Category Archives: benefits

The Cadillac Tax and Large Employers

Employers have held the line on healthcare cost increases for the third year in a row, reports Mercer in its just-released 2015 National Survey of Employer-Sponsored Health Plans. Nonetheless, 23 percent of large employers are at risk of hitting the Affordable Care Act’s widely despised 40 percent excise tax cost threshold in 2018 — and 45 percent are at risk of hitting it in 2022, according to the report.

Per-employee health benefits costs grew by only 3.8 percent this year, marking the third year in a row of a growth trend of below 4 percent, says Mercer. As in previous years, however, large companies fared better than smaller ones in holding the line: Costs rose by 5.9 percent for organizations with 10 to 499 employees, compared to just 2. 9 percent for those with 500 or more.

Large employers were helped by a jump in enrollment for high-deductible consumer-driven plans, says Mercer, while use of these plans among small employers has grown more slowly. At large companies, enrollment has grown from 15 percent to 28 percent of covered employees within the last three years. At small companies, however, it’s risen from 17 percent to just 19 percent.

Total health benefit costs averaged $11,635 per employee this year, Mercer finds, including employer and employee contributions for medical, dental and other health coverage for employees and their dependents. Employers predict their costs will rise by 4.3 percent on average next year, taking into account changes they expect to make to their health plans to reduce costs. They predict costs will rise by 6.3 percent if they make no changes to their plans.

Mercer credits these cost-containment (some would say “cost-shifting”) strategies with lowering the number of plans expected to be hit by the Cadillac tax in 2018. However, the report notes that a plan’s actuarial value is not the only factor that can drive up costs above the excise tax threshold. Health plan costs can vary significantly by geographic region, the degree of competition among providers in a particular market and workforce demographics, it says. Furthermore, it cautions, due to the way the excise tax threshold is indexed, the number of employers vulnerable to the tax will grow every year that medical inflation exceeds the general CPI — thus, by 2022 45 percent of large employers are estimated to be liable for the tax unless they make changes.

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Parental Leave Enters Political Storm, Too

Paid parental leave has certainly taken over the media waves of big businesses trying to one-up each other in just how accommodating 510042321-- parents & newbornto new parents they can be. (See our most recent HRE Daily posts on large companies announcing such leave accommodations, including Michael J. O’Brien’s post just Wednesday on Amazon’s plan to up its allotted leave for new parents and allow them to share their paid time with partners not employed there.)

In addition to this race toward better policies, however, paid parental leave has entered a political-football frenzy of late as well. Just as Amazon was making its announcement Monday via a memo to all employees, newly elected Speaker of the House Paul Ryan, R-Wis., was in the news for resisting calls to back a federal paid-family-leave law.

And this despite his outspoken desire to spend more time with his own family, according to this Huffington Post piece and this — far-more critical — piece on, as well as the fact that he provides his own staff with paid family leave.

“Because I love my children and I want to be home on Sundays and Saturdays like most people doesn’t mean I’m for taking money from hardworking taxpayers to create a brand new entitlement program,” Ryan told Meet the Press in a recent taping. He thinks offering such leave is up to employers; it’s their role, not the government’s.

Yes, that’s the common Republican stance — less federal control in favor of more individual control — but personally, says Terri L. Rhodes, CEO of the San Diego-based Disability Management Employer Coalition, the Paul Ryans of the world, as well as most all businesses and politicians from both sides of the aisle, “are all probably thinking mandated paid family leave is a good thing.”

Small and mid-sized businesses, especially, tend to be in favor of a federal mandate, she says, because they can’t necessarily afford the sweeping changes and allowances big businesses can in their attempts to stay one step ahead of their competition.

This mad race is further compounded by the fact that some states — including New Jersey,  California and Rhode Island — already offer some kind of paid family leave, and some states, and many companies, are backing paid sick leave as well.

“For big multi-state or global companies,” says Rhodes, “they can afford to figure how all this fits in with their policies and costs.” They can find a way to make it all work. But for smaller and mid-sized businesses, it’s much more complex “when it comes to considering provisions and accruals” and such.

“If we had a mandated paid leave,” she says, the playing field would be leveled more in terms of “what is expected; it would be more cut-and-dried.”

What’s more, she adds, many large corporations may espouse more liberal parental-leave policies, but don’t actually “support the policy that’s just been announced” when it comes to the corporate culture. The actual taking of the leave may still be frowned upon internally, but the external employer brand comes out smelling like a rose.

