Health and Wellness Benefits

Health Insurance + Wellness Benefits

Health benefits can include health and dental insurance, as well as on-site wellness centers, on-site fitness centers, subsidies for joining a gym, and/or health- and fitness-oriented programs for employees’ children or spouses.

Benefits to Employers1

  • Reduces payroll taxes and workers’ compensation premiums, and employer contributions are tax- deductible
  • Improves recruitment
  • Increases retention, reducing turnover costs

Benefits to Children2

Improves health through increased access to health care, including primary care, dental care, needed healthcare services, mental health care, prescriptions, preventive care, treatment for chronic conditions, and prenatal care (for mothers)

Benefits to Parents/Families3

  • Improves health, through increased access to health care, including greater access to primary care, preventive screenings, ambulatory care, prescription medications and chronic disease care; greater medication adherence; and higher rates of diagnosis
  • Reduces depression
  • Improves self-reported health
  • Improves family economic security

Research or Recommendations from National Organizations

Uninsured newborns are more likely to be born at a low birth weight and are more likely to die than insured newborns. Uninsured women are more likely to have poor pregnancy and delivery outcomes.4

The American Academy of Pediatrics recommends quality, affordable health insurance for all children up to age 26 that includes coverage of essential pediatric benefits, such as prenatal and newborn care, postnatal home visits, preventive and wellness services, and urgent and emergency care, along with services for dental treatments, behavioral and mental health care, reproductive health, and treatment of substance abuse disorders.

In the 22nd Annual Best Practices in Health Care Employer Survey, insurance brokerage and advisory firm Willis Tower Watson says employers who are “best performers,” or employers who have lower than average health care costs, do the following:5

  • Take a broad view of health and wellbeing and design their workplace environment to make it easier for employees to stay healthy and make healthy decisions.
  • Encourage employees to take advantage of higher value/lower cost health care delivery models such as telemedicine.6,7
  • Analyze data to evaluate programs and assess performance.
  • Offer their employees an account-based health plan, which gives employees more accountability for their care decisions.
  • Use technology, such as mobile apps or wearables, to modernize employees’ health and well-being programs and experiences.

Range of Practices in the United States

Nearly all private employers in North Carolina with 50 or more workers (95 percent) offered health insurance to at least some of their employees in 2017. But only one in five (21 percent) of private employers with fewer than 50 employees offered health insurance in the same year. The majority of firms offering health benefits allow employees to enroll dependents, including children.8

In 2017, private employers with fewer than 500 employees paid an average of 64 percent
of health care premiums for their employee family coverage, and state and local governments with fewer than 500 employees covered an average of 72 percent of family coverage premiums. Private employers with 500 workers or more paid an average of 76 percent of health care premiums for employee family coverage, and state and local governments covered an average of 70 percent of premium costs.9

Relatively few employers (13 percent) offer health insurance benefits to part-time workers.10

Health care costs are prohibitively expensive for many American workers. A survey of the Federal Reserve Board showed that 44 percent of Americans could not cover an emergency expense of $400 or more, and only 30 percent of Americans with access to employer health insurance coverage are confident they can afford health care without financial hardship.11

Two out of three employers with fewer than 50 workers offer dental benefits, and 97 percent of employers with 50 or more employees offer dental benefits to their employees. Of those, 67 percent contribute toward the cost of the coverage.12

Forty-seven percent of firms with fewer than 50 employees and 82 percent of firms with 50 or more employees offer vision benefits to their employees. Of those, 54 percent contribute toward the cost of the coverage.13

In 2017, 63 percent of public sector employees and 39 percent of private sector employees had access to wellness resources and/or a general wellness program. Access varied widely by industry. Additionally, access was lower for lower- wage workers. Only 15 percent of workers whose wages were in the lowest 10 percent had access to wellness programs.14

Case Study

Forrest Firm

Location: Statewide • Year Founded: 2011 • Number of Employees: 45

When real estate paralegal and mother of two Christina McComas decided to leave the large corporate law firm she had been with for 17 years to join Forrest Firm, she admits she was a bit nervous. “It was definitely a leap of faith,” she says.

Her new employer was unlike any law firm she had ever worked for. However, after meeting James Forrest, the firm’s founder, she knew it was the right decision.

Christina McComas with her children

“Forrest has an entirely different vision for what a law firm can be,” McComas says. “I can be there for my children. I’m happy, and I’ve never looked back.”

Forrest Firm is a full-service corporate and business law firm and certified B Corporation with a team of 45 people in eight offices across North Carolina. The firm has been growing consistently and has been recognized for creating a work environment that values the health, well-being, and happiness of their employees as much as it values the needs of their clients.

When Forrest launched the firm in 2011, he had a successful background in corporate law but wanted to build a firm more closely aligned with his values. He started out working from home and kept an eye on overhead costs. As he grew, he attracted entrepreneurial attorneys who— like himself—wanted to work hard and be out meeting people, not necessarily sitting at a desk all day.

Forrest also wanted to create a family-friendly environment in his firm—an approach that is rare in the legal profession. Forrest Firm’s unique work-from-anywhere policy for attorneys and the family friendly, flexible approach for staff grew organically from the vision he had for his team.

“I am definitely more productive because of how I can structure my day.”

For attorney Leslie P. Lasher, who is pregnant with her second child, the set-up has been ideal. She works several days a week from home and heads into the office when necessary. “The firm offers a truly supportive culture that starts with senior leadership,” says Lasher. “Our founder does a great job of modeling work-life balance. He prioritizes time with his family and encourages us to do the same.”

Attorneys can structure their days in different ways. For instance, some fence off blocks of time when they’re with their family and then pick work back up later in the evening once their children have gone to bed.

