In the current benefits world, Dental insurance is largely an employer-paid product, while cancer insurance is a voluntary product. My question is…Why? Perhaps, the reason is the lack of a thorough thinking and evaluation process. If you look at it with an open mind, cancer insurance should be an employer-paid product exactly as Dental insurance is. Allow me to explain why.
When evaluating the risks to your business or client of an employee, contracting cancer versus needing a dental procedure, which one has the greater business disruption risk, HR risk, financial risk, health risk and psychological risk? Let's evaluate each one of these.
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First, what sets cancer apart is the combination of frequency and costs associated with the disease. Consider the following.
- Cancer affects 1 in 2 women; and 1 in 3 men in the U.S.(Medical News Today).
- Cancer patients are 71% more likely to have bills in collection or foreclosure (NPR).
- Cancer patients were 2.5 times more likely to declare bankruptcy; and those who went bankrupt were more likely to die from the diseases (NPR).
- NCI estimated the average cost of cancer in the year following diagnosis was $42,000 (NPR/NCI).
Cancer is devastating to employees and their financial situations have the potential to affect employers and stress and anxiety can directly impact productivity. On the other hand, while having serious dental issues is uncomfortable and disrupting, people don't declare bankruptcy because of them. Given this, which one has the greater potential to cause business disruption to your company if an employee goes without coverage? Cancer, of course. In fact, studies show that up to 53% of cancer survivors lose their jobs or quit working during or after treatment (Mehnert) – so the business has to replace and retrain for that position – perhaps even a key leader. If cancer causes the larger business disruption, shouldn't that be an employer-paid benefit, just as dental is?
And it makes sense that employers should provide a product that is complementary to the other primary employer-paid benefit; major medical. Most major medical plans now have high-deductibles and by providing cancer Insurance, the employer offers what is in essence, "deductible insurance" in the event of cancer, a significant need, particularly if you have a $5,000 deductible. The average leukemia patient, for example, with private health insurance, can expect to pay over $5,100 in their first year following diagnosis (NPR). Dental is totally separate from major medical in most instances, whereas cancer insurance is a true complement when major medical fails to meet all the expected costs. Wouldn't it make sense for the employer to offer a product that complements its other offering?
And as the financial risks mount, health risks are also far greater for someone contracting cancer. Not only is the overall health risk obvious, but those not adequately covered could self-impose a larger health risk by not undergoing needed treatments due to costs. For example, while 1 in 5 people taking oral chemotherapy abandon treatment, about half stop when out-of-pocket costs exceed $2,000, according to a 2017 Milliman analysis.
Next, you protect employers from HR issues that can arise when employees are diagnosed with cancer. The Disability Rights Commission recently stated that 82% of callers with cancer complained of unfair treatment at work after diagnosis (Personnel Today). Cancer is also recognized as a disability by the American with Disabilities Act (ADA). It is also regulated by FMLA and the Genetic Information Non-Discrimination Act (GINA). By providing cancer insurance, your employees are less likely to challenge you as an employer when it comes to fair treatment of employees with cancer.
In addition, studies have shown that cancer and cancer expenses disproportionately affect minorities. Therefore, offering cancer insurance could be part of an employer's overall DEI strategy. Providing this employer-paid benefit could be a significant contribution towards that goal.
Overall, we demonstrate to employers that cancer products are as valuable as dental, and I would argue essential, given the devastating consequences that this disease has on the workforce. Additionally, offering cancer policies as 'voluntary' makes people more prone to deny the possibility that cancer might happen to them. Psychologically, most people can fathom the reality of needing a dentist, but needing chemotherapy is at an entirely different level. Not buying a policy is sometimes a way to convince themselves they won't ever need it; but the statistics say they do – as cancer impacts 1 out of 2 women and 1 out of 3 men.
Therefore, by making the "switch" to cancer insurance as employer-paid exactly as dental is, we can overcome that obstacle – AND better protect the business owner from disruption and employees from financial stress or bankruptcy. This would be a huge benefit to businesses, employees, and particularly society, where the results are staggering, considering that 1 in 4 Americans with cancer have declared bankruptcy or lost their home to eviction or foreclosure (KHN).
One final interesting thought: One market segment that has taken the lead in offering employer-paid mandatory cancer insurance is state governments. In fact, 45 states now require mandatory cancer insurance coverage for some state employees (FLGOV.com). That's a nice endorsement of the growing understanding of providing cancer coverage, which is clearly associated with significant risks.
Sometimes, we do things because we have always done them that way. But let's stop for a moment, evaluate, and ask if it is the correct strategy. Employees still want, need and deserve dental coverage, but if you are doing what is in the best interest of the employer and employee in terms of financial risk, health risk, and business disruption risk, you might want to consider having a conversation about the "switch".
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