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www.mercer.com
Pan-European Employer Health Benefits Issues2008 Survey Report
Steve Clements, London
About the Survey
3Mercer
About the survey
Mercer’s second Pan-European health benefits issues survey
Online survey, May – June 2008
7 languages
Open to employers in 24 countries
Completed surveys were submitted by over 800 employers
Distribution of survey respondents across industry and employer size categories*
Industry
Manufacturing
Services
Financial services
Wholesale/retail
Health care
Other
36%
24%
12%
11%
6%
12%
Employer size
Fewer than 250 employees
250-999 employees
1,000-4,999 employees
5,000 or more employees
25%
21%
34%
21%
Key FindingsHealth-related benefits
5Mercer
65%
58%56%
62%
55%51%
62%
50%
23%
Attract and retain key employees Manage health risk Improve productivity andperformance
All Bulgaria Eastern Europe
Percent of respondents rating objective as important/very important
Attraction & Retention tops employers list of objectives for providing health benefits
6Mercer
The organization would struggle to retain top employees without offering current benefits, by country
21%
6%
34%
25%
33%
40%
40%
47%
38%
24% 67%
50%
40%
45%
44%
50%
58%
48%
63%
47%Ireland
Sweden
Belgium
France
UK
Turkey
Russia
Portugal
Poland
RomaniaStrongly agree
Agree
Percent of respondents that strongly agree/agree with statement
7Mercer
The organization would struggle to retain top employees without offering current benefits, by country
11%
6%
15%
11%
6%
14%
18%
10%
8%
22%
31%
29%
27%
31%
47%
43%
44%
56%
56%
Norway
Bulgaria
Germany
Switzerland
Netherlands
Czech Republic
Spain
Italy
Hungary
Finland
Percent of respondents that strongly agree/agree with statement
8Mercer
Social welfare reforms will increase pressure on employers to provide private health benefits
24%15%
24%
48%
31%
44%
All respondents Bulgaria Eastern Europe
Agree
Strongly agree
Percent of respondents that strongly agree/agree with statement
15%
31%
24%
44%
9Mercer
Cost of health benefits as a percentage of total payroll cost, by country
5.1%
5.6%
5.6%
5.6%
6.1%
6.1%
6.2%
7%
7.3%
7.5%
8.8%
15.4%
5.3%
2.2%
2.5%
2.7%
3%
3.4%
4.1%
4.2%
4.4%
Ireland
Russia
Italy
France
Hungary
Finland
Netherlands
UK
Turkey
Romania
Bulgaria
United States
All European respondents
Czech Republic
Norway
Poland
Germany
Sweden
Belgium
Spain
Portugal
Eastern Europe 5.1%
10Mercer
Cost is rising fast
4%
51%45%
7%
50%44%
Change in per-employee cost from 2006 to 2007
All countries
Average increase: 5.0%
Bulgaria
Average increase: 10.6%
Cost increased Cost decreased Cost stayed about the same
Percentages do not sum to 100 due to rounding
Eastern Europe
Average increase: 6.9%
0%
46%54%
11Mercer
Majority of employers expect to take action if cost increases continue at current rate
41%38%
34%30%
45%
70%
30%
40%
53%
27%
34%37%
Restrict scope ofcoverage
Shift cost to employees Restrict benefit eligibility Will not take any action
All countries
Bulgaria
Eastern Europe
Percent of respondents “very likely” or “likely” to take action
12Mercer
Overall fewer than half of respondents require employees to contribute to cost of benefits
5%11%
13%
57%
13%
0%9%
18%
55%
18%
Employees do not contribute Employees pay 1 − 10% Employees pay 11 − 30% Employees pay 31 − 50% Employees pay more than 50%
All countriesAverage employee contribution:
13% of total cost
BulgariaAverage employee contribution:
9% of total cost
Percentages do not sum to 100 due to rounding
Key FindingsAbsence Issues
14Mercer
Concerns for the Board of Directors
54%
46%
61%
52%
43%
50%52%
46%
40%
Impact of health on productivity Providing competitive benefits Cost of benefits
All Bulgaria Eastern Europe
Percent of respondents that believe their Board of Directors is concerned/very concerned with…
15Mercer
Type of health benefits provided
All respondents
BulgariaEastern Europe
Company sick pay 71% 23% 49%
Private medical plans 65% 46% 46%
Flexible working 57% 8% 42%
Individual health screening 54% 69% 45%
Long-term disability income support
51% 38% 30%
Flexible holiday 50% 23% 39%
Dental benefits 37% 23% 33%
Gym/fitness 33% 15% 38%
Employee Assistance Program
29% 0% 16%
Smoking cessation 26% 15% 17%
Dietary advice 14% 0% 10%
16Mercer
Average number of days absent due to sickness
4%
22%
36%
11%
28%
Percentages do not sum to 100 due to rounding
27%
9%
18%
18%27%
0-4 days5 days6-10 days11-20 daysMore than 20 days
All countries BulgariaMedian days absent : 5 days
No specific absence management program : 20%
Median days absent : 10 days
No specific absence management program : 38%
17Mercer
Leading causes of long-term absences
11%9%
25%
62% 61%
50%
17%
26%
52%
17%17%20%
50%
33%
17%
All Eastern European Bulgaria
Musculoskeletal (including low-back pain)Stress/mental healthCancerRespiratoryHeart disease
Percent of respondents reporting each condition as among their top three causes
Conclusions
Health benefits help attract & retain key staff
Cost and risk is increasing
Welfare reform is shifting cost
Review your healthcare strategy now
Healthy workforce = productive workforce
19Mercer
Insurer/ supplier networkInsurer/ supplier network
Health and absence strategyHealth and absence strategy
WELL PERSONWELL PERSON
Pre-employment health assessments
Well person screening
Health promotion initiatives
Organisational health policies
Healthy infrastructure
ILL PERSON
Absence reporting services
Absence case management
Fast track access to healthcare
Private medical insurance
Independent medical assessments
Primary care services
LONG TERM SICK PERSON
Ongoing case management
Independent medical assessments
Long term disability insurance
Vocational rehabilitation services
Long term case review
Key messages