The sad reality — in the United States, anyway — is that “having a family still isn’t looked on as a great career path,” Rhodes says. “That’s a problem for everyone” — big business, small business … and Paul Ryan.

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Amazon’s New Approach to Parental Leave

From a public relations—and maybe an employee relations—perspective, it could take a while for Amazon to sweep away all of the debris left behind by this recent New York Times article.

But you can’t say the company isn’t trying.

Last month, the ubiquitous online retailer was back in the news, as it expanded its Amazon Connections program in an effort to solicit more frequent feedback from employees with regard to their job satisfaction, leadership opportunities within Amazon and more.

And, just this week, a number of media outlets have picked up on an Amazon memo sent to employees on Monday, which effectively announced a revamped parental leave policy that increases the amount of paid family leave time available to full-time hourly and salaried employees as well as Amazon’s fulfillment center and customer service workers. The new policy affords birth mothers with up to four weeks of paid pre-partum medical leave, followed by 10 weeks of paid maternity leave. Birth mothers and all other new parents who have been with the company for more than one year can also take a new six-week paid parental leave.

Not all of these reports, however, touched on what seems like an especially unusual aspect of the new policy.

In addition to allotting more paid time off to new mothers at Amazon, the company has also unveiled its “Leave Share” program, which allows eligible employees to share all or some of their six weeks of parental leave with a spouse or partner who doesn’t receive paid leave from his or her employer.

Amazon shared details of Leave Share with the Chicago Tribune, offering an example of how an employee could take advantage of this new benefit.

“Julia is an associate at an Amazon Fulfillment Center and recently had a baby. She’s taken 10 weeks of paid maternity leave and would like to come back to work.

“Ideally, she’d like her husband to take some time off at this point, which would make her return to work easier. However, her husband’s employer provides only unpaid paternity leave, and it’s going to be financially difficult for him to take time off. That’s where the Leave Share Program can help. Julia can share all or a portion of her paid parental leave with her husband, and he can stay home and help with their new baby.”

While this example involves a birth mother, the Leave Share concept works the same way for Amazon fathers and same-sex couples, according to the company.

Of course, Amazon isn’t the first high-profile organization to broaden the scope of its parental leave policy. But it will be interesting to see if other large companies follow suit, and start offering employees the ability to share their paid leave time with spouses and partners.

You can count Kristin Rowe-Finkbeiner, executive director and CEO of, among those who think workers should already have such options at their disposal.

In a statement released within hours of Amazon’s Monday memo hitting the media, Rowe-Finkbeiner called for action on a national level to make that happen.

“While we celebrate’s announcement, it is long past time that our elected officials take a comprehensive, national approach that will guarantee that ALL working families will have the ability to earn paid family and medical leave insurance,” she said. “You shouldn’t have to win the ‘boss lottery’ to be covered by this critically important policy that studies show boosts families, businesses and our economy.”

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The Ongoing Expansion of Worksite Health

Affordable Care Act uncertainties be damned—employers are going ahead with their plans to launch on-site health centers.

That seems to be the overarching message to emerge from Mercer’s new targeted survey on worksite clinics.

The New York-based consultancy’s poll is actually a follow-up of sorts to last year’s National Survey of Employer-Sponsored Health Plans, in which 29 percent of organizations with 5,000-plus employees that provide an on-site or near-site clinical site said they offer primary care services. (That figure marks a 5 percent increase in the number of companies saying the same in 2013.)

For this recent survey, all participants from the 2014 poll that reported offering a worksite clinic were invited to answer detailed follow-up questions about their clinic operations. Among the 134 respondents, 91 percent of those with clinics identified controlling total health spend as a “very important” or “important” objective in establishing an on-site center. For 77 percent of survey participants, reducing lost employee productivity was also a key goal, with 68 percent saying they consider improving member access to healthcare important or very important.

These findings are very much in line with what Towers Watson’s 2015 Employer-Sponsored Health Care Centers Survey uncovered earlier this year. In that survey, 75 percent of 105 organizations currently offering employer-sponsored health centers cited increasing productivity as a key goal, with 74 percent indicating the same about reducing healthcare costs, and 66 percent reporting they hope to improve employee access to healthcare services.

What experts at both Towers Watson and Mercer find most interesting about these figures, however, is the suggestion that the ACA’s infamous excise tax hasn’t deterred many employers from building new on-site health clinics, or from expanding existing centers.

