2013 Healthcare Benefits Trends Study

2013
Healthcare
Benefits Trends
B E N C H M A R K S T U D Y
healthcaretrendsinstitute.org

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2013HEALTHCAREBENEFITSTRENDS
Background
In the fall of 2013, the Healthcare Trends Institute, an educational
platform focused on the rapidly changing healthcare benefits industry,
conducted a national survey regarding trends in employee healthcare
benefits. Polling more than 300 human resources (HR) executives, benefit
specialists, and other benefit decision-makers across the country, the survey
explored the current state of employee healthcare benefits as well as how
they are expected to develop in response to sweeping healthcare reform
legislation, also known as the Affordable Care Act (ACA). This includes the
shift to defined contribution health plans, the launch of insurance exchanges,
and the implementation of wellness plans.
This survey formed the basis for the 2013 Healthcare Benefits
Trends report on the following topics:
CURRENT STATE OF HEALTHCARE BENEFITS:
Identifies the most widely deployed employee and healthcare
benefits plans, as well as how companies are responding to healthcare
reform legislation.
USE OF DEFINED CONTRIBUTION HEALTH PLANS, INSURANCE
EXCHANGES, AND WELLNESS PLANS:
Details the awareness and adoption of defined contribution
health plans and insurance exchanges (public and private), and the use
of wellness programs to incentivize employees.
HEALTHCARE BENEFITS TRENDS – LOOKING FORWARD:
Measures the importance of notable healthcare benefits trends
and the outlook for 2014.

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Study Highlights
• Health insurance is the most common type of employee benefits offered today
with 95.2% of respondents reporting their company currently offers it
• The majority of the employee health benefit programs offered by respondents’
companies include employee+ dependents (80.8%), PPO (70.8%), prescription
drug (66.8%), and mental health (45.6%)
• The majority of respondents (64.8%) indicated health benefits offerings were
very important for retaining and attracting employees
• Of those whose companies offered employee health benefits, a majority (35.2%)
of the respondents indicated their company offers three or more different group
health insurance plan options, 34% reporting only offering one group health
plan option, while slightly less (30.8%) offered two health plan options
• Respondents indicated healthcare reform will impact their employee benefits
packages by increasing employee cost-sharing (38.4%) and increasing premium
contributions (33.6%)
• The majority of respondents (59.4%) indicated they were somewhat to very
familiar with Defined Contribution Plans (DCPs) as they relate to health benefits
• Of the respondents who indicated they were interested in DCPs for the future,
55.8% reported they were considering for 2015 followed by 26.9% in 2016,
and 17.3% indicated considering DCPs before the end of 2014
• 62.1% of respondents are somewhat to very familiar with public exchanges
and 55.5% somewhat to very familiar with private exchanges
• Of the respondents indicating they were somewhat to very familiar with
exchanges, more than half (51.3%) indicated they believed exchanges will help
employees make more cost-conscious benefit decisions as well as offer a wider
array of options for benefit plans
• 43.9% of companies surveyed are already using some kind of healthy lifestyle
incentive/program, while 22.6% are considering one for the future
• To promote positive health outcomes, 61% of companies offer at least one
wellness program, and 43% offer employees the opportunity for health
risk assessment

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What employee benefits does your
company currently offer?
Health Insurance - 95.2%
Dental Insurance - 90.4%
Vacation Time - 88.8%
Paid Holidays - 87.6%
Life Insurance - 84%
Disability Insurance - 77.2%
Retirement Benefits - 75.6%
Wellness Program - 53.6%
Tuition Reimbursement - 52%
EAPs - 48.8%
Domestic Partner Benefits - 39.2%
Parking - 24%
Recreational Facilities - 12.4%
Only Mandated Benefits - 12.4%
Other - 12.4%
Automobile - 9.2%
Meals - 7.6%
Hazard Pay - 5.2%
Which of the following describes your company’s
current employee health benefits program?
Employee + Dependents - 80.8%
PPO - 70.8%
Prescription Drug - 66.8%
Mental Health - 45.6%
HMO - 36.8%
Employee-only - 36.4%
HDHP/HSA - 28%
Retireetoformeremployees-19.6%
Self-Insured - 17.6%
Catastrophic - 11.6%
Underwritten by Insurer - 6.8%
Indemnity - 6%
None - 3.6%
Other - 2.4%
Mini Med - 1.2%
Figure 1.2 (findings on next page)

