In 2019, employers most often strengthened their total rewards by enhancing compensation (73 percent) and medical benefits (52 percent). But employers also enhanced other offerings, including voluntary and supplemental benefits (40 percent), leave policies (37 percent), well-being initiatives (32 percent) and retirement benefits (31 percent) and pharmacy benefits (18 percent).

"What employers can least afford is stagnation, so total rewards approaches must evolve along with the market," the authors write. "They must also improve incrementally in ways that complement business priorities and sustainability. Achievement of these objectives can't be bought with the most expensive or extensive offerings, but they can be attained with competitive benefits that are designed to appeal more strongly to the wants and needs of key talent."

Employers are also holding off on increasing the share that workers pay for health care – across the board. Indeed, nearly half (47 percent) of employers did not increase employees' cost sharing at all in 2019, up from 45 percent the previous year. No added expenses were absorbed by plan participants for premiums, deductibles, out-of-pocket maximums or drugs.

"In 2019, employers continue to balance employee cost sharing with other methods of proactively reducing the financial burden through a focus on preventing disease and improving workforce health," the authors write.

The most frequently employed cost-management tactic is the use of telemedicine (52 percent). Other strategies include changing plan carriers (33 percent); applying narrow provider networks (14 percent); using designated centers of excellence (8 percent); integrating health and disability management (7 percent) and offering second-opinion services (6 percent).

To encourage workers to lower health care costs, employers are offering well-being incentives (41 percent), chronic care or preventive disease management (26 percent), cost-transparency tools (24 percent) and nonsmoker premium discounts (12 percent).

Additional cost-management strategies include restricting health plan dependent eligibility and monitoring adherence to rules, such as performing eligibility audits (16 percent), enacting a spousal surcharge or exclusion (13 percent), auditing claims (12 percent) or applying a separate charge per dependent (7 percent).

Gallagher also found that comprehensive whole-health and well-being strategies are gradually gaining ground — up 2 points from last year to 20 percent in 2019.

"Designed to take a cost-effective, integrated approach to benefits, they focus on better meeting not only employees' physical health needs, but also the financial, career and emotional aspects of their well-being" the authors write. "The tendency to choose this approach increases with the size of an organization."

Among employers that go without a well-being strategy (49 percent), the most common reason is a lack of staff capacity or time to implement programs (57 percent). Other obstacles include a shortage of employee interest (28 percent), uncertainty about the return on investment (23 percent) and leadership's belief that "well-being isn't their organization's role" (12 percent). Of those currently without a strategy, 41 percent plan to add one by 2021.

"The value of employee well-being has the potential to reach far beyond claims data" the authors write. "And more employers are realizing that it powers all the key metrics of profitable performance, including better management outcomes for absence and leave, health risks and disease — as well as improved engagement, productivity and retention."

Employers are also making these enhancements and changes:

• Expanding elective health offerings: nearly half or more employers now offer autism treatment (64 percent), hearing aids (48 percent), bariatric surgery (47 percent) and infertility services or fertility treatment (46 percent).
• Financial-wellness offerings: 69 percent of employers now offer financial advisor sessions; 54 percent provide financial literacy education and 49 percent offer tuition assistance.

Read more:

• Can corporate well-being programs really help employees get healthy and reduce health care expenses?
• How to maximize the power of wellness incentives
• Expanding access to health care