“ … Companies are adding centers despite concerns around the Affordable Care Act and its excise tax, which [requires] that the cost of an on-site center has to be included in the cost of delivering healthcare to employees,” Allan Khoury, senior health management consultant at Towers Watson, told HRE in June.

“If that cost goes too high, you violate the Cadillac tax. But we’re still seeing great support for these clinics among employers.”

That’s not to say companies aren’t concerned that on-site health centers’ operational costs could help push them over the threshold for the excise tax, of course. But, by and large, most organizations remain convinced that their clinics “will deliver positive net value,” said David Keyt, principal and National Onsite Clinic Center of Excellence leader at Mercer, in a statement.

In the latest Mercer survey, 15 percent of respondents said they believe their general medical clinic will hurt them in terms of the excise tax calculation, but 11 percent said they think it will help, “presumably by helping to hold down the cost of the company’s health plan,” according to Mercer. Twenty-eight percent think it won’t have an effect either way.

And, ultimately, most companies aren’t really using cost as a barometer for the value of their on-site health centers anyway, according to Keyt.

“For many employers, employee satisfaction is a more important measure of success than ROI,” he said. “If employees are using the clinic, it means they haven’t been taking time off work to visit a doctor, and that they’re getting the medical care they need to stay healthy and productive.”

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Diagnosing the State of Vehicle Benefits

Woman driving car

Workers and their employers like vehicle benefits.

Despite up-and-down gas prices and clogged freeways, the American love affair with the car continues, as does the enthusiasm among American workers and their companies for vehicle-related benefits. A recent WorldatWork survey of more than 400 comp specialists finds that nine out of 10 of the organizations surveyed offer a car allowance, company car, fuel reimbursement or other vehicle benefit to at least some of their employees.

Vehicle-related benefits are far more prevalent among American companies than among their foreign brethren: 74 percent of U.S. companies surveyed offer them, compared to 24 percent in Canada, 21 percent in Western Europe and 20 percent in the U.K.

The most-common vehicle-related benefit is fuel or mileage reimbursement (70 percent), while 69 percent say car allowances are the “most popular” program. Car allowances are typically offered to executives (75 percent), while 66 percent of organizations provide their executives with a personal vehicle.

Interestingly, many companies use their vehicle-related benefits as a recruiting tool: Two thirds (66 percent) say they always or sometimes promote these benefits as a “key employee benefit” to attract recruits. This makes sense, given that 64 percent say vehicle benefits have a positive impact on employee satisfaction.

Increasingly, vehicle benefits are taking a new turn as the popularity of electric cars continues to grow. In the Atlanta region (the nation’s second-largest market for electric vehicles), Nissan and Georgia Power have teamed up to help companies with at least 100 employees purchase EV charging stations. Employers can receive a $1,000 rebate for each 240-volt, Level 2 charger they install — half the amount comes from GP, and the remainder comes from Nissan (maker of the Nissan Leaf, incidentally).

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Not So Fast on the Netflix Good News, Says Group

Invariably, any large company — especially one that’s in the news — attracts its detractors as well as its fans. Just try “Googling” “anti-494368457 -- mother and infantWalmart websites” and see what comes up on the nation’s largest employer.

So no surprise, really, that Netflix’s recent announcement — that it would offer unlimited leave to new moms and dads, allowing them to take off as much time as they want during the first year after a child’s birth or adoption — has yielded an “anti-stir.”

A women’s group calling itself UltraViolet just rolled out an ad campaign last week against what it claims are Netflix’s discriminatory practices in not opening its new leave program to the poorest among its ranks instead of just the wealthiest. (Here’s the actual petition for those who want to join the fight.)

According to an emailed announcement about this new uprising, “more than 47,700 UV members have demanded Netflix give its hourly workers the same ‘unlimited’ parental-leave benefits that workers who make $300,000 receive.” As Nita Chaudhary, UV’s co-founder, puts it:

“People are taking notice that Netflix is expecting praise for extending parental leave to its higher-paid employees, yet it doesn’t extend those benefits to the hourly employees who need it most.

“It’s important that Netflix set an example for the rest of employers and companies nationwide: With one in four moms going back to work less than two weeks after giving birth, Netflix can turn the tide by giving ALL employees equal benefits — not just reserve those benefits [for the wealthiest ones].”

