Open enrollment is coming to an end soon. With that in mind, employees with an accident, critical illness, or hospital indemnity plan must ensure they file any wellness benefits they may have qualified for. Wellness benefits are often not filed, although the employee most likely had a qualifying event in that calendar year.
I recently completed a survey of wellness claims filed in 2024 for over 1,175,326 employees. Each participating employer requested their wellness claims data from their supplemental carrier for my review. You may click on the Wellness Benefits Stats Link to see my findings.
There are several reasons why an employee might not file for their wellness claim benefit, even if it’s available through their accident, critical illness, or hospital indemnity policy:
- Lack of Awareness: Employees might be unaware of the benefits or how to file a claim.
- Complex Process: Filing a claim might be perceived as too complicated or time-consuming.
- Fear of Repercussions: Some employees might fear negative consequences, such as being seen as less reliable or facing discrimination.
- Privacy Concerns: Employees might be concerned about their medical information being shared or not being kept confidential.
- Distrust in the System: There might be a lack of trust in the insurance provider or the company’s benefits administration.
- Financial Concerns: Employees might worry about potential out-of-pocket costs or how filing a claim might affect their premiums.
- Cultural Stigma: There can be a stigma associated with seeking help for mental health or wellness issues, which might deter employees from filing claims.
- Addressing these barriers through clear communication, simplifying the claims process, ensuring confidentiality, and fostering a supportive culture can help increase the utilization of wellness benefits.
