November 11, 2022

The Family Benefits Bundle

Employers can play a key role in retaining and supporting the well-being of employees with parenting and caregiving responsibilities, and bringing those who left the workforce back, by offering needed, inclusive benefits that support the diverse experiences of employees and their families.

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Since the pandemic started, 56% of unpaid caregivers have experienced anxiety or depression (2.5 times the rate of the general population), and caregivers have 10 times the rate of suicidal ideation. And caregiving today, which impacts one in four millennials and one in five Gen Xers, is undermining financial well-being. Caregivers are leaving the workforce, reducing their work hours and not taking promotions, all of which could have long-term economic impacts, disproportionately for women. This section includes ways to support caregivers of elders, adult dependents and children with disabilities, as well as other family health management tools.

Elder and Adult Dependent Care

Even before the pandemic, an aging population, delayed retirements and a shortage of qualified caregivers have resulted in many employees taking on new and additional caregiving responsibilities. Employer support can help employees balance their work and home lives and avoid burnout.

Table 5.1: Benefits to Support Caregivers

Children with Disabilities or Unique Needs Care

Globally, approximately 93 million children live with disabilities, and those caring for them face numerous challenges.¹ The caregiving responsibilities of these employees often impact work (e.g., passing up promotions, reducing hours) and well-being. The cost of caregiving caused roughly half the 16.8 million Americans caring for children with disabilities to reduce their savings for retirement or other major expenses, like education for other children.²

Table 5.2: Benefits for Caregivers of Children with Disabilities

The Impact of Caregiving on Work and Well-being

Only one in four employers (27%) in 2021 believe they have programs and policies in place to effectively support employees with caregiving responsibilities, a decrease from two in five in 2020.⁶

Who's Leaving the Workforce and Why?

One in three caregivers left a job due to unmet caregiving responsibilities, and highly titled, highly paid employees are most likely to leave a company because of work-family conflict.⁷ What’s more, the costs associated with turnover alone can run as high as 213% of an employee’s salary.⁸

According to McKinsey’s Women in the Workplace 2020, the following factors are predictive of whether an employee considers downshifting or leaving:

• Lack of flexibility at work;
• Feeling like they need to be available to work at all hours, i.e., “always on”;
• Housework and caregiving burdens due to COVID-19;
• Worry that their performance is being negatively judged because of caregiving responsibilities during the pandemic;
• Discomfort sharing the challenges they are facing with teammates or managers;
• Feeling blindsided by decisions that affect their day-to-day work; and
• Feeling unable to bring their whole selves to work:
  • Mothers are more likely than fathers to worry that their performance is being negatively judged,due to their caregiving responsibilities.
  • Black women are more likely than women and men overall to feel like they can’t bring their whole selves to work.

Productivity and Career Goals

More than 80% of employees with caregiving responsibilities said it affected their productivity; in contrast, only 24% of employers responded that caregiving influenced workers’ performance.⁷ Furthermore, 33% of caregivers report that their caregiving responsibilities lead to setbacks in their career or work goals. ⁹

Time

Caregivers are spending an average of 24 hours per week on caregiving tasks.¹⁰ One in five millennial caregivers spend 40 hours per week or more.¹¹

Gender Disparities

Working female caregivers spend, on average, approximately 60% more time caregiving for aging loved ones, compared to their male counterparts, and women are three times more likely to retire earlier than expected to become a caregiver.¹⁵

Well-being and Mental Health

Caregivers are twice as likely to develop chronic illness and 49% experience exhaustion, 27% stress on marriage/relationship and 60% are overwhelmed by financial stress.^12,13,14 Furthermore, caregiving takes a toll on mental health, with 70% of caregivers reporting adverse mental health symptoms—55% reported anxiety or depression, 32% reported passive or serious suicidal thoughts. The effects are even worse for sandwich caregivers, those caring for people under and over 18, with 52% reporting serious suicidal thoughts, 12 times the rate of nonparents/noncaregivers.¹⁴