The women’s group contends this exemption was somehow left out of the company’s announcement, the latter of which has certainly been reverberating positively throughout the business community, as this feature about the move in Fortune indicates. And this, from BuzzFeed News, indicating other big Silicon Valley companies have been following suit — including Microsoft and Adobe — in announcing similar unlimited paternity leave programs since Netflix’s announcement.

Indeed, I saw no mention of any exemption in the announcement. Nor was it mentioned in Andrew R. McIlvanie’s blog post that included news of the announcement. (Though that post does examine the problem of unlimited leave policies being launched in corporate cultures that don’t support them … which may or may not be the case at Netflix.)

I did reach out to the company about all this, and got the following back from a company spokesperson:

“Across Netflix, we compare salary and benefits to those of employees at businesses performing similar work. Those comparisons show we provide all of our employees with comparable or better pay and benefits than at other companies. For example, medical and life insurance for DVD workers exceeds market standards. All DVD employees including hourly are also eligible for a minimum of 12 weeks off for maternity or paternity leave. We are regularly reviewing policies across our business to ensure they are competitive and help us attract and keep the best employees.”

Nothing on the UV ad campaign. Nothing on any exemption in its new policy. Like so many other big-splash initiatives and subsequent fallout, I guess we’ll just have to let this one play out.


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How Wellness Programs Must Evolve

Last month a diverse group of experts gathered in New York for a roundtable discussion on “redefining workplace wellness.” The group spanned academia, the health professions and corporate America and while their conclusions weren’t necessarily groundbreaking, they were nonetheless insightful and thought-provoking. The Global Wellness Institute organized the meeting and they’ve just released a report summarizing the discussion — I’ve included some of the highlights below:

1. It’s Time to Get Past “Unscientific Mud-Slinging on ROI.”

The argument over return-on-investment is one of the great bugaboos bedeviling wellness. But the roundtable participants agreed that in the future companies will shift their focus on ROI to a “wider ‘return on value': not just lower healthcare costs, but important gains in retention and productivity.” “Critics are misusing this ‘ROI science’ to castigate critical, fledgling workplace health efforts,” said participant Dr. Kenneth R. Pelletier, clinical professor of medicine at UC-San Francisco and the University of Arizona. “These critics are also imposing a ‘standard of evidence’ that doesn’t exist for any other workplace investment — like a software upgrade. Successful companies — Google is a shining example — have moved well beyond ROI, to embrace total value on investment, and workplaces where a culture of health is the norm.”

2. Take Seriously That Technology-Enabling 24/7 Work Is “Killing Us.”

Those midnight calls to discuss project updates with the team in Dubai or Singapore? No good, conclude the experts: “Technology has suddenly spawned new, global work realities: imprisonment by screens, and a powerful erosion of the line between now always-on ‘work’ and ‘life.'”

James Brewer, workplace consultant at Steelcase, said large companies could learn a thing or two from their much-smaller counterparts: “Start-ups appear to be more proactive in implementing policies that help their employees define when it is OK to ‘turn it off’ and disconnect … these types of policies are largely absent in larger companies.”

Paul Terry, president and CEO of Staywell, said so-called “resilience” and “high-performance cultures” may just be colloquialisms for “high endurance cultures.” In the future, the experts agreed, tackling this 24/7 version of work will become a focus of wellness programs, possibly including a redefinition of “productivity.”

3. Embrace the Tech

Innovations like telemedicine let workers connect with doctors in ways that don’t involve a disruption to their work schedules, the experts noted. And wearables may look very different in the future, according to Dr. Pelletier: “invisible, ingestible nanotechnology, wireless Bluetooth, and the next generations of the Apple Watch will capture a broad spectrum of employees’ biometric data effortlessly and around the clock.”

4. Don’t Forget the Remote Workers

Employees working remotely may suffer more loneliness and a lack of peer support in their work and their health, the experts note. Smart wellness programs will shift from “workplace programs” to “total workforce solutions.”

“Sustaining a culture of health across the increasingly remote workforce will be utterly key in the future,” said Dr. Fikry Isaac, chief medical officer at Johnson & Johnson. “And in order to impact these remote and at-home workers, smart companies will touch on, and include, the family, significant others and the communities where they live.”

