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Survey Report

2021 Emerging From the Pandemic Survey

Highlights of key findings, United States

February 24, 2021

Employers are preparing benefits plans for a ‘new normal’ and hybrid workforce and are highly focused on addressing behavioral health issues.
Health and Benefits|Employee Experience|Ευεξία
Risque de pandémie

About the respondents

Research findings are based on responses from 494 organizations in the U.S. employing 6.4 million employees. The survey fielded January 5 to 20, 2021. Additionally, the sections under “Highlights and trends” include related findings from our employee-based research, the 2020 Global Benefits Attitude Survey.

Respondent profile

Figure shows: Northeast – 20%, Southeast 18%, North Central – 28%, South Central – 7%, West – 10%, Dispersed nationally – 17%
Respondents by geography
Figure shows: Manufacturing – 24%, Financial services 14%, General services – 13%, Health care – 13% , IT and Telecom – 11%
Respondents by industry
Wholesale and retail – 11%, Energy and utilities – 7%, Public sector and education


Health care costs, COVID-19 vaccines and behavioral health challenges are top of mind

Our Emerging From the Pandemic Survey, which fielded in January 2021, assessed employers’ key program priorities and explored opportunities to improve the health and wellbeing of their workforces.

Following a year that saw reduced health care utilization, over 90% of employers report their medical and pharmacy plan costs were at or under budget in 2020. Nevertheless, employers expect 2021 health care costs to rise 4.2% above last year’s budget before plan changes, well above the rate of inflation.

Over half of employers are planning or considering taking action to improve access to the COVID-19 vaccines via onsite clinics (55%) and through vendor solutions (65%). Very few employers have established policies requiring employee vaccinations, but many are planning or considering mandating vaccines to return to work in person (45%) or as a condition of employment (34%). Regarding testing for COVID-19, roughly a quarter of employers (24%) that test their employees at the workplace do so on a regular basis.

As has been the case throughout the pandemic, employers’ top priority continues to be communicating the benefits and wellbeing programs that may be useful to employees. Additionally, employers are increasing their focus on wellbeing, in particular through mental health services, and tools or programs to improve the physical wellbeing of employees.

Employers’ biggest wellbeing challenges are rising stress and burnout, and higher mental-health-related claims.

Employers’ biggest wellbeing challenges are rising stress and burnout, and higher mental-health-related claims. Increased caregiving demands (67%) and decreased social connections (61%) are the leading drivers of mental health issues. Yet only one in four employers believe their programs and policies to support employees with caregiving responsibilities are effective. Moreover, improving social connections will remain a challenge as nearly two in five employees are expected to be working remotely at the end of 2021, which, according to our research, makes employees more likely to feel disconnected from their teams or organizations.

In response, employers are focusing on behavioral health, with nearly all employers (94%) offering telebehavioral health services and over two-thirds (67%) providing a digital platform for mental health services. They are also prioritizing increased communication to boost engagement in existing behavioral health programs over the next three years. In addition, organizations are making changes to the features of paid time off (PTO) or vacation/sick day benefits in an effort to promote emotional wellbeing. Half have already implemented these types of changes.

Employers are prioritizing increased communication to boost engagement in existing behavioral health programs over the next three years.

As employers look to the future, a growing number are making it a priority to develop a strategy for benefits in a post-COVID-19 environment. Our findings will help employers transform their benefit programs for a hybrid workforce that includes onsite as well as remote workers.

COVID-19 vaccines, treatment and testing
  • Access. To increase access to vaccines, almost one-fifth of employers (18%) have assessed the feasibility of onsite vaccination clinics with 55% planning or considering taking action in this area. In addition, 14% of employers have explored vendor solutions to provide vaccines to employees and 65% are planning or considering doing so.
  • Requirements. Almost no employers have established policies mandating vaccines; however, many are planning or considering a policy requiring proof of vaccination as a condition for returning to in-person work (45%) or as a condition of employment (34%). Roughly four-fifths of employers (79%) indicate such policies would apply to all employees.
  • Support. While 14% of employers have already developed policies and procedures to make it easy for workers to get the vaccine, over three-quarters (77%) are planning or considering doing so.
COVID-19 treatment
  • Roughly two-fifths of employers (41%) waive out-of-pocket costs for treatment of COVID-19, while slightly more than one in 8 (13%) reduce out-of-pocket costs for such treatment. Of those that have waived out-of-pocket costs for COVID-19 treatment, 33% have not set time limits on this benefit and 32% are not sure they will impose time limits.
Testing and tracing
  • Over a fifth of employers (23%), including 58% of those in health care and 45% of those in the public sector, offer COVID-19 testing at the workplace. Most employers (86%) waive out-of-pocket costs for these tests. More than four-fifths (83%) of those that offer workplace testing use the polymerase chain reaction (PCR) test.
  • Approximately a quarter of employers (24%) that offer workplace testing test employees at the workplace on a regular basis. Fifty-six percent of employers performing onsite tests report they test fewer than 25% of their onsite employees. Most employers (80%) use workplace contact tracing to alert employees to a potential exposure.

