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The Rough Notes Company Inc.



January 12
10:36 2017

Practical benefit can help workers address health insurance gaps and manage increased costs

It used to be a throw-in, a cheap benefit that employers added to their plan designs at nominal cost as part of a package of ancillary coverages that included term life, dental and vision benefits.

The old Accidental Death and Dismemberment (AD&D) policies paid a limited schedule of benefits for rare catastrophic claims; as a result they were often overlooked by employees.

But now a new breed of accident insurance benefits are becoming more attractive—and necessary—for employees who are sharing their employers’ rising healthcare costs and facing more limited group medical benefits. As employer health insurance premiums rise, plan sponsors have shifted to higher deductible health plans and Health Savings Accounts (HSAs) that place more financial demands on their employees, benefits experts say.

Newly designed and more flexible accident insurance products—now more likely to be voluntary and employee-paid—are filling in the gaps in group medical coverage and giving workers more opportunities to fund a broader range of needs.

“With the rapid growth of benefits with high-deductible major medical plans, employees need something more to cover the additional expenses that fall within their deductibles,” explains Jeff Sterling, vice president of employee benefits at Hub International-Texas in Dallas, who offers Chubb Workplace Benefits products to his clients.

“With major medical deductibles ranging as high as $5,000 to $10,000 annually, many employees just don’t have the financial resources to meet their deductibles if an emergency arises,” he adds. “They need accident insurance to fill in those gaps for sudden emergency room visits, sports accidents or unpredictable hospital admissions.”

Janet Buzil, vice president of marketing and product development at Chubb Workplace Benefits in Glenview, Illinois, agrees. “Medical plan deductibles are going up. High-deductible health plans are here to stay. Employers are not likely to pay for richer benefits as their own medical costs continue to increase. But they are willing to find ways to help their employees manage the costs that are being shifted to them.”

“With little to no savings, employees need options to protect their finances in ways that major medical simply does not, which makes access to products like accident coverage important to all employees.”

—Stephanie Shields
Vice President of Product Innovation and Marketing

Buzil says the new accident plans are designed to pay benefits directly to employees who choose them, simplify the claims process, and meet the economic needs that come with emergencies. “Our goal is to put money in their pockets when they need it,” she says.

Surveys say …

The increase in deductibles comes at a time when U.S. employees are still recovering from a multi-year recession and tapped savings. According to a study conducted by the Board of Governors of the Federal Reserve system in Washington, released in May 2016, nearly half of Americans surveyed in 2015 (46%) said they could not cover an emergency expense for $400 or more.

The Report on the Economic Well-Being of U.S. Households in 2015 was developed by consumer research firm GfK, which surveyed a panel of 50,000 consumers about their economic preparation. The survey also noted that 22% of respondents experienced a major unexpected medical expense for which they had to pay out of pocket the prior year, and 46% of those said they had a major medical expense for which they currently owe debt.

“Something has to be in place to provide the first-dollar coverage that individuals do not have,” Sterling says. “As a result, voluntary accident insurance plans that are designed to fill in gaps are becoming more popular.”

Insurance industry research confirms the employee dilemma. According to the 2016 Aflac Workforces Report, 52% of employees have less than $1,000 saved for unexpected out-of-pocket expenses associated with a medical event.

Aflac’s Stephanie Shields, vice president of product innovation and marketing, says the need to fill in the holes has spurred product creativity and market growth.

“With little to no savings, employees need options to protect their finances in ways that major medical simply does not, which makes access to products like accident coverage important to all employees,” she says. “Employers are looking for ways to reduce out-of-pocket costs while maintaining consistency in coverage for employees.

“This has led employers to consider voluntary benefits—such as an accident plan—as an important part of the medical plan decision-making process. They are seeking plan designs that directly complement each other for a more holistic employee solution,” Shields says.

New plans

Insurers agree there’s a growing recognition of the need for accident insurance products and have launched their own efforts to design broader and more creative plans. New accident insurance products from Aflac, Transamerica Employee Benefits, Chubb Workplace Benefits, Standard Insurance Company and others provide coverage features that extend beyond medical treatments to include family transportation and lodging, rehabilitation services, daily recovery costs and family care when caregivers are recovering from illness or injury.

And employers are responding. While insurers report little interest in paying for these broader accident benefits as part of comprehensive group benefits, they are very interested in choosing and endorsing the coverage for their voluntary benefits, along with more traditional extended life insurance, critical illness insurance and long-term care insurance.

