) 49% 66% * When offered 47

49 Continued growth in use of outcomes-based incentives More large employers linking incentives to what employees do about their health Health Offer lower premium contributions to non-tobacco users Provide incentives for achieving or maintaining targets for BP, BMI, cholesterol 15% 17% 18% 20% 9% 10% 12% 6%

50 Measuring health management ROI can be challenging, but results are encouraging Very large employers Health Just under two-fifths have formally measured ROI with over 75% reporting a positive impact on medical plan trend No Yes Substantial positive impact on medical cost trend 23% 62% 38% Small positive impact on medical trend 56% No improvement in medical trend was found so far 20% 49

51 The largest employers lead the way with innovations that reward high-quality, efficient providers Health Value-based design 27% 50% Accountable care organizations 10% 25% Surgical centers of excellence 22% 37% High-performance networks 15% 27% Collective purchasing of medical benefits 13% 24% Telemedicine 11% 18% Medical homes 5% 13% Reference-based pricing Large employers 10% Employers with 20,000+ employees 12% 50

52 ACA CDHP Health Cost Choice 51

53 Refocusing on a Total Benefits message Meeting diverse needs without driving up employer costs Choice Percent of large employers offering the benefit Voluntary Benefits Work / Life Benefits* 90% Disability 83% Fitness center or discounts 64% Vision 77% 60% Accident Whole / universal life Cancer / critical illness 59% 49% 43% Legal consult / referral Financial consult / referral Dep. care resource / referral Elder care resource / referral 41% 38% 32% 31% 30% Long-term care Auto / Homeowners Hospital indemnity Pet 28% 19% 17% 9% Telecommuting / Work from home Adoption assistance On-site / near-site dep. care 25% 22% 11% 0% *Data on work/life benefits (with the exception of fitness centers) is from Mercer s 2012 survey 52

54 Private exchanges poised for rapid growth One-fourth of all employers considering switching to a private exchange within two years, and 45% would consider within five years Choice Why? Promotes efficiency by allowing employees to buy only what they need Allows employers to add choice while reducing administrative burden Eases transition to a sustainable program 45% 42% In 2 years In 5 years 25% 22% 24% 20% 12% 10% Considering private exchanges for either actives or retirees Considering for active employees Considering for pre-medicareeligible retirees Considering for Medicare-eligible retirees 53

55 Questions?

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