Strategy and planning
Key priorities over next six months
  • Over two-thirds of employers (68%) indicate communication of benefits and wellbeing programs is their most important benefit priority, a finding consistent with surveys conducted in April and June 2020.
  • Employers are increasing their focus on different aspects of wellbeing.
  • Roughly three-fifths of employers (62%) are boosting mental health services and stress/resilience management, up almost 20 percentage points over April 2020.
  • 27% are offering tools or programs to improve the physical wellbeing of employees, more than double the 12% that were providing these tools in April 2020.
  • The number of employers focused on improving employees’ social connections has doubled from 7% in April 2020 to 14% in January 2021.
  • The vast majority of employers (82%) say COVID-19 will continue to have negative impacts on employee wellbeing over the next six months.
  • Developing a strategy for benefits in a post-COVID-19 environment is a key priority for roughly a third of employers, up from 15% in June and 18% in April 2020.

Mental/behavioral health
  • Most employers (93%)* say behavioral health will be a priority for their organization over the next three years.

*Indicates those who responded moderately and extremely important.

What’s behind employees’ rising mental health issues?
  • Employers say increasing caregiving demands (67%) followed by decreased social connections (61%) and the impact of family/friends who have contracted COVID-19 (57%) are the leading drivers of these issues.
Caregiving remains a challenge
  • Almost six in 10 employers (56%) report their employees face caregiving issues with young and school-age children.*
  • Only one in four employers (27%) in 2021 believe they have programs and policies in place to effectively support employees with caregiving responsibilities, a decrease from two in five in 2020.*
  • Over half of employers (58%) offer referral services for finding childcare, but fewer provide emergency or backup childcare services (26%) or support for the formation of learning pods, tutoring or other school-focused needs (22%).

*Indicates to a very great extent

Remote work can lead to social isolation
  • Remote work is here to stay. While 11% of employees were working remotely before the pandemic and 57% are currently working remotely, employers expect 37% of employees will be working remotely at the end of 2021.
How are employers supporting employees with behavioral health challenges?

Employers are providing a range of services, including:

  • Tele-behavioral health services (94%)
  • Crisis intervention support (83%)
  • Tele-mental health support (e.g., virtual coaching) (83%)
  • Mental health digital platform (67%)
  • Nearly half of employers (46%) offer mobile apps to reduce stress and increase resiliency. Employers expect employee use of tools to address mental health needs will increase substantially over the next 12 months.
How do employers assess the effectiveness of their efforts in behavioral health?
  • Approximately three in five employers agree that their behavioral health programs help members find timely and effective treatment (60%) and provide members with excellent access to care (57%).
  • However, only one in five indicate their behavioral health program helps to decrease disability claims.
  • Employee assistance programs (EAPs) are falling short. While most employers (96%) offer EAPs and 39% made enhancements to their program in 2020, employers are not particularly satisfied with their EAPs’ performance. EAPs earned a net promoter score of 5.

Employers are prioritizing the following behavioral health program activities over the next three years:

  • Increase communication to boost engagement in existing programs (68%)
  • Add/promote access to tele-behavioral health services (52%)
  • Improve advocacy/navigation support (49%)
  • Take actions to address stigma (47%)

Time-off programs
  • Few employers expect to change the type of leave programs they offer, which may include programs with separate vacation, sick and personal days; paid time-off programs; and unlimited PTO programs.
  • Employers made changes within their existing time-off programs to help employees cope with the many challenges of the pandemic. In particular, employers indicated that by making these changes they were looking to promote emotional wellbeing (67%) and to boost talent acquisition and retention (50%).*
  • Over three-fifths of employers provided additional sick leave to individuals with a COVID-19 diagnosis (67%) or a potential COVID-19 exposure (61%).
  • Over a quarter (28%) offered parents additional paid time to care for young or school-age children.
  • Roughly half of employers (49%) changed the features of vacation/sick day benefits, and over half (56%) changed the features of their PTO program due to the pandemic.
  • Many employers that were making changes added or increased (or planned to do so) the annual carryover limits of their PTO (53%) or vacation/sick benefits (59%). Employers should be aware of potential financial liabilities associated with these actions.

*Indicates to a very great extent

Taking action to support employee wellbeing
  • Employers have the opportunity to take action to support the wellbeing of employees more effectively. Fewer than one-third of employers (29%) believe their wellbeing programs have effectively supported their employees during the pandemic.*

*Indicates to a very great extent

How did employers’ response to the pandemic affect their wellbeing programs?
  • Employers are divided on this issue with 31% saying their company’s response to the pandemic hindered their wellbeing programs and 36% indicating that their company’s response accelerated their programs.
  • Approximately half of companies (47%) that reported their performance was positively affected by the pandemic report they are accelerating their wellbeing approach and activities.
  • Employers in financial services (51%), high-tech (46%) and general services (45%) are most likely to say their organization’s response to the pandemic has accelerated their wellbeing efforts.
How are employers supporting employee wellbeing?
  • Employee sensing. A third of employers (33%) have conducted broad-based employee surveys and another 36% are planning or considering doing so.
  • Strategy. Thirty-eight percent of employers have connected diversity, equity and inclusion strategy to wellbeing, while 44% are planning or considering making this connection. In addition, over a quarter of organizations (26%) have expanded their vision of wellbeing to include the talent value proposition and employee culture, with 45% planning or considering a similar strategy.
  • Technology. Over a quarter of employers (28%) offered or expanded access to digital engagement solutions, while 44% are planning or considering taking a similar action.
    • Over two in five (43%) offer or plan to offer a wellbeing portal. Sixty-four percent of those offering or planning to build a portal are partnering with a third-party vendor.

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