Building Inclusivity Into Employee Benefits

Plan sponsors are increasingly promoting diversity, equity and inclusion (DEI) in their benefits packages, a survey from Willis Towers Watson has found.

According to Willis Tower Watson’s “Emerging Trends in Health Care Survey,” four-fifths of the 446 employers that responded said they would take steps to promote DEI in their workplace culture and policies over the next three years, compared with 55% that took measures in the past three years. Additionally, seven in 10 employers indicated they would promote DEI-related aspects of their benefit programs and well-being programs throughout the coming three years.

Rachael McCann, senior director of health and benefits at Willis Towers Watson, notes that inequities caused by the pandemic have brought more attention to DEI benefits and efforts.

“We certainly saw this movement and focus beforehand, and at times it was isolated to looking at fertility benefits or parental leave,” she explains. “The past year has really moved forward very quickly, recognizing inequities not just in design, but access to programs, whether that’s to health care, virtual care, eligibility or thinking about domestic partners or those who may be in part-time roles.”

As societal shifts take place and the workforce evolves, McCann asks employers to think about their workforce and the challenges its employees face. Does your plan offer benefits that support families? Are there fertility, infertility and adoption benefits? What inequities have your employees experienced? What is your employees’ gender mix? What does your employee demographic need?

The answers to these questions will help employers get a sense of how to improve a benefits plan to suit all needs; however, it only scratches the surface of a range of issues and inequities countless workers face. The Willis Towers Watson survey finds that evaluating social determinants of health—non-medical factors that influence health outcomes—is integral when assessing benefits, well-being program effectiveness and the future of an employee’s financial wellness.

“Social determinants of health thinks about the influence of where someone lives—their environment, education, access to health care, social connections and support, the community around them,” McCann explains. “If you think about access to transportation, healthy food, the terminology of food deserts, health deserts—how do those factors impact how they might engage in health care, savings for today and for retirement?”

Someone who lives in an inner city may engage with their benefits differently from someone who lives in the suburbs. Studies show suburban residents are more likely to have access to grocery stores, healthy food options and parks to exercise in, whereas poor, urban neighborhoods are unlikely to have those same options, thus creating food and health deserts. “As employers are really trying to manage program costs and help employees thrive in their health, it becomes critical for employers to understand, do we have employees living in an area where there isn’t this access?” McCann says. 

At Mercer, the company developed its own DEI list to help plan sponsors check off best practices. “We have a couple of areas that we do deep dives on, including benefits for transgender members who have gender dysphoria and inclusive family benefits, including fertility, adoption and surrogacy,” says Michael Garrett, a principal in Mercer’s Total Health Management Practice who regularly meets with clients to discuss DEI practices.

Along with offering a number of diverse benefits, Garrett emphasizes the importance of communicating such benefits effectively. Supporting these benefits will both contribute to the program’s success.

As an example, he says he had a past client that was interested in forming a disability-inclusive brand. The client was focused on covering hearing aids and eyewear and eliminating limits and exclusions on physical therapy, occupational therapy and speech therapy. However, when asked how the client planned to communicate its benefits, the client responded that it would send out a PDF and review it with employees. That led Garrett to ask, “Well, how does someone with vision loss access that information?”

“Same with doing a webinar during open enrollment period—do you have closed captioning? Live transcriptions? Written transcriptions? How you communicate your benefits is very important and thinking about individuals with limited proficiency is also important,” he stresses. “All of this signals to employees that you’re thinking about DEI from a broad perspective.”

Ensuring benefit providers are diverse is also crucial in supporting DEI. One example includes increasing racial and ethnic diversity among in-plan physicians, Garrett says. Ensuring your benefits package has Black and brown medical professionals available is vital to supporting employee bases, he adds. He says research shows that Black patients are more likely to have better health outcomes when treated by Black physicians.

An area that is seeing more demand and offerings is transgender benefits. The Willis Towers Watson survey found 19% of employers say they have taken actions to include benefits for transgender employees and plan to do more this year and in 2022. Twenty-seven percent say they have taken action in adding these benefits but have no other plans to implement additional services in the next year or two, and 10% said they have not taken action yet, but are planning to do so throughout the next year or two.

“This is a space that continues to evolve and grow,” McCann says.

These benefits, in a traditional medical program with prescription drug coverage, may focus on anything from hormone suppression to surgical procedures that help individuals change their gender, such as facial feminization surgery (FFS), for example, McCann says.

She adds that offering these procedures helps combat gender dysphoria and helps allow an individual to visibly look how they feel, yet these surgical procedures continue to be dismissed as elective cosmetic practices and thus are not covered by many health insurance plans.

But, as more transgender employees enter the workforce and as more trans awareness circulates, companies are implementing benefits that support their workers. According to the Human Rights Coalition’s Corporate Equality Index (CEI), 71% of Fortune 500 and more than 91% of CEI-rated businesses offer transgender-inclusive health insurance coverage. That’s up from 0% in 2002 and is 22 times as many businesses in 2009.

Still, offering benefits is only one layer in creating a trans-inclusive workforce, McCann says. Being more aware of trans health issues, adding gender-neutral language and facilities, and normalizing pronouns all create a supportive environment.

“An employer may put in a benefit, but do they have a supportive culture?” she asks. “It’s not just checking the box on benefits; it’s ensuring that the culture and the broader support that that individuals and colleagues need are in place.”