2025年全球员工保险福利趋势报告-突出强调了常见的 Health Trends 2025 Adapting plans to optimize value

HealthTrends

2025

Adaptingplanstooptimizevalue

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Healthtrends2025:Adaptingplanstooptimizevalue

Thetop-linefindingsinourHealthTrends2025report

maysoundfamiliar.Costlycancerclaims.Widespread

cardiovascularandmetabolichealthconcerns.Unmet

mentalhealthneedsandmedicaltrendpushingupcosts.

Butbehindtheseenduringissues,alotischanging—employers’andinsurers’responsestothese

well-acknowledgedthemescannotremainstatic.

Thetrendsoutlinedinthisreportwillhelpemployersdeependialoguewiththeiradvisorsandinsurers.

Exploringmoreinnovativeformsofcostcontainment,embracingeffectivenewtreatmentregimes,and

ensuringthatmedicalcoveragemeetstheneedsof

thewholeworkforceareessentialasmedicalcostsandworkforceneedscontinuetorise.

Medicaldevelopments,suchasinnovativetreatmentsforobesityandshiftingpatternsofdiagnosisfor

conditionslikecancer,willchangeinsuranceclaims

patternsbecauseoftheirsignificantlyhighercost.

Planmanagementoptionsandapproachesforcost

containmentmustmoveforwardtokeephealthcare

affordable,forbothemployeesandemployers.

Healthcareprovisionwillalsoneedtocontinueevolvingtomeettheneedsofadiverseworkforce.

Forour2025report,MercerMarshBenefits(MMB)

surveyed225insurersacross55marketstoexplorethekeytrendsshapingemployer-providedhealthbenefits.ThissurveywasfieldedinJuneandJuly2024.

2

Healthtrends2025:Adaptingplanstooptimizevalue3

Usingnew

techniquestokeepplans

Meeting

persistentworkforce

needs

ExecutivesummaryManaging

intensifyingrisks

affordable

Beyondtraditionalleversofcostcontrol,innovativenewpracticesareemerging.Thesehaveyet

tobewidelyadoptedandusedbyinsurers.

Themedicalconditionsthatdrive

costshaveremainedlargely

consistentoverthelastdecade

—COVID-19aside.However,the

impactofthesehealthconditionsisincreasing.

Medicalcoverageremains

narrowlydefineddespitethe

Trend

holistichealthandwell-being

needsofadiverseworkforce.

Thisinadequacyofcoverisoftenexacerbatedbyinflation,whichmayerodebenefitmaximums.

Employerslookingtocontaincostshouldlookbeyondthe

obviousstrategies.Theyshouldconsider,request,andevaluatemoreaggressiveapproachestoincludehow,when,andwherecareisdelivered.

Employersshouldevaluatetheir

programstooptimizetheir

investmentinemployeehealth,

balancingnotjustcost,butalsotheemployeeexperience.

Whatit

means

Asemployerslooktoshiftbenefitsspendtowardsthosehighlyvaluedofferingslikemedicalcoverage,

understandingunmetworkforceneedsandhealthriskswillbecomeevenmorevital.

82%ofinsurersreportan

increaseintheincidenceofcancertreatmentclaimsoverthelastfiveyearsforindividualsunderthe

ageof50.

46%ofinsurersbelievethatartificialintelligenceforfirst-linediagnosis,imagingand/or

navigationwilldecreasehealthplancostswithinthenextfiveyears.

Key

finding

39%ofworkersindicatethatvirtualadvice,viaartificialintelligencepoweredchat,foranxiety,sadness,orrelationshipissueswouldbehelpful.

Only15%ofinsurerstodayprovidethisbydefault.

Healthtrends2025:Adaptingplanstooptimizevalue4

Definingmedicaltrend

Medicaltrendistheyear-over-yearcostincreasefor

claimsunderamedicalplanonaper-personbasis,

assumingnochangestothebenefitsprovided.Thisrateofgrowthistheresultofavarietyoffactors,including:

•Medicalinflation(increaseinper-unitcostsforthesameservice/supply)

•Alteredtreatmentmix(forexample,movingtomoreexpensiveoradvancedtreatments)

•Utilizationpatterns(forexample,peoplenotaccessingcareduetoCOVID-19)

•Regulatorychanges

Medicaltrendrates

Globaltrendratesareprojectedtostabilizein2024

and2025.However,ratescontinuetobepersistentlyhigh.Nearlyallregionsareseeingtrendratesabove10%inbothyears.Insurerssay2024trendisdrivenbymedicalinflation,utilizationchanges,andchangestotreatmentmixes.