Racial Disparities

Latinx families are significantly more likely to take care of a loved one than Black or White families. Black and Latinx caregivers are in high-intensity care situations more often than either White or Asian caregivers. During the pandemic, Black and Latinx families experienced a greater increase in time spent on care than White families.¹⁵

Income Disparities

Caregivers with higher incomes report significantly higher levels of health. Those with lower incomes are in high-intensity situations more often, provide greater hours of care weekly and feel less supported by their employers.¹⁶

Serious Conditions and Other Family Health Management Concerns

Working parents and caregivers, especially women, often have the second shift of managing their family’s health and well-being, from the daily nutrition, routine physical exams and immunizations to serious, and sometimes life-threatening, chronic condition management.

Table 5.3: Benefits for Family with Serious Conditions and Other Family Health Management

Recommended Business Actions to Support Childhood Vaccinations

According to a World Health Organization (WHO) survey, more than a third of responding countries report disruptions in their routine immunization services due to the COVID-19 pandemic.¹⁶ Employers have an essential role to play in supporting working parents and reducing barriers to getting eligible children and dependents vaccinated. Here are recommended practices from the Health Action Alliance and American Academy of Pediatrics:

• Offer paid time off or flexible scheduling
• Help schedule vaccine appointments or provide access to vaccines for eligible children and dependents (e.g., free or discounted childcare while parents with multiple children attend vaccine appointments, transportation benefits)
• Reinforce (and make sure) COVID-19 vaccines are free for employees and their families
• Plan an on-site COVID-19 vaccine clinic open to all employees and their families
• Offer modest incentives to encourage working parents to vaccinate eligible children

Learn more about recommended actions, key messages and sample communications by exploring Resources to Help You Take Action: Business Action on Childhood Vaccinations and the Business Group’s National Immunization Awareness Month: Addressing Gaps in Child Immunizations blog.

Taking on the Obesity Epidemic

New data and research are upending traditional thinking about weight and weight loss and informing new ways to address the escalating obesity epidemic. Whether obesity affects an employee or a family member, it can take a toll on their well-being. For employers seeking to align their weight management strategy with the latest evidence, the Business Group’s Practical Playbook: Managing Overweight & Obesity offers recommendations for creating a comprehensive benefits package to treat obesity, including behavior-based interventions and pharmacological and surgical treatment.

Meeting the Mental Health Needs of Kids and Teens

Seventy-one percent of parents believe the pandemic has taken a toll on their child’s mental health, increasing the time, stress and energy they spend on caregiving.¹⁷ 

According to the World Health Organization (WHO), half of all mental health conditions start before age 14, but unfortunately, most cases are undetected and untreated.¹⁸ Employers can support employees and their children by expanding provider networks, promoting easier access to virtual care and helping parents navigate the complex care system.

Below are specific employer recommendations:

• Where possible, make mental health supports, such as EAPs and virtual mental health services, available to kids under 18 through health plans or standalone providers. Services that can be provided through text can be a good way to increase utilization by younger people.
• Consider reducing or eliminating cost-sharing for mental health services, or specifically for pediatric mental health.
• Push health plans to audit their mental health provider networks for pediatric mental health expertise. One large employer found that several of its in-network mental health providers actually had the ability to treat kids/adolescents but weren’t tagged as such in their provider directory.
• Consider emerging vendors focused on kids’ mental health.
• Communicate, communicate, communicate to employees about child and adolescent mental health and what benefits are available to support them.
• Support parents and caregivers which can have a positive trickle-down effect on kids, because parents will then have more capacity to take care of their dependents without getting burned out in the office and at home.

To learn more, watch Nurturing Young Minds: Employer Support for the Mental Health Needs of Kids and Teens from the Business Group’s Mental Health Summit.

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Resource Family and Caregiving Plan Design & Administration