Employers Mull Higher Health Plan Cost-Sharing for Unvaccinated Staff

Some employers are implementing a new incentive for their workers to get vaccinated against COVID-19: Charging them higher health insurance premiums if they don't.

A recent brief from consulting firm Mercer reported that employers are looking at surcharging the health insurance premiums for employees who refuse vaccination for reasons other than disability or sincere religious belief. Many employers apply similar surcharges for employees who use tobacco.

Delta Airlines recently informed its employees that they will face $200 monthly increases on their health insurance premiums starting Nov. 1 if they aren't vaccinated against Covid-19, citing steep costs to cover employees who are hospitalized with the virus.

Employers may choose this option for a simple reason: The large costs of hospital stays and treatments for COVID-19 patients. When health plans incur large claim costs, they must either accept lower profits or make up the difference by spreading the costs among plan participants. Charging higher premiums penalizes vaccinated and unvaccinated employees alike.

The U.S. Equal Employment Opportunity Commission has said that it is permissible for employers to require workers to be vaccinated. However, many employers have been hesitant to take that step, fearing negative employee reactions, waves of resignations and bad publicity.

Freedom of choice

Surcharging insurance premiums for unvaccinated workers may be an appealing alternative for some employers. Rather than ordering employees to get vaccinated, they would leave them free to choose.

Those who would rather bear higher costs as a consequence of refusing a vaccine would be free to make that choice. In turn, vaccinated employees would not have to subsidize the health care costs of colleagues who make riskier decisions.

A Mercer spokesperson has estimated that any surcharges would be in the range of $500 to $1,300 per year.

Extra costs like that might induce reluctant workers to get the shots. If unvaccinated employees decide to get vaccinated in order to avoid a surcharge, the workplace should be safer and more productive. Absenteeism due to illness can negatively impact productivity.

The takeaway

Employers need to consider the following before implementing surcharges:

• The EEOC has provided guidelines for employers wishing to offer vaccine incentives. Employers should stay within those guidelines.
• Are the incentives necessary? They might not be in areas or workplaces where vaccination rates are already high.
• The line between "encouraging" and "coercing" employees to get vaccinated is not well-defined. Employers should avoid imposing surcharges that could be viewed as coercive.
• Some employees have pre-existing health conditions that make the vaccinations unsafe. Others seriously practice religions that forbid their use. Federal law requires employers to accommodate these workers.

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