When deciding which employee benefits to buy, family medical history matters, according to the 2019 Aflac WorkForces Report.

Nearly three out of four workers (73 percent) say their family history is somewhat to extremely influential in guiding their health insurance decisions, Aflac found. For good reason, as at least 20 percent say they or a member of their immediate family in the last year has suffered a major health event, such as heart attack, stroke, cancer or a serious accident requiring hospitalization.

"One way employers can help employees manage unexpected health care costs with no direct cost to the company is by offering voluntary insurance like accident, critical illness, dental or vision, which provides an extra layer of financial protection when they need it most," says Matthew Owenby, Aflac's chief human resources officer.

It could very well be an easy sell, as a majority (84 percent) of workers say they would be likely to purchase insurance to help cover costs associated with a serious illness, such as cancer, heart attack or stroke, that they know is in their family history. Gen Zers and millennials are especially receptive, according to the survey.

And voluntary insurance fits that bill — 85 percent of workers say they see a growing need for that type of insurance, up from 63 percent in 2014. One main reason: 52 percent say they would not be able to cover an unexpected medical bill of $1,000 or more.

Drilling down, nearly four in 10 (39 percent) could not go more than three weeks without a paycheck, down from 44 percent in 2018. This number increases to 51 percent for millennials. In addition, 18 percent of workers say they live week to week, paycheck to paycheck, down from 20 percent in 2018.

Almost a quarter (23 percent) of millennials live week to week, paycheck to paycheck (for those paid weekly). For those workers paid bi-weekly, 43 percent of millennials could not go two weeks without a paycheck, compared with a third of the total population.

"Even in today's strong economy, employees' financial conditions remain fragile, and a significant number of people do not have the savings to handle unexpected out-of-pocket health care costs," Owenby says.

While workers may seem receptive to a variety of benefits, they need a little guiding hand to thoroughly understand exactly what's entailed, according to the survey. More than half (56 percent) spend less than 30 minutes researching benefits options – and 24 percent spend less than five minutes or didn't do any research altogether.

Why? Because a majority (58 percent) of employees say understanding what insurance or benefits they need is somewhat or very stressful. Gen Zers (68 percent) and millennials (64 percent) are more likely to say this is stressful.

Income may play a role as 49 percent of those with household incomes under $50,000 say it is stressful, compared with 42 percent with household incomes between $50,000 and $99,900 and 40 percent with household incomes of $100,000 or more.

Almost one in five (18 percent) of all employees would rather skip their morning coffee than research their benefits — for millennials, the percentage increases to 24 percent. As a result, most workers (93 percent) choose the same benefits year after year. Millennials (91 percent) and Gen Z (87 percent) numbers are lower than those 39 and older (95 percent).

More than six in 10 (61 percent) say negotiating medical billing is somewhat or very stressful. This increases to 66 percent for millennials compared to 59 percent for those 39 and older. Almost half of workers (48 percent) say submitting a health insurance claim is somewhat or very stressful. Gen Zers (68 percent) and millennials (61) are more likely to say it's stressful, compared with 39 percent of those 39 and older.

While 78 percent of workers say they feel confident they understood everything for which they signed up, almost four in 10 (37 percent) of workers say they need more information — such as whether certain doctors are in their network, or what their out-of-pocket costs could be — to be more confident during open enrollment. This is up from 30 percent in 2018. Nearly one in five (18 percent) say more money would help them be more confident.

Overall, just over half (52 percent) of workers are very or extremely satisfied with their overall benefits package, down from a high of 61 percent in 2018. When asked what would the one thing they would like to change to improve the way they enroll in benefits, 27 percent say more plan options so they can pick what they need; 25 percent say simpler language to help them understand what is and isn't covered; and 17 percent say broader coverage.

"While workers may be responsible for their health care decisions, the wrong choices can greatly affect their performance and state of mind in the workplace," Owenby says. "That's why it's critical for companies to communicate with employees about their benefits and provide them with educational resources to help them understand their options and feel more confident in their selections."

Other key survey findings include:

More employees (38 percent) say the ongoing national debate about health care has helped them to better understand their health care options compared with 24 percent who said it has made them more confused about choices. These figures increase significantly for younger generations, with 49 percent of millennials and 78 percent of Gen Zers saying the debate has helped.
Just over six in 10 workers (61 percent) are very or extremely satisfied with their job, down from 65 percent in 2018. More than half of workers (52 percent) would be willing to take a job offer that included a slightly lower compensation but a more robust benefits package, down slightly from 55 percent in 2018.

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The impact of family history on benefits decisions

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