Figure1:Medicaltrend2019-2025

Global

2019

9.7%

2020

5.7%

2021

10.1%

2022

10.1%

2023

12.0%

2024

11.4%

2025

10.9%

Canada

6.9%

3.9%

7.1%

7.0%

9.0%

9.0%

10.0%

Asia

10.2%

3.5%

8.9%

10.7%

12.7%

13.0%

13.0%

Europe

8.0%

3.5%

10.9%

11.4%

13.0%

11.7%

10.4%

LatinAmericaandCaribbean

13.4%

8.0%

11.1%

10.0%

10.0%

10.6%

10.4%

MiddleEastandAfrica

11.1%

9.6%

10.2%

9.3%

12.4%

10.6%

10.7%

Pacific

4.6%

5.2%

5.0%

2.9%

9.0%

11.5%

9.3%

Figure2:Topthreetrendinfluencersbyregion.Howdoyouexpecteachofthefollowingtrendcomponentswillimpactyour

76%

72%

71%

68%

64%

62%

56%

48%

market’sprojected2024medicaltrendrate?(Verysignificant+significant).

88%

82%

81%

80%

79%

73%73%

MiddleEastandAfrica

LatinAmericaandCaribbean

GlobalAsiaEurope

Medicalinflation,includinghigherpricesduetocurrencyfluctuations,transportation,and/orlaborcosts

Utilizationchangesduetohigherincidenceofhealthconditions

Changesintreatmentmix

(e.g.,advancementsin

technologyleadingtodifferenttreatmentpatterns)

Utilizationchangesduetochangesinpublicsystemscope,quality,affordability,and/oraccess

Ratesfor2019,2020,2021,2022,and2023areretrospective.Ratesfor2024and2025areprospective.Unweightedglobalaveragesused.ThiswasgatheredinJune-Julyfrom225insurers,withmedicaltrendratessubmittedbyinsurersvalidatedbyourlocalteamsusingtheirowninternalbookofbusinessdata,country-specificinsurersurveysandsubjectiveassessments.PleasenotetheUnitedStatesisnotpartoftheresearch.FormoreinformationontheratesintheUS,refertothisyear’s

NationalSurveyofEmployer-SponsoredHealthPlans

.

Healthtrends2025:Adaptingplanstooptimizevalue

UShealthupdate

TocapturedevelopmentsintheUS,whichisoutside

ofthescopeofthissurvey,Mercerconductsanannual

NationalSurveyofEmployer-SponsoredHealthPlans

.

Thisyear’ssurveyfoundthattotalhealthbenefitcost

peremployeeisexpectedtorise5.8%,onaverage,

in2025,afteraccountingforplannedcost-reduction

measures.Thiswouldbeathirdconsecutiveyearofcostgrowthabove5%,following10yearsofannualincreasesaveragingaround3%.IncreasedutilizationofbehavioralhealthservicesandGLP-1s(expensiveprescriptiondrugsfortreatingdiabetesandobesity)havecontributed

somewhattothecurrenttrend.However,thebiggestdriversmaybestructuralissuesaffectingthepriceofservices,suchashealthcarelaborshortagesandhealthsystemconsolidation.

Ad

EmployersexpectUShealthbenefitscostperemployeetorise5.8%onaveragein2025

5

Healthtrends2025:Adaptingplanstooptimizevalue

Part1

Managing

intensifyingrisks

6

Healthtrends2025:Adaptingplanstooptimizevalue7

WhiletopcausesofhealthplanclaimsbydollaramountandfrequencyremainlargelyconsistentwithpreviousHealthTrendsreports,diggingintothosefiguresrevealssignificantchanges.

Forexample,instancesofcancerinyoungerworking

agepopulationsareincreasing,andcatastrophicclaimsarepushingmoreemployeestothelimitoftheirlifetimeclaimsthresholds.Groundbreakingtreatmentsfor

conditionslikeobesitycouldhaveasignificantimpactoncardiovascularandmetabolichealth,butarecurrently

verycostly.

Bothemployersandinsurersneedtoconsiderhowtheywillmanageevolvinghealthrisks,whilekeepingplansaffordable.

1

2

3

4

5

Figure3:Globaltopcausesofclaimsbydollaramountandbyfrequency

Topcausesof2023claimscostbyfrequency

Topcausesof2023claimscostbydollaramount

Diseasesofthe

Cancer

circulatorysystem

Diseasesofthe

circulatorysystem

Respiratoryconditions

Musculoskeletalconditions

Gastro-intestinaldiseases

Respiratoryconditions

Gastro-intestinaldiseases

Cancer

Musculoskeletalconditions

Healthtrends2025:Adaptingplanstooptimizevalue8

Keepingplansaffordable

Ashealthrisksevolve,factorsthatcontributetothe

affordabilityofhealthcareplanswillalsoshiftovertime.Theimpactofhigh-costclaimantsisauniversalworryglobally,butotherdriverscanberegion-specificandareoftenrelatedtowidersocialandeconomicfactors.

