How COVID-19 is reshaping the design and delivery of global benefits

Employers with multinational operations face a daunting set of challenges in designing and delivering benefits in a world reshaped by the pandemic. Participants in our discussions emphasized the need to be nimble in addressing these challenges, shifting as required from traditional models and embracing new and existing technologies to deliver health care and other benefits to employees efficiently.

Designing benefits in uncertain times

Until herd immunity is achieved and the longer-term effects of COVID-19 are better understood, companies will operate in a highly fluid environment. The following considerations can help guide organizations in designing benefits to meet employee needs in these uncertain times.

• Increasing the duty of care. Employers may need to reassess their role and responsibilities amid the ongoing pandemic. Zurich’s Wendy Liu believes that in this environment employers have a heightened duty of care. Liu points out that this may not always entail funding new programs but can involve providing access to support, for example, through voluntary benefits. “Employees expect the employer to play a bigger role in helping them mitigate or navigate the situation. This would be supported by a new funding mechanism and relationship between employee, employers and their insurers,” adds Liu.

  This heightened duty of care is prompting GE to focus on the haves and have-nots among their employees when it comes to medical care. The pandemic has also highlighted those countries where governments haven’t invested in health care systems as much as expected. GE’s Kerrie Rowland explains, “Health care benefits typically vary by country. However, this might be a case where we want to step in and have a GE standard because there are countries in Africa where both the health infrastructure and government support are lacking.”

  GE has also decided to provide life insurance to employees in countries where this benefit does not typically exist. Rowland emphasizes how GE prioritized employee needs in this situation: “Obviously right now there are a lot of cost pressures, but we’ve prioritized doing the right thing.” 

• Considering additional COVID-19-related coverages. Given that we can likely expect future waves of the virus and that its long-term effects are not yet well understood, employers may need to consider additional coverages in cases where the cost of care exceeds a plan limit. For example, if a health care plan has an annual maximum, an employer may consider providing additional support through a supplemental or even a top-up plan on a local or global basis, which can help provide or support minimum standards in medical plan design for multinational employers.

Some employers are considering offering COVID-19 testing as they prepare to reopen offices in locations where testing may be inadequate. Mars’ Christopher de Wolfe comments, “We need to ask if we want to offer some form of COVID testing — either antibody or active testing — in those places where testing is difficult to access. This is part of the return-to-work conversation.”

• Prioritizing the wellbeing of the whole person. All discussion participants expressed concern about the impact of the pandemic on employee wellbeing. They emphasized the importance of a more holistic approach to wellbeing that goes beyond physical health.

Mars’ Ian Langer noted, “We will need to look at the impact this is having on people from a stress and mental health perspective — how well they are able to cope long term — because we’re asking many of our associates to maintain a working relationship without going into an office probably for as long as a year.” Consequently, employers may need to reevaluate their wellbeing programs to ensure they are focused on the needs of the whole person.

In addition, the programs need to be better connected to traditional benefit plans in their communication and delivery to help drive higher employee engagement. Zurich’s Paolo Marini concurred and believes “personalized holistic wellbeing programs together with effective communication and employee engagement will be key to meet the changing needs of the workforce.”

Rethinking health care delivery

The pandemic is prompting employers to rethink the complex issue of health care delivery to ensure employees are able to access quality care efficiently. This may involve navigating from a government-provided health model to a hybrid model that combines public and private delivery of health services.

For example, GE’s Rowland describes how going forward public health care providers will need to ensure they have capacity for the next wave of COVID-19 or the next pandemic. Consequently, they will not be able to stretch themselves the way they have in the past to meet other demands. “We need to be able to find some other way to access medical treatments so that health services are free to deal with pandemics,” adds Rowland. To address this issue, some employers are providing their employees with a path to private health care. In many instances private health care is used to ensure speed of access to treatments once an initial diagnosis is made in the public health system.

The evolving role of telehealth

Participants noted a strong uptick in telehealth utilization during the pandemic, but many questions persist as to how telehealth can be integrated in the health care journey over the longer term. Cigna’s Asbaty remarked, “The usage we have seen is unbelievable — up tenfold on previous levels. We’re treating hundreds of thousands of people in over 150 countries and offering all major specialties, not just GP [general practice], including mental health.”

However, Asbaty noted that it remains to be seen whether telehealth can maintain this momentum post-pandemic. Philip Austin, also representing Cigna, highlighted the potential role of telehealth as the first point of contact in the health care system: “We can apply learnings from COVID to the care model to determine how telehealth can be used as a general practitioner’s gateway to seeing a consultant. But we need strong data and analytics to prove to a buyer why you would integrate it into the traditional health care model.”

Rowland voiced a similar perspective, adding, “A development could be to drive the behavior through, say, a higher deductible or copay if choosing to bypass telehealth as the entry point.”

Mars’ de Wolfe emphasized how telehealth can speed access to the right care. “Telehealth is good for triage. There are many situations where telehealth has been known to expedite the care of associates, making sure they are properly looked after so that they can quickly return to work.”

The Willis Towers Watson perspective

The following considerations can help companies recalibrate their approach to the design and delivery of benefits in a COVID-altered workplace.

• Determine if your organization should expand duty of care obligations to meet the needs of employees in countries with inadequate health care systems. How far will your organization go to bridge gaps?
• The pandemic allows employers to reposition medical benefits as a critical business tool, not just a cost. If you are facing budget constraints, identify plan design features that might be scaled back without significantly affecting the quality of benefits.
• In countries where the government is the primary provider, determine if employees need a path to private health care in order to secure quick access to specialized care (possibly via telehealth triage).
• Telehealth has the potential to make private health care more affordable and easier to access for all; however, how can it be fully integrated in current medical plan design? There is a need to continue to stay current with evolving telehealth legislation and vendors to better understand the limits and opportunities.

Our series also includes a recently published article on the impact of the pandemic on benefit costs; upcoming articles will focus on employee engagement in benefits and the changing insurer landscape.

The discussions were led by Willis Towers Watson consultants Francis Coleman, managing director, Global Services and Solutions, and Paul Devitt, senior director, Global Services and Solutions.

Discussion participants included:

Ann Asbaty,
CEO, the Americas – International Markets, Cigna

Philip A. Austin,
Head of Strategy and Global Business Development, Cigna

Kerrie Rowland,
International Pension & Benefits COE Leader, GE

Christopher de Wolfe,
Global Director of Risk Management, Mars Incorporated

Ian Langer,
Global Benefits Director, Mars Incorporated

Wendy Liu,
Global Head of Corporate Life & Pensions, Zurich Insurance Company Ltd

Paolo Marini,
Global Head of Customer and Distribution Management, Corporate Life & Pensions, Zurich Insurance Company Ltd

Fergus Cardiff,
Global Partnership Director, Corporate Life & Pensions, Zurich Insurance Company Ltd