5. Mental Health Must Be a Greater Priority

Most global wellness programs have focused on physical health, the experts noted. However, the rampant “do more with less” approach to work along with the aforementioned 24/7 nature of many jobs means “we have a once-silent, but now getting louder mental health, stress and ‘burnout’ epidemic on our hands.”

“More stressful jobs and lives mean emotional well-being is taking a toll from East to West. Twenty percent of the U.S. population (at any given time) has a diagnosable mental health issue, and the research on the state of employee mental health/stress in places like Asia is sobering.”

This has led to more addictions — sleeping and anti-anxiety pill use keeps climbing, the experts noted.

There’s hope on the horizon, they also noted: research around neuroplasticity, and studies on the effectiveness of approaches like positive psychology, meditation and mindfulness is “exciting,” and the near future will bring more innovative strategies for addressing mental health and stress, and “not just for Silicon Valley and Wall Street executives.”

There’s plenty more in the report, and it’s a worthwhile read.

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The Paradox of Unlimited Paid Leave

Paid leave is in the news lots these days: President Obama has just drafted an executive order requiring federal contractors to provide paid leave for medical or health reasons or to care for a sick relative. Employers who fall under the order’s purview would be expected to provide a minimum of about seven days of paid leave per year and to allow the leave to accrue year after year. The executive order — which is expected to go into effect within a couple of months – would not only affect hundreds of thousands of employees, but may have an effect that extends beyond federal contractors: “You can build an expectation that paid sick leave comes with a job,” Elise Gould, a senior economist at the Economic Policy Institute, told the New York Times. “Changes in cultural norms matter.”

rbrs_0240Over in Silicon Valley, meanwhile, the cultural norm is plush benefits for the employees of the area’s tech behemoths – and now Netflix has raised the bar: Earlier this week it announced it would offer unlimited paid maternity and paternity leave. Employees can stay out as long as they like to care for their newborn or newly adopted children while still receiving full pay and benefits, said Netflix Chief Talent Officer Tawni Cranz.

Netflix’s announcement makes the generous leave policies offered by Facebook, Google, Accenture and Johnson & Johnson – which offer paid leave for up to four or five months – pale in comparison. However, the longstanding question about unlimited time-off policies – whether they’re for vacation, health reasons or the birth or adoption of a child – is that if you leave it to the discretion of employees as to how much time to take, won’t they actually end up taking less time (or none at all) than if they were given a set amount?

“An unlimited policy sounds great in theory,” writes Jena McGregor, the On Leadership columnist for the Washington Post. “Unless the culture really supports it, however, employees won’t know how to react and may even end up taking off less time than they otherwise would.”

When tech firm Evernote began offering unlimited vacation time to its employees back in 2011, it noticed some employees were actually taking less vacation in order to look better to their bosses, writes MarketWatch’s Catey Hill. The company then actually began paying people $1,000 to actually take a vacation, she writes.

The culprit may be “work martyr syndrome,” Hill writes: Employees – especially those in highly competitive workplaces – are looking for any advantage they can, and by deciding to take less (or even no) time off, they believe they’re looking better in the eyes of their bosses. “You’re trying to show you’re a harder worker,” executive coach Marc Dorio told Hill.

In other words, unless Netflix and other companies offering unlimited time off actually build support for extensive parental or medical leave time into their culture (with leaders setting the example), it will probably be a perk in name only.

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The Incredibly Shrinking Carrier Market

It’s official: Anthem announced this morning plans to purchase Cigna for more than $48 billion.

Word Cloud Merger & Acquisitions

Word Cloud Merger & Acquisitions

Coming on the heels of Aetna’s $37 billion proposed deal to acquire Humana, the Anthem-Cigna proposed merger, were it to be given the green light by regulators, would inevitably reshape the health-insurance landscape and provide employers with one less option to consider. But according to experts I spoke to earlier today, deals like the one announced this morning also have the potential of being a boon to employers and employees.

If the Anthem-Cigna transaction goes through, Anthem will have more than $115 billion in pro forma annual revenues, based on the most recent 2015 outlooks publicly reported by both companies. Anthem President and CEO Joseph Swedish would serve as chairman and CEO of the combined company and Cigna’s President and CEO David Cordani would take on the titles of president and COO.

Here’s Swedish’s take on the proposed merger …

“We believe that this transaction will allow us to enhance our competitive position and be better positioned to apply the insights and access of a broad network and dedicated local presence to the health care challenges of the increasingly diverse markets, membership, and communities we serve. The Cigna team has built a set of capabilities that greatly complement our own offerings and the combined company will have a competitive presence across commercial, government, international and specialty segments. These expanded capabilities will enable us to better serve our customers as their health care needs evolve.”

