Employers often report being frustrated when they offer what they believe to be an innovative health insurance option to employees and few people select it during the enrollment period. This experience makes employers less likely to offer such options, even though they are convinced that their workers would be healthier and costs over time lower if employees took advantage of the opportunity.
One solution: force employees to opt out, rather than opt in, to such programs. But how well does that work?
Researchers at UCLA can offer some insight into that. The short answer: Yes, opt out works very well. But how did they determine this?
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The research team identified 11 self-insured employers with insurance covering 5,014 employees. All 11 offered a voluntary option: a diabetes health plan. Six employers offered it with voluntary enrollment, while the other five used the opt-out alternative.
"Of the 1,549 people in the voluntary sign-up group, only 35 percent opted into the program. By contrast, 91 percent of the 3,405 people in the opt-out group were enrolled, simply by choosing not to take action to drop out," the research team reported.
Other findings reported from the study:
- The voluntary enrollment group who had incomes of more than $75,000 a year or a bachelor's degree were likelier to enroll than those with lower incomes.
- Among those automatically enrolled, the subgroups that had the highest percentage of people covered were Hispanics, covered dependents, and persons who had one nondiabetes comorbidity, such as hypertension or congestive heart failure.
"While many great wellness programs exist for employees of many businesses, they are often not taken advantage of due to the time it takes to enroll or a lack of understanding of the eligibility requirements," said the study's first author, Lindsay Kimbro, project director in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. "This study shows that an opt-out strategy can take away those roadblocks and make it easier for participants to take advantage of these programs that can greatly benefit them."
The findings are published in the American Journal of Managed Care.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