Danielle Lehman, senior product manager at Standard Insurance Company in Portland, Oregon, says AD&D insurance’s limited coverage met very few employee needs, but the new plan designs are more valuable to employees in the long run even though they are employee-paid.

“The new products can be configured to cover 70 to 80 different types of treatments,” she says. “And even though only a few small employers are interested in paying for the coverage, employees get better rates and know they benefit from the oversight and concern of their employers in providing the benefits at the workplace.”

Lehman adds, “Employers make the choices of what benefits to offer, but employees make the decision about what is best for themselves or their families. With these new benefits, they can purchase coverage for the most common injuries, such as auto accidents and sports injuries, which rarely pierce a major medical deductible.”

Jeff Caldwell, director of strategic partnerships at Transamerica Employee Benefits in Little Rock, Arkansas, cites LIMRA’s U.S. Marketing Voluntary Sales reports as documentation of the market growth.

“The accident insurance market experienced almost 10% growth in 2016, which is close to this market’s growth in 2015. The growth in accident sales reflects how agents are integrating accident insurance into an employer’s overall benefits strategy and using plan designs to supplement an employer’s major medical plan.”

He says the growth resurgence is also being fueled by accident product plan designs with wellness benefits that complement an employer’s health benefits strategy. Accident plans can include payments for health screenings, behavior modification and other activities that not only can improve employee health but also reduce employers’ catastrophic claims.

“The old AD&D coverage was one of the least used employee benefits—used by less than 1% of covered employees—because it covered so little. Today we have risen to the challenge of building accident benefits that supplement medical insurance.”

Caldwell says the upward trend is expected to continue in 2017 as small and mid-sized employers review their benefits programs. Agents and brokers can take advantage of this opportunity by asking clients to review their accident plan designs to choose a product with the most current features and benefits.

“What I have seen is employers using accident insurance to help employees cover those now uncovered expenses: the $250 emergency room co-pay, urgent care costs and some non-medical expenses like transportation and home help,” he says.

Spreading the word

Marketing the new accident insurance products is not easy. Insurers note that agents and brokers must work a little harder to educate employers about the plan designs and deliver the product knowledge to the employees who finally make the benefit choices.

“As employers integrate voluntary products into their benefits strategy, they need to ensure that their employees understand the importance of the product,” Shields says. “As high-deductible health plans continue to grow in popularity, this leaves more responsibility on employees for medical costs. Voluntary benefits are a way to ease the burden of high out-of-pocket costs for care. Integrating voluntary benefits into a benefits strategy can save the employer premium dollars and still provide the protection and coverage needed to recruit and retain employees.”

Employers must learn to make choices that match their employees’ needs, and employees must make good choices for their families’ needs. “I think it can be overwhelming for employees,” says Buzil. “There are a lot of choices to make at enrollment, and getting a better understanding the value of supplemental health insurance benefits requires some education and assistance.”

As a result, insurers are providing a growing roster of collateral benefits communications, enrollment support and decision support technology that automates not only the choices but also the order of choices according to plan design relevance.

“Employers are providing more decision support to employees and helping guide employees to purchase these plans,” Shields says. “Employers have been communicating with their workers in various ways, such as in-person interaction, presentations and online tutorials and consulting advisers to help them explain the importance of accident coverage.

“Insurance carriers also have been working with employers and advisers to position accident products more strategically in the enrollment process so they directly follow the major medical decision. When this happens, employees are better able to see the connection between holes that may exist in their medical plan and how voluntary products can help cover those risks.”

The Standard, for example, provides decision-support tools that include online access to videos describing the product, as well as common claims examples, Lehman says.

Sterling adds that the extra work can be worth the effort. Agents and brokers who can artfully educate employers about the new accident benefits and how they complement a traditional benefit plan design can enhance their overall value proposition.

“In many cases, using our ability to match voluntary benefits to an employer’s benefits plan has been the deciding factor in reaching our goal—getting a broker of record letter,” he says.

For more information:


Chubb Workplace Benefits

Hub International

Standard Insurance Company

Transamerica Employee Benefits

The author

Len Strazewski is a Chicago-based writer, editor and educator who specializes in marketing, management and technology topics. In addition to contributing to Rough Notes, he has written on insurance for Business Insurance, Risk & Insurance, the Chicago Tribune and Human Resource Executive, among other publications.

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