“I am definitely more productive because of how I can structure my day,” says Lasher. “If my child has a doctor’s appointment or a school event, I can be there, and it’s not a problem. It’s not a secret if we’re spending time with our family.”

And, perhaps surprisingly for some, clients support the firm’s approach. “You’re not less of an attorney because you value your family,” says Lasher. “Our clients recognize that you can have a very sophisticated law firm that is structured differently. We respond within 24 hours, travel to meet our clients, and focus on their needs.”

Lasher has found that if she has an out of office message that lets people know she’s with her family on vacation or at an event, they’ll inquire. “My clients actually ask. They want to know how the event went or how vacation was,” says Lasher. “Our approach is building and fostering a deeper relationship with our clients. I’m not just drafting a contract for them.”

Forrest Firm’s offices are staffed full-time during regular working hours by office managers and paralegals, and attorneys are free to work or meet clients in one of the firm’s offices. To encourage connection, the firm uses cloud-based phone, computer, and chat platforms to communicate, and the full team meets in person from across the state periodically. In addition, a liberal travel policy encourages attorneys to visit other offices and get to know their colleagues across the state.

“It takes courage but it’s possible. Don’t be afraid to try something different.”

“We continue to think about ways to foster a team environment with people working remotely,” says Lasher. “For example, we’re very purposeful about discussing work and non-work issues via instant messaging to encourage community even if we’re not sitting right next to each other.”

McComas believes Forrest’s approach is an antidote to the physical, mental, and emotional demands that contribute to high turnover in the legal profession. “We all do our best to help the firm,” says McComas, “and we don’t have to sacrifice our families to do so. There is a lightness—a happiness—in our firm that I haven’t experienced elsewhere.”

Change is not easy, but Lasher is optimistic. “You have to be brave to create change in an industry that is so steeped in tradition,” says Lasher. “It takes courage, but it’s possible. Get feedback from your employees on what they like and what they don’t. Don’t be afraid to try something different.”


Sample Benefits at Forrest Firm

  • Major medical insurance, many options which are offered at no cost to the employee with both Flexible Savings and Health Savings Accounts
  • Dental and vision, which is covered at 100 percent for the employee and their families
  • Paid time off for staff, which includes paid personal/vacation days, paid community service days, and paid holidays
  • Flex time program for staff; work from anywhere and open time off policy for attorneys
  • 401(K) with firm match
  • Celebrations for work and life milestones
Show 14 footnotes
  1. North Carolina Early Childhood Foundation. “The Research Basis for Family-Friendly Workplaces.” June 14, 2018. https://files.familyforwardnc.com/wp-content/uploads/2018/04/NCECF_FFNCpolicyfactsheet-061418.pdf
  2. North Carolina Early Childhood Foundation. “The Research Basis for Family-Friendly Workplaces.” June 14, 2018. https://files.familyforwardnc.com/wp-content/uploads/2018/04/NCECF_FFNCpolicyfactsheet-061418.pdf
  3. North Carolina Early Childhood Foundation. “The Research Basis for Family-Friendly Workplaces.” June 14, 2018. https://files.familyforwardnc.com/wp-content/uploads/2018/04/NCECF_FFNCpolicyfactsheet-061418.pdf
  4. National Academy of Sciences. “Health Insurance is a Family Matter.” US Institute of Medicine Committee on the Consequences of Uninsurance. 2002. https://www.ncbi.nlm.nih.gov/pubmed/25057625
  5. Willis Tower Watson. “High-performance insights –best practices in health care: 2017 22nd Annual Willis Tower Watson Best Practices in Health Care Survey.” 2017. https://www.willistowerswatson.com/-/media/WTW/PDF/Insights/2018/01/2017-best-practices-inhealth-care-employer-survey-print-wtw.pdf
  6. Effects of domestic violence on children.” U.S. Department of Health and Human Services Office of Women’s Health. https://www.womenshealth.gov/relationships-and-safety/domestic-violence/effects-domestic-violence-children
  7. DeRigne, LeaAnne, PhD; Patricia Stoddard-Dare, PhD; Linda M. Quinn, PhD; Cyleste Collins, PhD. “How Many Paid Sick Days Are Enough?” Journal of Occupational and Environmental Medicine. June 2018. https://journals.lww.com/joem/Abstract/2018/06000/How_Many_Paid_Sick_Days_Are_Enough_.1.aspx
  8. Henry J. Kaiser Family Foundation. “Percent of Private Sector Establishments That Offer Health Insurance to Employees, by Firm Size.” 2017. https://www.kff.org/other/state-indicator/firms-offering-coverage-by-size/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
  9. U.S. Department of Labor Bureau of Labor Statistics. “Employee and employer premiums for medical care benefits in 2017.” April 2, 2018. https://www.bls.gov/opub/ted/2018/employee-and-employer-premiumsfor-medical-care-benefits-in-2017.htm
  10. Kaiser Family Foundation. “2017 Employer Health Benefits Survey.” September 19, 2017. https://www.kff.org/report-section/ehbs-2017-section-2-healthbenefits-offer-rates/
  11. Mercer. “Mercer’s National Survey of Employer-Sponsored Health Plans.” 2017. https://www.mercer.us/reports/mercer-national-survey-introduction.html
  12. Kaiser Family Foundation. “2017 Employer Health Benefits Survey.” September 19, 2017. https://www.kff.org/report-section/ehbs-2017-section-2-healthbenefits-offer-rates/
  13. Kaiser Family Foundation. “2017 Employer Health Benefits Survey.” September 19, 2017. https://www.kff.org/report-section/ehbs-2017-section-2-healthbenefits-offer-rates/
  14. U.S. Department of Labor Bureau of Labor Statistics. “Employee Access to Wellness Programs in 2017.” January 3, 2018. https://www.bls.gov/opub/ted/2018/employee-access-to-wellness-programs-in-2017.htm