Shiftingthecostsofhealthcarefrompublictoprivate(oftenemployer)purchasers,andchangesinthe

providerlandscapearemajorsourcesofcostconcernsinEurope.Thisistheonlyregionwherethesefactorsareatopconcern,with68%ofinsurerssayingtheyhada

significantimpacton2024medicaltrend.Thiscorrelateswithfindingsfromour

PeopleRisk2024

report.InItaly,forexample,healthcaresystemdeteriorationwasseenasthefourth-rankedpeoplerisk,basedonboththe

severityaswellasthelikelihoodoftherisk.Globally,

healthcaresystemdeteriorationwasranked20th.

IntheLatinAmericaandtheCaribbeanregionand

intheMiddleEastandAfrica,fraud—suchasbillingforservicesthatneverhappenedorperforming

unnecessarytests—isakeyaffordabilityissue,ranksasatopthreeconcern.

Figure4:Keepingplansaffordable—topthreeconcernsbyregion

1

2

3

Global

High-costclaimants

(80%)

Newcancertherapies

(71%)

Inefficientandwastefulcare

(61%)

*Indicatesa‘tie’fortheranking.

Asia

Europe

LatinAmericaandtheCaribbean

High-costclaimants

(87%)

High-costclaimants

(68%)

Newcancertherapies

(89%)

Newcancertherapies

(74%)

Cost-shiftingfrom

governmenthealth

programstoemployerplans

(57%)*

High-costclaimants

(84%)

Inefficientandwastefulcare

(68%)

Physician/hospitalconsolidation

(57%)*

Fraud

(62%)

High-costclaimants

(83%)*

Fraud

(83%)*

Newcancertherapies

(79%)

MiddleEastandAfrica

Healthtrends2025:Adaptingplanstooptimizevalue

Spotlightoncardiovascularandmetabolichealth

Metabolicandcardiovascularriskisthebiggestriskfactorformedicalcostsglobally,

accordingtooursurvey.TheWorldHealthOrganization(WHO)hasidentified

cardiovasculardisease

astheleadingglobalcauseofdeath.Cardiovasculardiseases

(CVDs)impacttheheartandvascularsystem,andincludecoronaryarterydisease,

heartfailure,heartattack,stroke,andhypertension.MetabolicriskscontributetoCVDsandincludehighbloodpressure,obesity,andhighcholesterol.Smokingandphysicalinactivityincreasetheserisks.Metabolicriskfactorscontributetoindividualsbeing

impactedbydiabetes,which

affects8.5%ofadults

.

Topriskfactorsonmedicalcosts(Global)

Metabolicandcardiovascularrisk

1

2

Mentalhealthrisk

3

Psychosocialrisk

4

Endemicinfectiousdiseases

+

5Tobaccosmoke

9

Howemployerscanhelp

managediabetesand

cardiovasculardiseaserisk

Bothdiabetesandcardiovasculardiseasecanbewellmanaged,preventingcomplicationsandpoorclinicaloutcomes,withappropriatesupportinplace.This

couldinclude:

•Accesstoessentialmedicationsinbothinpatientandoutpatientsettings

•Educationaboutmetabolicandcardiovascularrisksandhowtocontrolthem

•Earlypreventionanddetectionprograms

•Accesstoprimarycaretocaptureriskearly

•Digitalself-management,suchasapps

•Complementaryprogramssuchasnutrition

therapy,geneticprofiling,plandesignincentives,andmentalhealth

Healthtrends2025:Adaptingplanstooptimizevalue10

Weightlosstosupportcardiovascularandmetabolichealth

Morethan40%ofadultsareoverweight

accordingtothe

WHO

.Overweightadultsareatriskofawiderangeof

relatedconditions,

including

:

Sleepapnea

Cardiovasculardiseasessuchascoronaryarterydiseaseandstroke

Musculoskeletalissuesincludingchronicbackandjointpainandarthritis

Type2diabetesandprediabetes

Mentalhealthconditionssuchasdepressionandanxiety

TheGLP-1classofdrugs,historicallyusedfordiabetes,arenowfoundeffectiveforweightlossinclinicaltrials.Examplesofthesearefoundunderthebrandnames

ZepboundandWegovy.

GLP-1drugsacttocontrolbloodsugar,manageappetite,andslowdigestion,whichinturn

leadstoweightloss

.Aspartofaclinicalweightlossprogram,GLP-1drugscan

resultinsignificantbodyweightreductionofbetween

15%

to21%in72weeks

.Thesedrugs,however,comeatacost.