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Findings: Figure 1.1
• Health insurance is the most common type of employee benefit offered today
with 95.2% of respondents reporting their company currently offers it
• Dental insurance (90.4%), vacation time (88.8%), and paid holidays (87.6%)
are the next most frequently offered
• According to respondents, less than 10% of companies offer automobile (9.2%),
meals (7.6%), or hazard pay (5.2%)
• The majority of the employee health benefit programs offered by respondents’
companies include employee+ dependents (80.8%), PPO (70.8%), prescription
drug (66.8%), and mental health (45.6%)
• Less common employee health benefits include indemnity (6%), and
mini med (1.2%)
• 3.6% of those surveyed reported their companies offered no employee health benefits
Insights:
Health insurance leads the list of employee benefits, signifying its
importance to today’s workforce. The fact that the most common health ben-
efits offered are PPO “family” plans that cover Rx drugs and mental health
suggest that the companies surveyed offer the kind of benefit-rich coverage
many Americans have come to expect from their group health plan.
Will employers of any size offer a rich level of coverage in the fu-
ture? This is just one of the questions being asked in the midst of healthcare
reform. Other questions are: How will the costs of healthcare change
over time? As more costs are shifted to the consumer and away from the
employer or insurer, how will plan designs change?
Many experts believe that in order to continue offering healthcare
benefits in an economy of rising costs, more companies will begin offering
consumer-driven health plan options such as Health Savings Account pro-
grams, which couple a high-deductible health plan with an HSA. These plans
tend to have lower monthly premiums and are designed to give people more
control over their healthcare savings. They are also ideal for use in a defined
contribution health plan benefit model, embraced by companies looking to
control their costs while still providing the important health coverage their
employees value and need.

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Findings:
• Of those whose companies offered employee health benefits, a majority
(35.2%) of the respondents indicated their company offers three or more
different group health insurance plan options
• 34% reporting only offering one group health plan option, while slightly less
(30.8%) offered two health plan options
Insights:
The survey results show an almost even spread in the numbers of
health insurance plan options offered by respondents’ companies: 1, 2, or 3 or
more. Employees of companies offering three or more different plans may, for
instance, have their choice of a PPO plan, HMO plan, and or a high-deductible
health plan—and they’ll take their anticipated healthcare needs, provider
network(s), and budgets into account while making their selection.
One of the goals of the ACA is to ensure Americans have choice
with respect to how they pay their share of healthcare costs. The health plans
on the Health Insurance Marketplace for individuals are categorized based on
monthly premium and out-of-pocket costs; the plans on private exchanges
are also evaluated based on coverage and price comparisons. By putting health
insurance into a consumer marketplace where people compare plan benefits
and prices—and as healthcare costs shift to the consumer—it’s likely employers
may move toward the addition of options, increased flexibility, and employee
choice while designing healthcare benefits.
How many different group health insurance
plan options do you give employees?
3 or more - 35.2%
2 - 34%
No - 30.8%

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Findings:
• 58.5% of respondents reported their companies have not yet put into effect any
new business practices regarding health or other company benefits due to the
Affordable Care Act
• 41.2% of respondents reported their companies had put new business practices
in place in response to the ACA
Insights:
These findings indicate that businesses are at different stages along
the ACA learning curve, making decisions and implementing changes as
they’re ready. While a few of the employer-related ACA provisions have
already taken effect, such as the requirement to notify employees of the new
health insurance marketplace, others have yet to take center stage.
Some companies may have gotten a head start by preparing to
meet the terms of the Wellness Regulations of the ACA, which becomes
effective in 2014. Employers are permitted to offer employees rewards of
up to 30% (it was previously 20%) of the cost of participating in a wellness
program and meeting certain health-related standards.
Another of the key ACA provisions many employers have started to
contemplate is the “Play or Pay” mandate. Beginning in 2015, the ACA will
assess a $2,000 fee per full-time employee, excluding the first 30 employees,
on employers with more than 50 employees that don’t offer coverage and
have at least one full-time employee receiving a premium tax credit. Many
businesses have already begun to prepare to comply with the health insurance
coverage reporting requirements associated with this regulation.
Additionally, employers will need to determine if their insurance
plans meet the federal definitions of “affordable” and “minimum value.”
Some businesses may have a “wait and see” attitude and still consider what
steps to take—or what business practices they’ll have to change—in order
to maintain compliance with ACA.
Yes - 41.2%
No - 58.5%
Has your company put any new business
practices into effect regarding health plan
benefits or other company benefits due
to the Affordable Care Act?

