Business Group on Health Lists Top Open Enrollment Trends for 2021

WASHINGTON, DC, September 29, 2020 — Business Group on Health today released a list of several trends that employees may see during open enrollment – the time when employees and their families make important decisions about health care and other employee benefits for 2021. The list is based on data from the Business Group’s annual Large Employers’ Health Care Strategy and Plan Design Survey and conversations with employers.

“Open enrollment is a terrific opportunity for employees to carefully review and evaluate benefits offerings from their employers,” said Ellen Kelsay, President and CEO of Business Group on Health.

It is especially true this year as employees may have adjusted their work routines and daily lives and many employers have enhanced benefits. Many of the enhanced benefits employees can expect to see are in areas that employers had already been investing in, and the pandemic has accelerated, including greater access to virtual care options and mental health services.

Ellen Kelsay, President and CEO, Business Group on Health

The open enrollment trends the Business Group identified for 2021 are:

  • Modest cost increases: The pandemic has generated a lot of uncertainty around costs. What employees will pay for health care benefits, including premiums and out-of-pocket costs, may rise along with total health benefit costs, which employers expect to rise an average of 5% in 2021. On top of already high levels, these increases are larger than wage growth and overall economic growth. Most large employers will continue to cover almost 70% of the costs.
  • More virtual care options: Virtual care offerings increased during the pandemic and are expected to continue to grow in 2021. This includes both the number and types of virtual care options and availability through telehealth platforms and regular providers. Fifty-three percent of large employers will offer more virtual care options in 2021. Most employers offer telehealth for minor, acute care and mental health, and many are extending virtual options to weight management, care management for chronic conditions such as diabetes and cardiovascular disease, prenatal care, and musculoskeletal care management/physical therapy.
  • Expanded focus on mental health: In the wake of the pandemic, employers are expanding access to mental health services and supports. Almost nine in ten employers will offer access to online mental health resources including apps, videos, and webinars while nearly two-thirds will provide manager training to help recognize mental health issues and direct employees to appropriate services. Half of large employers will conduct campaigns to reduce the stigma that exists related to mental health conditions and treatment.
  • Growth in onsite clinics: On-site clinics have proven to be flexible enough to adapt to the evolving landscape. Sixty-one percent of employers will have an on-site clinic in place next year to provide basic health services at select locations. Some employers are expanding their on-site services. More than a third of employers will bring primary care directly to employees at selected worksites. Other services offered include COVID-19 testing and virtual counseling.
  • Access to more Centers of Excellence (CoE): Employers have been adding more CoE care options to their benefit packages for the past several years to encourage employees to receive treatment at selected hospitals known for high-quality specialty care. Eighty-one percent of employers will have at least one condition specific CoE in place next year. Bariatric surgery is the most common procedure for which employers offer a CoE, with 68% doing so. Other CoEs focus on musculoskeletal conditions and cancer.

About Business Group on Health

Business Group on Health is the only non-profit organization devoted exclusively to representing large employers' perspective on health policy issues and optimizing workforce strategy through innovative health, benefits and well-being solutions. The Business Group keeps its membership on the leading edge of innovation, thinking and action to address health care cost and the delivery, financing, affordability and experience with the health care system. Business Group members, many of whom have operations globally, include 74 Fortune 100 companies, and provide health coverage for more than 60 million workers, retirees and their families in over 200 countries. For more information, visit

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Ed Emerman
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