Employee benefits are often a hidden gem within an organization, but with the recent rise in interest surrounding weight loss medications, they’ve taken center stage. Medications like Ozempic, Mounjaro, and Wegovy have become hot topics, and your employees are likely paying attention. In fact, surveys indicate that these medications may already be playing a crucial role in attracting and retaining talent.
According to a recent Kaiser Family Foundation survey, an astounding 70% of respondents were aware of these weight loss medications. HR Brew reports that nearly 45% of employees would consider changing jobs to access obesity management coverage. As this awareness and demand grow, organizations must carefully consider their coverage options.
Understanding Weight Loss Medications
Ozempic, Mounjaro, and Wegovy are among the most prominent prescription medications for weight loss. These once-a-week injectables have garnered attention for their potential to help patients shed unwanted pounds. Despite initial skepticism surrounding their FDA approvals, they are now viewed as essential tools in effectively managing obesity.
The benefits of these medications are substantial. Clinical trials have shown an average weight loss of 5% to 15% at 6- and 12-month checkpoints, with some users experiencing a remarkable 20% reduction in body weight. Beyond aesthetics, healthy weight management significantly reduces the risk of various medical conditions, including diabetes, heart disease, stroke, kidney disease, and cancer. For example, a study of Wegovy demonstrated a remarkable 20% risk reduction for serious heart ailments.
However, there are challenges to overcome. These injectable medications come with a substantial price tag, currently costing over $1,000 per month per employee. BenefitsPRO estimates that they could increase annual employer costs by 25%. Furthermore, individuals must commit to weekly injections for life to maintain the benefits. Serious side effects, such as nausea and digestive issues, can also pose challenges, and not all users achieve their desired weight loss.
Coverage Considerations
Navigating high-demand, high-cost medications like these requires careful consideration. Employers face the complex task of balancing potential health gains against the lack of long-term data for these new drugs.
To make informed decisions, establish coverage with long-term goals in mind. While the initial expense is high, the ultimate gains are predicted to come from reduced expenses related to diabetes, heart disease, high blood pressure, and other chronic health conditions. Employee utilization is a crucial factor; use plan data and surveys to gauge interest and predict utilization rates. With over 40% of U.S. adults considered obese, the potential for health improvements is significant. Healthier weight management can reduce absenteeism and improve productivity, which can lead to organizational gains. Obesity-related absenteeism costs employers $8.65 billion annually, with productivity losses totaling $66 billion, according to the International Foundation of Employee Benefit Plans (IFEBP).
Review your current coverage regarding obesity and weight loss. While prescription medications are in the spotlight, it’s essential to understand your employees’ preferences. The IFEBP reports that 22% of employers cover weight loss-related prescription drugs and 45% cover bariatric surgery. To enhance coverage, consider collaborating with a care team, including doctors, dietitians, health coaches, and therapists. Exploring prior authorization or step therapy requirements can also encourage employees to try other strategies before using weight loss injectables, promoting a more holistic approach to health.
Promoting Workplace Health and Culture
Weight loss medications are not stand-alone solutions. Managing obesity requires a comprehensive approach, considering cultural, physiological, and mental factors. Your workplace culture plays a pivotal role in promoting weight management. Convenience is essential; stock healthy and readily available food in kitchens, cafeterias, break areas, and vending machines. Support employees with healthy meal delivery services or packaged food subscriptions, including options for remote workers.
Wellness programs should encompass a range of healthy habits, including nutrition education, cooking classes, fitness wearables, gym memberships, and online or on-site fitness classes. Encourage breaks, stretching, walking meetings, and movement throughout the workday to foster a healthier workplace culture.
Industry Standards and Compliance
Benchmark industry standards to gain insights into the competitiveness of your benefits. While coverage of weight loss medications is primarily limited to large employers due to costs, it’s worth noting that HR Executive reports 49% of large employers plan to cover these medications in 2024. Compliance with legal requirements, such as the Employee Retirement Income Security Act (ERISA) and the Mental Health Parity and Addiction Equity Act (MHPAEA), is essential. Ensure that coverage doesn’t indicate encouragement, endorsement, or guaranteed results, and consult with your benefits adviser to avoid potential claims of discrimination.
Work with Your Team
As weight loss medications receive more attention, prepare to discuss the topic with your employees transparently. Whether you decide to cover these medications or not, provide thoughtful communications and guide employees to explore other wellness offerings.
Employee Benefit Services by Hotaling
Weight loss medications can be a key element in promoting a healthier and more productive workforce. By carefully considering coverage options, understanding employee needs, fostering a healthy workplace culture, staying informed about industry standards, ensuring compliance, and engaging in effective communication, organizations can make informed decisions that benefit both their employees’ health and their bottom line. Weight loss medications may indeed hold the key to a brighter, healthier future for your organization.
To explore how weight loss medication coverage can benefit your organization and employees, contact Hotaling Insurance Services. Our Employee Benefits specialists can help you evaluate potential costs, overcome barriers, and develop comprehensive wellness solutions and communication strategies to optimize your coverage.