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Findings:
• Respondents indicated healthcare reform will impact their employee benefits packages by increasing employee
cost-sharing (38.4%) and increasing premium contributions (33.6%)
• Only 6% indicated reform would narrow their networks of hospitals and physicians
• Less than 5% (3.2%) indicated it would shift their company towards defined contribution plans (DCP)
Insights:
While it remains to be seen how healthcare reform will affect the cost of employer-sponsored
health benefits, these findings indicate that employers recognize the impact of rising healthcare costs on
their benefits package—whether they are taking on an additional financial burden or passing the costs along
to employees. Based on the ACA mandates already in effect, reform efforts are generally mandating that
plans offer “richer” coverage, and richer coverage is more expensive.
Both a plan’s design and cost-sharing structure can make a big difference to employers and employees
alike. Even if employers choose to shift a larger share of healthcare costs to employees by moving to more
consumer-driven high deductible plans, they can enable employees to better plan for their healthcare utilization
and savings, or at least give them the tools they need to make the most of their coverage. Wellness and other
healthy lifestyle programs including smoking cessation or disease management can also help promote efficient
use of health care and spending.
How will healthcare reform impact your
employee benefits package?
Increase employee cost-sharing - 38.4%
Increase our premium contributions - 33.6%
Other - 28.4%
Enhance wellness, preventative health programs - 22.4%
Adopt new wellness, preventative health programs - 12.8%
Reduce covered benefits - 12.4%
Introduce HDHPs/CDHPs - 8.4%
Narrow networks of hospitals & physicians - 6%
Shift to defined contribution plans (DCP) - 3.2%

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Findings:
• The majority of respondents (64.8%) indicated health benefits offerings were
very important for retaining and attracting employees, while only 1.6% felt
they were not important
• In addition, more than half of respondents indicated health benefits were
very important towards improving employee morale and satisfaction
(56.6%) and improving employee health, reducing absenteeism, and
improving productivity (52%)
Insights:
Half of the respondents, at the very least, find it important to match
the competition on healthcare benefit offerings. This suggests that moving
forward, they’ll continue to offer health benefits that have value to employees
and prospective employees.
How important are your health benefits
offerings to...
5 - Very important
4
3 - Important
2
1 - Not important
Retain and attract quality employees – 4.48 Avg. Rating
Improve employee morale and satisfaction – 4.34 Avg. Rating
Improve employee health, reduce absenteeism, improve productivity – 4.215 Avg. Rating
Match competition – 4.16 Avg. Rating
64.8%22.5%7.8%3.3%
1.6%
56.6%28.7%11.5%
1.6%
1.6%
52%27.9%14.8%3.3%
2%
50%27.1%16.2%2.9%3.8%

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2013HEALTHCAREBENEFITSTRENDSDEFINEDCONTRIBUTIONPLANS(DCPS)
Findings:
• The majority of respondents (59.4%) indicated they were somewhat to
very familiar with Defined Contribution Plans (DCPs) as they relate to
health benefits
• 40.6% of respondents indicated they were not familiar with DCPs as they
relate to health benefits
Insights:
Defined Contribution Plans began as retirement accounts for
retiring employees. Throughout the years, large companies began to adopt
the DCP model to allow all employees to pick and choose the benefits most
important to them. Employers of all sizes are learning that DCPs provide
employees with a specific dollar amount toward health insurance and a
private exchange on which to shop for their benefits. Employees who want
more benefit-rich health plans or additional health options contribute
more based on their selections.
5 - Very familiar
4
3 - Familiar
2
1 - Not familiar
40.6%
How familiar are you with Defined
Contribution Health Benefit Plans?
13.9% 16.8% 12.7% 16%