And Cordani’s take …

“The complementary nature of our businesses will allow us to leverage the deep global health care knowledge, local market talent, and expertise of both organizations to ensure that consumers have access to affordable and personalized solutions across diverse life and health stages and position us for sustained success.”

There’s been three national players for a while, with all three of them trying strengthen their portfolios through mergers, explained Tucker Sharp, global chief broking officer at Aon Hewitt in Somerset, N.J. “Someone can put out a headline that says, ‘Five carriers become three.’ But there really have been three national players and what’s happening here is really about building scale … .”

Sharp also noted that lately there’s a bit of merger one-upmanship going on between the carriers and providers. For some time now, he said, the hospitals and physician groups have quietly been merging to get the upper-hand in negotiating with the carriers. Now, much like “an arms race,” you’re seeing the insurer carriers trying to improve their leverage.

At the end of the day, he said, the operational efficiencies and greater scale gained from these mergers could lead to better deals with health providers and benefit employers.

When I asked Sharp if there’s anything HR leaders should be doing differently in light of the Anthem-Cigna news, he said nothing at the moment, noting it’s going to take time for things to work their way through the regulators. If you’re an HR executive, he added, there’s probably nothing you need to worry about for the rest 2015 and 2016.

I also asked Steve Wojcik, vice president of public policy at National Business Group on Health in Washington, for his assessment of the announcement.

His response: “There are some potential upsides and some potential downsides. In the end, we’re looking for some of the cost savings and pricing to trickle down to the employers and employees. But there also are obviously some concerns, because there are only a few players left standing—so employers that want to put their plan administration out to bid are going to have fewer bidders … .”

Wojcik predicts that the Aetna-Humana deal will probably meet less resistance from regulators than the Anthem-Cigna deal because Humana is a smaller player in the employer market, though a much bigger player in the Medicare market.

In evaluating these deals, he said, regulators need to factor in that the health insurance market is dynamic, not static. They’re going to need to weigh into their thinking, he explained, some of the new entities, such as accountable care organizations, that have emerged in recent years and the impact they’re having on the overall market.


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CDHPs Are Closing the Satisfaction Gap

employee health 1Traditional health insurance plans may still be the most popular option among employees, but consumer-driven plans are beginning to catch on with the workforce.

That seems to be the biggest takeaway from new data coming out of the Employee Benefit Research Institute.

Along with Greenwald & Associates, the Washington-based non-profit research institute recently conducted a survey of nearly 2,000 adults between the ages of 21 and 64, who had health insurance through an employer or purchased health insurance on their own, either directly from a carrier or through a government exchange. According to EBRI’s report on the findings, employees enrolled in traditional health plans are expressing greater satisfaction with their coverage than those in consumer-driven health plans, “but the ‘satisfaction gap’ appears to be narrowing.”

Generally speaking, 61 percent of traditional-plan enrollees described themselves as “extremely” or “very” satisfied with their health plans, compared to 46 percent of those in CDHPs, and 37 percent of employees enrolled in high-deductible health plans.

According to EBRI’s Paul Fronstin, however, overall satisfaction rates have been on the upswing among CDHP enrollees in recent years, while the opposite is true for those participating in traditional health plans.

Cost differences may help explain the emergence of this trend, notes Fronstin, the director of EBRI’s Health Research and Education Program and author of the aforementioned report.

Forty-eight percent of traditional-plan participants said they were “extremely” or “very” satisfied with their out-of-pocket costs when EBRI conducted this same poll in 2014. At that time, 19 percent of high-deductible health plan enrollees said the same, as did 26 percent of CDHP participants. In terms of contentment with what they’re paying out of their own pockets, satisfaction rates for all three groups have been trending upward since 2011, according to EBRI.

In addition, employees in CDHPs or HDHPs were less likely than those in traditional plans to recommend their health plans to friends or co-workers, and were less apt to stay with their current plans if given the option to switch plans—as was the case in past years, according to EBRI.

But, as the survey found on a broader scale, “the percentage of HDHP and CDHP enrollees reporting they would be extremely or very likely to recommend their plan to friends or co-workers has been trending upward,” the report notes, “while it has been flat among individuals with traditional coverage.”

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