Employees need their employers to share the cost of mental health treatment as a bona fide employee benefit.
According to the National Alliance on Mental Illness (NAMI), 20% of adults in the U.S. will experience mental health problems each year, yet less than half of those diagnosed receive treatment. Why? The almighty dollar, of course.
Mental health care is expensive, and many adults, even those gainfully employed and with tremendous benefits, cannot afford the ongoing costs necessary to treat the many common mental health issues afflicting society today.
Anxiety, depression, substance abuse, PTSD, eating issues, phobias, bipolar disorder. These were an issue pre-pandemic; in 2019, the National Institute of Mental Health (NIMH) reported nearly 52 million adults experienced some form of mental illness. According to the Centers for Disease Control (CDC), depression interferes with physical and mental job tasks between 20% and 35% of the time.
But these conditions alone are not the only problem.
Mental health disorders often lead to other medical problems. For example, NAMI reports individuals with depression are 40% more likely to develop cardiovascular or other metabolic disorders, and 32% of adults with mental illness also experience a substance abuse disorder. In addition, the CDC reports that “the costs for treating people with mental health disorders and other physical conditions are two to three times higher than for those without co-occurring illnesses.”
I see this as a public health crisis the workplace must engage in, considering the average adult spends roughly one-third of their waking hours at work — when they aren’t absent.
Mental health and comorbidities significantly impact employee absence, as employee wellbeing and absenteeism are inextricably linked. Beyond that, productivity suffers when mental illness goes untreated. Known as “presenteeism,” mental health costs employers significantly when employees are at work but not focused. Simply put, workers struggling with mental health issues get less done.
According to research from the National Safety Council and the National Opinion Research Center at the University of Chicago, employees with mental health problems cost their employers nearly $5,000 per year in lost workdays, increased turnover, and higher health care costs.
So, what can employers do? Staying the course is not an option, and it shouldn’t be if the end goal is a healthier, safer, and more productive workforce.
Employees need their employers to share the cost of mental health treatment as a bona fide employee benefit. Supplemental benefit products can help accomplish this, whereas mental health and drug or alcohol issues have been exclusions previously. Therefore, removing these exclusions is a positive step forward.
Riders are also a possibility, enabling employees to elect the coverage. However, with a rider, employees receive only a streamlined version of benefits that would otherwise be more robust and flexible if it were a separate policy.
Another option is expanding Employee Assistance Plans (EAPs), covering a practical and sufficient number of doctor visits instead of one or two that have been the standard practice. However, most EAP plans are not subject to COBRA as they are, in essence, referral sources instead of actual health plans.
We need to innovate.
While these options are all well and good, building insurance products where mental health services are a part of the plans — such as inside critical illness insurance (CI) product — is the future. This is important for several reasons, including the high value placed on this employee offering. In addition, the insurance carrier will not be subject to adverse selection like it can be as a rider.
To make this a reality, carriers and employers must come to the table.
In a recent announcement from Thrive, the behavior-change technology company founded by Arianna Huffington, and the Society for Human Resource Management (SHRM), Johnny C. Taylor, Jr., SHRM President, and CEO, stated, “Now more than ever, employers must commit and provide adequate resources to support their employees’ successful mental health and wellbeing. It’s not just good for their businesses – it’s also the right thing to do.”
Thrive and SHRM brought more than 80 companies together, including brands such as Marriott International, CVS Health, and Microsoft, to pledge that “The times are uncertain. Our commitment to mental health is not… That’s why we’ve come together to pledge to continue prioritizing our employees’ wellbeing and mental health through the uncertain times ahead — and maintain our investments and commitments in this critical area.”
In most employees’ minds, employers must realize this situation is real; mental health coverage is second only to traditional health and dental care. So, they must find a broker or consultant willing to be the collaborative link between themselves and insurance carriers – one who can be creative in this partnership to help carriers deliver innovative solutions.
As for carriers, they must realize this is their opportunity to help employers shine and build stronger relationships with their employees. Carriers that design customizable products with offerings such as mental health care built-in will ultimately differentiate themselves in a marketplace where product differentiation is critical. This strategy will also allow them to charge an appropriately higher premium that will offset any adverse selection concerns, which may be a problem for carriers that create standalone mental health care products.
“There are several things an insurance carrier can do to make mental health a bigger priority in their critical illness products, including covering mental health screenings under wellness benefits, providing EAP resources at the time of the claim, or adding mental health conditions as insured benefits under their plan,” said Matt Ennis, Director, Strategy, Product and Marketing at Reliance Standard.
Finally, brokers must keep fighting the good fight, demanding this of carriers. If they want to see a better result for their clients, brokers must engage; be that creative, collaborative partners; and be intentional about finding – and helping create – the ancillary products their clients need and deserve.
“While mental health conditions are a challenge as they cannot be diagnosed definitively with blood tests or x-rays, this is a challenge the industry must come together to solve. Mental health greatly impacts a person’s likelihood of being disabled or dying prematurely,” Ennis concluded. It’s a problem where the employer, employee, carrier, and broker are aligned in their interests – an excellent starting point.”
What’s the worst thing that could happen? Doing nothing. And the best?
Successful employers; productive, healthy employees; trusted brokers and consultants; and profitable carriers.
Positives all around.