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Findings:
• Of those respondents who indicated they were somewhat – very familiar with
DCPs , a majority (54.1%) indicated offering a DCP would help employees
make more cost-conscious benefit decisions. Furthermore, 40.5% of these
respondents indicated that a DCP offering would also lead to increased
employee understanding of benefit costs
• Allowing the company to continue offering benefits otherwise in jeopardy and
leading to lower health benefits costs for the company were reported with the
same frequency (31.5%)
Insights:
Employers interested in DCPs understand the value that their
companies receive if they were to provide a fixed dollar amount toward
health coverage. A well-run private exchange will provide numerous health
plan options with several network and prescription drug networks from
where their employees can choose. Containing healthcare costs remains
paramount to companies, but as the findings indicate, so does involving the
employee in the process to help ensure positive healthcare outcomes that
are mutually beneficial to both employers and employees.
Do you think offering a defined
contribution plan (DCP) would:
Help employees make more cost-conscious benefit decisions - 54.1%
Lead to better employee understanding of benefit costs - 40.5%
Offer a wider array of options for benefit plans - 39.6%
Allow continued health benefits otherwise in jeopardy - 31.5%
Lead to lower health benefit costs for the organization - 31.5%
Allow less focus on benefit selection and more on employee value - 28.8%
Other - 10.8%
DEFINEDCONTRIBUTIONPLANS(DCPS)

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Findings:
• The majority of respondents (36.1%) indicated they were considering DCPs
for the future while just more than a quarter (25.2%) indicated they were not
interested on adopting DCPs
Insights:
With about 56% of respondents interested in learning about and
considering DCPs for the future indicates that each year more and more
companies will begin using DCPs as a means for their employees to choose
and enroll in the health benefits most important to them. This insight is
supported by the fact about 94% of the employers surveyed currently offer
health insurance and 65% are committed to providing health insurance to
attract and retain employees. And yet, the average cost of health coverage
is about $10,000 per employee. Therefore, controlling these costs through a
DCP may provide the solution many employers turn to in the near future.
Where are you in the process of exploring/
adopting defined contribution plans?
Considering for
future - 36.1%
Not interested - 25.2%
Still learning - 18.9%
Already using - 14.4%
Other - 5.4%

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Findings:
• Of those respondents who indicated they were interested in DCPs for
the future, 55.8% reported they were considering for 2015 followed by
26.9% in 2016
• Only 17.3% indicated considering DCPs before the end of 2014
Insights:
As large employers gear up for the ACA 2015 mandates, foremost
in their minds is the $2,000 per full-time employee penalty for not providing
health coverage to their employees. Instead of dropping coverage and facing
a government penalty, employers may view DCPs as a way to continue
giving their employees this benefit and keeping their businesses’ competitive
edge in hiring and retaining talent. Providing a DCP would also allow
companies to receive numerous tax benefits from offering health coverage.
If considering exploring/adopting
defined contribution plans (DCPs) for
the future, when?
2015 - 55.8%
2016 - 26.9%
2014 - 17.3%

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What partners would you depend on to
help you learn about new health benefit
designs such as defined contribution plans?
Insurance Broker - 46.2%
Benefit Consultant - 45.3%
Will do research independently - 44.9%
Insurance Carrier - 23.7%
TPA (Third Party Administrator) - 19.1%
Industry/Trade Association - 17.8%
Payroll Co. - 7.2%
Other - 5.1%
What information would your company
be looking for regarding new health
benefit designs, such as defined
contribution plans?
How would our company benefit from DCP? - 27.6%
What are DCPs? - 25.7%
Do employees like DCPs? - 19.1%
What other health plan designs are available? - 15.8%
Other - 9.2%
Can our company offer a DCP plan under PPACA? - 2.6%

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• Insurance brokers (46.2%) and benefit consultants (45.3%) were the top two
external partners respondents reported they would depend on to learn about
new health benefit options and DCPs
• 44.9% of respondents reported they would do the research independently
• Payroll companies (7.2%) are the least used resource for learning about the
latest health benefit plan designs
• Of those interested in learning more about new health benefit designs, the
top information sought out by respondents included how the company would
benefit from a DCP (27.6%) and more information about fundamentals of
DCP offerings (25.7%)
• Only 2.6% indicated wanting to know more about whether or not their
company could offer a DCP under the PPACA
Insights:
Over time, outreach and educational efforts by insurance brokers
and benefit consultants at least initially, have the potential to significantly
impact company decision-makers. These two groups as well as online tools
will need to match the changing needs of employers as they begin the
process of considering DCPs and then move to more sophisticated customers
of private exchanges.
In light of the ACA mandates, employers are also looking at ways
to continue providing benefits and control their healthcare costs. Relevant
information that provides cost-saving business solutions that employers can
implement in their companies, make the deliverer a valuable asset in this
new world of healthcare reform.

