1. THE IMPACT OF HEALTH CARE REFORM
Findings from the 2014 Aflac WorkForces Report
HCR14027 03/25/2014

2. • The 2014 Aflac WorkForces Report is the fourth annual Aflac employee
benefits study examining benefits trends and attitudes.
• Fielded in January 2014 by Research Now, a global online-sampling and
online data-collection company.
• Responses from 5,209 American employees, 1,856 business decision-
makers and 314 benefits brokers.
• Findings show the effect health care reform is having in the workplace and
the growing importance of voluntary benefits to workers.
• For details on the survey methodology, visit aflac.com/aboutAWR.
About the 2014 Aflac WorkForces Report
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3. Controlling cost was a top business objective
for 49% of companies
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Companies implemented the following measures in 2013:
•22% eliminated or cut back employee benefits options in 2013.
•28% increased employees’ copayments.
•28% increased employees’ share of the premium.
•9% eliminated contributions for family coverage.

4. The continuing move to consumer-driven health care
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A consumer-driven health care model gives
consumers the primary decision-making role
regarding the health care they receive. Yet,
•71% of workers have not heard of the phrase
consumer-driven health care.
• Of those who have heard the phrase,
only 19% say they understand it extremely
or very well.
•19% of employers offered a High Deductible
Health Plans (HDHPs) as an option in 2013.
•48% of employers offered Flexible Spending
Accounts in 2013.

5. Employees are confused about heath care reform
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• 73% of workers agree that health care
reform is too complicated to understand.
• 71% of workers agree that their personal
health insurance situation will become
more confusing.
• Though the online exchange or
marketplace for individual coverage
opened in 2014, only 10% of workers say
they are very or extremely knowledgeable
about federal and state health care
exchanges.

6. • Only 40% understand health care reform extremely or very well.
• Nearly 2 in 10 employers say they do not understand health care reform at all or
very well.
• Yet, 68% of workers at least somewhat believe their employer will educate them
about changes to their health care coverage due to health care reform.
• 45% of employers will rely on brokers or insurance companies to suggest
changes to their benefits packages due to the changing health care
environment.
Employers are confused about heath care reform too
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7. Workers’ Top 4 HCR Concerns

8. Concern No. 1: They don’t know enough to
effectively manage their health care options
• 51% of workers say they do not prefer to be in control of their health care
expenses/options because they don’t have the time or knowledge to effectively
manage it.
• Workers have limited knowledge of key consumer-driven health plan options.
Those who say they are extremely or very knowledgeable about:
• Flexible Spending Accounts – 40%
• Health Savings Accounts – 31%
• High Deductible Health Plans – 26%
• Health Reimbursement Accounts – 21%
• 47% of workers have not begun to prepare themselves for possible changes to the
health care system.
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9. Concern No. 2: Unsure how they will be affected
Since many do not understand health care reform, they are left wondering how
health care reform will impact them.
• While 26% of workers strongly or completely agree they will have better
insurance because they will have greater control:
o Only 14% of workers strongly or completely agree that the quality of their
health care will increase as a result of health care reform.
Many indicate they believe health care reform will affect the cost of their
health care coverage.
• The majority (86%) at least somewhat agree the medical costs they are
responsible for will increase.
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10. Concern No. 3: They are not financially prepared
The reality is that many companies already shift a significant share of health care
premiums to their workers, and yet:
• 42% say they are not at all or not very prepared to pay for out-of-pocket
expenses associated with a serious illness or injury.
• 49% of employees have $1,000 or less to pay for out-of-pocket expenses
associated with an unexpected serious illness or accident.
• 27% of employees have less than $500 available to pay for out-of-pocket
expenses associated with an unexpected serious illness or accident.
• 39% of workers would have to borrow from their 401(K) and/or from friends and
family to pay for out-of-pocket expenses associated with an unexpected serious
illness or accident.
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11. Concern No. 4: They underestimate out-of-pocket
medical costs, resulting in financial stress
Very few American workers understand the impact of medical expenses on their
overall financial health. In fact, many workers are facing financial crisis:
• 42% say they are not at all or not very prepared to pay for out-of-pocket
expenses associated with a serious illness or injury.
• 69% of workers at least somewhat agree that they regularly underestimate the
total cost of an injury or illness, including medical, household and OOP
expenses.
• At least 1 in 10 (13%) workers are currently dealing with high medical bills,
roughly 20 million workers.
• Nearly one-quarter (24%) of the workforce has been contacted by a collection
agency due to medical costs and/or had their credit score negatively impacted.
• 10% of workers have missed bill payments due to high medical costs, totaling
approximately 15 million workers.
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12. At a Critical Crossroads

13. Benefits impact employee attitudes
The 2014 Aflac WorkForces Report shows that employee perceptions of the
degree to which their employers care about them weighs heavily on their loyalty
or lack thereof.
•When asked how influential an overall benefits package is in the decision to
leave a current employer, 78% say at least somewhat influential.
o 57% of workers are at least somewhat likely to take a job with lower pay
but better benefits options.
•When asked what their current employer could do to keep them, 41% said
“improve my benefits package.”
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ONLY 14% OF WORKERS SAY THEY ARE EXTREMELY
SATISFIED WITH THEIR CURRENT BENEFITS PACKAGE.

14. Employees rate benefits higher than employers do
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15. • “Personal financial issues” was named as the top nonwork related issue that
distracts most employees during work.
• Voluntary insurance policies help employees cope with living expenses and
out-of-pocket costs associated with accidents or illnesses – costs major medical
insurance was never intended to cover.
• Voluntary insurance policies are designed to pay regardless of major medical
insurance, including policies that will be in place through public or private
marketplaces and exchanges.
• Voluntary benefits options help offer workers an essential safety net.
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Change presents an opportunity
Health Care Reform does not eliminate the need for voluntary
insurance; it shines a spotlight on employees’ increasing need for
voluntary benefits!
WORKERS MAY WELL BE THE ONES RESPONSIBLE FOR THEIR
HEALTH CARE DECISIONS, BUT THE WRONG CHOICES CAN
GREATLY AFFECT THEIR PERFORMANCE AND STATE OF MIND IN
THE WORKPLACE.

16. Workers want benefits – and are willing to pay for them
• 88% of workers at least somewhat agree that voluntary benefits options
are a part of a comprehensive benefits program.
• 52% of those without access to voluntary benefits options say they would
at least be somewhat likely to purchase voluntary benefits options if their
employer offered them.
• 63% see a growing need for voluntary benefits options.
• When asked why the need for voluntary benefits options is growing today,
workers say:
o Rising medical costs: 76%
o Rising medical coverage costs: 66%
o Increasing deductible and copays: 61%
o Because employer reduced benefits and/or coverage: 37%
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17. Thank you
This material is intended to provide general information about an evolving
topic and does not constitute legal, tax or accounting advice regarding any
specific situation. Aflac cannot anticipate all the facts that a particular
employer or individual will have to consider in their benefits decision-making
process. We strongly encourage readers to discuss their HCR situations with
their advisors to determine the actions they need to take or to visit
healthcare.gov (which may also be contacted at 1-800-318-2596) for
additional information.