Majority of Workers Lack Information Needed for Informed Health Coverage Decisions

With a landmark component of the Affordable Care Act (ACA) implementation just days away, many workers and employers do not yet have the information needed as they navigate the personal and financial implications of the law.

Only 13 percent of workers and 25 percent of employers feel very informed about ACA. This insight is one of many from the inaugural study conducted by the newly launched Transamerica Center for Health Studies(SM) (TCHS).

Inside the survey entitled First Annual Transamerica Center for Health Studies Survey: Benchmark on Health Care Coverage Perceptions and Readiness, workers clearly identified the information they need to feel better informed about their health care coverage options, including: description of the available benefits, a comparison of how the cost of health insurance may change, and a comparison of coverage among the available plans. When asked what they provided to workers, only 12 percent of employers reported providing all three pieces of information. About half of employers provide a description of benefits, 30 percent provide either a comparison of coverage options, and 24 percent provide a comparison of cost.

• Employers and workers face directly conflicting interests regarding health insurance coverage: Employers prioritize lower costs over higher quality, while workers prioritize higher quality over lower cost. 62 percent of workers said “I would prefer to pay more for a higher quality insurance option”; 57 percent of employers said “My company would prefer to reduce insurance costs even if it means a lower quality health insurance option.”
• More workers express interest in receiving one-on-one counseling and detailed comparisons about health care benefit options than employers who currently offer these items. Online tools and Benefits Advisors are seen as the most helpful channels for seeking health coverage-related information by workers yet are less likely to be offered by Employers.
• Small businesses (1-49 employees) are the least likely to offer health care benefits to employees, make changes to their benefits offerings, or engage employees with education or advice about health benefits. Nearly 50 percent of small businesses do not offer health care benefits to any employees; 82 percent of small businesses have not made changes to their benefits offerings in the past year; and 43 percent have never proactively engaged their employees in education or advice about the health care benefits offered. Small businesses are also more likely than medium or large companies to prefer reducing insurance costs even if it means a lower quality health coverage option.
• The majorities of workers and employers indicate they are prepared to make health coverage decisions related to the ACA, but many have not taken any action to prepare. Sixty-seven percent of workers felt they were prepared to make decisions about their health coverage by January 2014, but 57 percent also said they had done nothing in the past 12 months to prepare for the ACA.
• Employers and workers share common interests in wellness programs. 83 percent of employers strongly or somewhat agree that implementing health/wellness and disease management programs lead to better control of health care costs. And 34 percent of workers identified discounts for wellness services as elements missing from their health care options. Older people value this option less than their younger counterparts.

“Health care is about individuals–the lives and livelihoods of people, families and businesses,” said Hector De La Torre, executive director of TCHS. “The notable differences in perceptions between employers and workers may lead to misinformed decision-making. These health care decisions can impact a worker’s individual health, loved ones’ health and even the household bottom line. We need to make sure workers and employers alike have access to reliable, unbiased information about health coverage.”