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2013HEALTHCAREBENEFITSTRENDSPRIVATE/PUBLICEXCHANGES
Findings:
• 62.1% somewhat to very familiar with public exchanges and 54.5% somewhat
to very familiar with Private exchanges
• Overall respondents were less familiar with private exchanges (45.5%) than
public exchanges (37.9%)
Insights:
The recent October 1 launch of the public and state exchanges and
the subsequent media coverage of the online process has promoted familiarity
with the term “public insurance exchanges.” The public exchanges are designed
initially only for individuals to purchase coverage. As most employers surveyed
provide group coverage for their employees, the awareness of the public
exchange may not be as important to these respondents. Additionally,
because DCPs are just starting to gain ground among employer groups,
awareness of private exchanges is expected to grow in correlation with DCP
use in companies.
How familiar are you with public and
private healthcare exchanges?
Public
Private
37.9%
45.5%
5 - Very familiar
4
3 - Familiar
2
1 - Not familiar
12.3% 20.4% 14.5% 14.9%
11.7% 18.6% 10.8% 13.4%

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Findings:
• Almost half (47.2%) of respondents indicated they are not interested in
an exchange type model for healthcare benefits
• Still learning accounted for 23.4% of responses, while only 6.4% reported they
were already using an exchange type model for their healthcare benefits
Insights:
Education of DCPs and private exchange models will continue
to play a large role as to their adoption rate in companies. As the findings
indicate, private exchanges have the potential for enormous growth in the
coming years. Private exchanges are new avenues that employers will need
to fully explore in order to make informed decisions for their companies.
Due to the tax incentives offered to smaller companies through the Small
Business Health Options Program (SHOP), many smaller businesses may
find this program beneficial as an alternative to private exchanges.
Where are you in the process of offering
an exchange type model for healthcare
benefits (individual or group policies)?
PRIVATE/PUBLICEXCHANGES
Not interested - 47.2%
Considering for
future - 17%
Other - 6%

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Findings:
• Half of respondents interested in an exchange type model for healthcare
benefits indicated they would consider offering in 2015
• The other half of respondents were closely split on whether they would offer
in 2014 (26.9%) or wait until 2016 (23.1%)
Insights:
In 2015, ACA provisions will regulate a penalty for companies, with
100 or more full-time employees, who do not offer coverage pointing to an
interest in private exchanges in 2015.
If considering offering an exchange type
model for healthcare benefits, when?
2015 - 50%
2014 - 26.9%
2016 - 23.1%

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Findings:
• Of the respondents indicating they were somewhat to very familiar with
exchanges, more than half (51.3%) indicated they believed exchanges will help
employees make more cost-conscious benefit decisions as well as offer a wider
array of options for benefit plans
• Allowing for employees to focus less on benefit selection and more on employee
value was the least popular response with 16.3%
Insights:
Of the respondents familiar with private exchanges, more than half
believe exchanges will have the ability to make an impact on cost and options.
Healthcare plan affordability and options are two of the main goals of the
healthcare reform and show a correlation with employer’s beliefs about
exchanges. These findings are also consistent with employers’ understanding
of the benefits associated with DCPs. As employers look to implement
cost-saving measures within their organizations, they will rely on mechanisms
that increase employees’ knowledge and awareness regarding benefit costs.
Do you think private exchanges will:
Help employees make more cost-conscious benefit decisions - 51.3%
Offer a wider array of options for benefit plans - 51.3%
Lead to better employee understanding of benefit costs - 43.8%
Allow employers to continue offering benefits that would otherwise be in jeopardy - 36.3%
Lead to lower health benefit costs for organization - 23.8%
Allow employees to focus less on benefit selection and more on employee value - 16.3%
Other - 12.5%

