Employers are concerned about covering workers’ mental health needs, survey finds

Almost three years after the covid-19 pandemic upended workplaces, mental health coverage remains a priority for employers, according to an annual employer survey fielded by KFF.

Nearly half of surveyed large employers — those with at least 200 workers — reported that a growing share of their workers were using mental health services. Yet almost a third of that group said their health plan's network didn't have enough behavioral health care providers for employees to have timely access to the care they need.

As millions of employees were sent away from shuttered office buildings to work from home or risked infection while working on the front lines, mental health problems soared. Now, even as many workplaces have returned to a semblance of "normal," some workers are still grappling with the changes of the pandemic years and seeking mental health services.

Although 4 in 5 employers reported that they had enough primary care providers in their health plan's network, only 44% of all employers reported they had enough behavioral health providers, according to the KFF survey.

"That is the number that for me shows how bad access to mental health care providers is," said Matthew Rae, associate director for the program on the health care marketplace at KFF. "That, in conjunction with the huge increase in demand for mental health services."

The 2022 KFF Employer Health Benefits Survey, released Oct. 27, analyzed the responses of a random sample of 2,188 employers with at least three employees.

Overall, the survey found that this year's premiums for health care coverage were remarkably similar to last year's. Annual premiums for family coverage are $22,463, on average, this year, compared with $22,221 last year. On average, workers this year are paying $6,106 toward those premiums, while employers pick up the rest of the tab.

For single coverage, workers are paying $1,327 out-of-pocket toward their premiums, which average $7,911 in total. Employers pay the remaining portion.

The relative stability in premiums stands in contrast to overall inflation, which has been 8% so far in 2022, and workers' wages, which have risen 6.7%, according to KFF's calculation — perhaps, the report suggested, because the annual premiums were finalized in fall 2021, before price increases were apparent.

That trend may not continue.

"Employers are already concerned about what they pay for health premiums, but this could be the calm before the storm, as recent inflation suggests that larger increases are imminent," Drew Altman, KFF president and CEO, said in a news release accompanying the report. "Given the tight labor market and rising wages, it will be tough for employers to shift costs onto workers when costs spike."

Among large employers, 14% said more employees were using services to treat substance use in 2022, although about half said they did not know whether there had been an increase, according to the survey.

Among all surveyed employers with 50 or more workers, 17% said they had also seen an increase in the number of workers who had requested leave for mental health conditions under the federal Family and Medical Leave Act. That law allows certain employees at companies with 50 or more workers to take up to 12 weeks of unpaid leave annually without the risk of losing their jobs.

Although the use of telemedicine services has eased somewhat since early pandemic lockdowns, 90% of surveyed employers reported that they offered a plan that covers telemedicine services. More than half of large employers reported that telemedicine would be "very important" in enabling them to provide their workers with access to behavioral health services in the future. In contrast, only about a third of those employers said the same was true for providing access to primary care, while 24% said telemedicine would be "very important" in enabling them to provide access to specialty care.

Twenty-seven percent of large employers reported that this year they added mental health care providers to their plan's network, either in person or through telemedicine.

In addition to covering mental and behavioral health care services, 81% of large firms said they have an employee assistance program for mental health services, while 44% said they offered employees mental health self-care apps.