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Findings:
• COBRA Compliance is indicated to be the attribute that most respondents (35.3%)
felt to be very important to offering health plans in an exchange environment
• Carrier integration (33.6%) and health spending accounts (33%) were also
indicated to be attributes felt to be very important
• The majority of respondents (9.5%) indicated payroll processing to not be an
important attribute
Insights:
Results indicate that employers are looking for an exchange environment
to provide many value-added services. Employers list COBRA compliance,
integration with health spending accounts and carriers, premium payment
automation and payroll processing all to be important attributes for working
with a private exchange. Streamlining these processes has equal appeal to
small and large businesses, and demonstrates a desire for simplified employer
administration of benefits.
Please rank the attributes you would
value in offering health plans in an
“exchange” environment:
Carrier Integration – 3.83 Avg. Rating
Payroll Processing – 3.57 Avg. Rating
Premium Payment Automation – 3.69 Avg. Rating
Health Spending Accounts (e.g. Health Savings /Flexible Spending) – 3.76 Avg. Rating
33.6%
26.7%
29.2%
33%
COBRA Compliance – 3.71 Avg. Rating
35.3%
5 - Very important
4
3 - Important
2
1 - Not important
29.3%23.3%6.9%6.9%
27.6%29.3%6.9%9.5%
32%24.8%6.2%7.1%
25.2%26.9%8.4%6.7%
21.8%25.2%10.1%7.6%

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Findings:
• Most respondents (84.9%) are looking for plan and cost comparison tools in a
benefit offering within an insurance exchange environment
• Online access (76.2%) and combined benefit enrollment (61.1%) are also
features respondents want to see included
• The least selected feature was progressive cost tracking tools (27%)
Insights:
Employers are requesting a comprehensive platform to provide
employees with tools to help them make knowledgeable decisions and engage
them in the healthcare process. The high percentage of employers seeking
online access for their employees also suggests ease of use is a priority for
handling enrollment and questions.
If you choose or could design a benefit
offering using an insurance exchange
environment, what features would
you include?
Plan and cost comparison tools - 84.9%
Online access - 76.2%
Combined benefit enrollment - 61.1%
Help line - 56.3%
Consolidated employer billing services - 47.6%
Financial account options - 36.5%
Progressive cost tracking tools - 27%
Other - 4%

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Findings:
• The majority of respondents (53.2%) indicated they would research private
exchanges independently while going through an insurance broker (53.2%) or
benefit consultant (48.4%) were also popular selections
• Only 5.6% indicated they would go through a payroll company
Insights:
Employers are looking for reliable resources to help them navigate
this new system of healthcare. The response to this question is similar as
to how employers would like to get information regarding DCPs. They are
willing to do their own research, but are also looking to their broker or benefit
consultant to provide insight and recommendations that make sense for their
business. Opportunities exist for brokers to become health program experts
to get their foot in employers’ doors, and to share their knowledge through
reliable online resources for those employers searching independently.
What partners will you depend on to
help you learn about private exchanges?
Will do research independently - 53.2%
Insurance Broker - 53.2%
Benefit Consultant - 48.4%
Industry/Trade Association - 30.2%
Insurance Carrier - 26.2%
TPA (third party administrator) - 19%
Payroll Company - 5.6%
Other - 5.6%

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2013HEALTHCAREBENEFITSTRENDSWELLNESS
Findings:
• 43.9% of companies surveyed are already using some kind of healthy lifestyle
incentive/program, while 22.6% are considering for the future
• The smallest majority (15.2%) indicated they are not interested in adopting a
health lifestyle incentive program
Insights:
Companies have long had an interest in keeping their workers healthy,
productive, and satisfied while cutting healthcare costs. Wellness programs
encourage employees to take measures to lead healthier lifestyles and prevent
possible future diseases. Employers responding positively to implementing
healthy lifestyle programs have made the correlation between influencing
employees to adopt healthier lifestyles and a reduction in employee
healthcare costs.
Where are you in the process of
exploring/adopting a healthy lifestyle
incentive/program?
Considering for
future - 22.6%
Not Interested - 15.2%
Other - 2.6%

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Findings:
• Of those offering wellness programs or services, 74.5% offer flu shots or
vaccinations, 69.4% offer an Employee Assistance Program (EAP), and 54.6%
offer gym membership discounts or on-site exercise facilities
• Only 4.2% of companies surveyed don’t offer any wellness programs or services
Insights:
Major pharmacy chains in conjunction with health plans have provided
more training for vaccination administration than ever before. Employers have
demonstrated in part why this may be the case, listing it as their top wellness
service for employees. Nearly 70% of employers also demonstrated that they
understand the importance of providing a culture that supports its healthy
lifestyle program with almost 70% of them noting that they have an Employee
Assistance Program in place to help workers with a variety of work/life
balance challenges.
What specific wellness programs/
services do you offer employees?
Flu shot or vaccinations - 74.5%
Employee assistance program (EAP) - 69.4%
Gym membership discounts or on-site exercise facilities - 54.6%
Smoking cessation program - 44.9%
Web-based resources for healthy living - 43.5
Weight loss program - 38%
Biometric screening - 31.5%
Other - 5.1%
None - 4.2%
WELLNESS

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Findings:
• To promote positive health outcomes, 61% of companies offer at least one
wellness program and 43% offer employees the opportunity for health
risk assessment
• Offering a disease management program was the least popular way employers
chose to promote positive health with 23.3%
Insights:
The Affordable Care Act incentives for 2014 recognize the link
between company wellness initiatives and lowering healthcare costs. The
Affordable Care Act creates new incentives and builds on existing wellness
program policies to promote employer wellness programs and encourage
opportunities to support healthier workplaces. The proposed rules also
implement changes in the ACA that increase the maximum permissible
reward under a health-contingent wellness program from 20% to 30% of
the cost of health coverage, and that further increase the maximum reward
to as much as 50% for programs designed to prevent or reduce tobacco use.
As employers will continue to be encouraged to provide wellness programs
to their employees, an increase in positive health outcomes should be
experienced by more and more organizations.
How do you promote positive health
outcomes at your company?
Offer at least one wellness program - 61%
Opportunity for health risk assessment - 43%
Provide incentives/rewards for certain health-related tasks - 36.8%
Biometric screening - 28.3%
Nothing at this time - 26.9%
Offer at least one disease management program - 23.3%
Other - 4.5%
WELLNESS

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2013HEALTHCAREBENEFITSTRENDSTHEDEMOGRAPHICS
Other - 18.9%
Manufacturing - 15%
Government - 11%
Technology - 10.6%
Education - 10.1%
Finance Insurance - 8.8%
Healthcare - 7.5%
Non-profit - 7.5%
Retail goods Services - 4.4%
Construction - 4.4%
Travel Entertainment - 1.8%
101-1000 - 33.6%
2,501 - 22.7%
50 - 22.7%
1001-2500 - 10.9%
51-100 - 10%
Approximately how many full-time
employees are in your company/
organization?
What industry is your company in?

27
Survey Summary/Conclusion
• Ongoing cost concerns among employers of all sizes will continue to spur
change both in the form of defined contribution plans and the use of health
insurance exchanges
• Most employers are interested in learning more about DCPs for the future
supporting the shift away from a traditional defined benefit model to manage
employee healthcare benefits and control costs
• Overall, employers are more familiar with public exchanges than private
exchanges. This may be due to the October 1 launch of the Federal Insurance
Marketplace, which coincided with survey data collection. As most employers
surveyed provide group coverage, the awareness of public exchanges may not
be as important to these respondents
• Because DCPs are starting to gain ground among employer groups,
awareness of private exchanges is expected to grow in correlation with
DCP use in companies
• We can expect an increase in the number of companies offering at least
one wellness program or health initiative as ACA wellness incentives go into
effect in 2014

28
About the Healthcare
Trends Institute
The Healthcare Trends Institute is an educational platform to help
employers, third-party administrators, health plans, brokers, banks, payroll
providers, consumers, and other stakeholders keep up with the rapidly
changing healthcare benefits industry. It covers a range of topics related to the
administration and management of healthcare benefits. To ensure all content
and programs achieve the highest level of quality and relevancy, the Institute
is guided by an Editorial Advisory Board comprised of subject-matter experts
that represent diverse aspects and perspectives within the healthcare benefits
industry. More information is available at www.healthcaretrendsinstitute.org
Tiffany Wirth, Executive Director
Healthcare Trends Institute
4324 20th Avenue, SW, Ste. 200
Fargo, ND 58103
P 701.499.7215
E info@HealthcareTrendsInstitute.
org
ABOUT EVOLUTION1, INC. – A WEX COMPANY
At Evolution1, Inc. – a WEX Company, we simplify the business of healthcare. We do that through innovative
cloud-based payment and technology solutions that administer and manage consumer-directed and defined
contribution accounts. But we don’t do it alone. Our network of partner organizations enables us to deliver our
industry-leading and award-winning solution to 125,000 employers and more than 11,000,000 consumers across
the country. Together we take the complexity out of defined contribution, HSAs, HRAs, FSAs, VEBAs, PRAs, wellness
plans, and transit plans. Learn more at www.evolution1.com.

2013 Healthcare Benefits Trends Study

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