CurrentlythereislimitedinsurancecoverageforGLP-1

drugsglobally.Fifty-threepercentofinsurerrespondentssaythattypicalplansdonotcoverprescriptiondrugs

forobesity,andafurther32%saythattheyhavenot

changedtheirapproachtocoveringthesedrugsfor

thetreatmentofobesity.IntheMiddleEastandAfrica,ontheotherhand,14%ofrespondentssaytheynowcoverthesedrugs,butonlyaspartofawiderconditionmanagementapproach.

LimitedcoveragemaybeareflectionofthefactthatusingGLP-1drugsforthetreatmentofobesityis

relativelynew,andtheiravailabilitymaybe

limited

incertainmarkets

.Yet,GLP-1drugcostconcernsarealreadyemerging.Morethanaquarter(28%)ofrespondentsgloballysaidthatGLP-1drugsarea

worryduetotheirimpactonplanaffordability.InLatinAmericaandtheCaribbean,andtheMiddleEastand

Africa,thatfigureincreasesto33%and34%respectively.

ThereisalottolearnaboutGLP-1drugs,especiallyaroundlong-termuse.

Basedontoday’sknowledge

,theyareshowinggreatpromisetohelphigh-riskplanmembersimprovetheirhealth.Thiswillhavetobe

balancedagainstaffordabilityanddurationofuse.

GLP-1drugsareprescribedtobeusedinconjunctionwithphysicianoversightandamorecomprehensiveweightmanagementstrategy,including:

•Closemonitoringbyprescribingphysicianstomanagesideeffects

•Utilizationincombinationwithothersupports,suchasnutritionandexercisecounseling

Priorauthorizationshouldalsobeaprioritytoensureclinicalappropriateness,suchas,beingusedforclinicalpurposes,ratherthancosmetic.

Healthtrends2025:Adaptingplanstooptimizevalue

Spotlightoncancer

Cancerremainsthetopglobalcauseofinsuranceclaimsbasedondollaramountsandisfourthhighestbasedonclaimfrequency.TheWHOprojectsthatoneinfivepeoplewilldevelopcancerintheirlifetime,with

35millionnew

cancercases

predictedby2050.

Concerningly,instancesofcancerare

increasingamong

youngerpopulations

globally.Insurersacrossallregionsreportincreasesintreatment-relatedcancerclaimsin

peopleunder50-yearsold.

Figure5:Percentageofinsurersthathaveseenincreasedtreatment-relatedcancerclaimsforindividualsagedunder50overthepastfiveyears

Global

82%

Asia

80%

Europe

84%

LatinAmericaandCaribbean

88%

MiddleEastandAfrica

76%

11

Healthtrends2025:Adaptingplanstooptimizevalue12

Preventativecancerscreeningenablesearlydetection,reducingtherisksofcostlierclaimsrelatedtolater

diagnosisandformingavitalpartofcostcontainmentandimprovedsurvivalrates.

Globally,only4in10plansincludepreventativecancer

screeningbydefault,despite50%ofemployeessaying

thattheseareahelpfulbenefitforthemandtheir

families,accordingtoMMB’s

HealthonDemand

research.Othercancerpreventiontools,suchasvaccinations

andgenetictesting,areevenlesslikelytobecovered.However,establishedpreventionprogramscanbe

incrediblybeneficialforpatients.TheHPVvaccination,

forexample,can

preventmorethan90%

ofHPV-attributablecancers.

Therearemanywaysforemployersto

bettersupport

employees

withcancer.Someemployers,forexample,havecreatedcancereducationmaterials,whichprovideplanparticipantsrecentlydiagnosedwithcancerwithinformationonbenefitsavailablefromemployers,thepublicsystem,andlocalnon-profits.

Figure6:Preventativecancermeasuresofferedasdefaultbyinsurers.

Relatedtocancer,whichofthefollowingdoesyourcompanytypicallyincludefor

employersponsorsofprivategroupmedicalinsurance?(Typicallyincludedbydefault)

Preventative screenings (forexample,mammograms,testingkits)

Vaccines(forexample,HPV)

Genetictesting

62%

43%

26%

50%

48%

24%

12%

28%29%

45%

GlobalAsia

Europe

LatinAmericaandtheCaribbeanMiddleEastandAfrica

13%5%

21%

13%

17%

Healthtrends2025:Adaptingplanstooptimizevalue13

Newtreatmentsforcancer,autoimmunediseases,and

morerareconditionsarecomingtomarket,offeringhopeforlife-threateningconditions.However,thesetreatmentscanbeexpensive.It’simportanttobeawareofhealth

innovationsandwhetherthey’recoveredbyaninsuranceplanaswellaspublichealthsystems.

Ifsomeoftheseexpensivetreatments,cancer-specificorotherwise,arecoveredunderanemployer-sponsoredinsuredplan,prepareformorevolatilityinclaims.If

notcovered,bereadytoaddressrequestsforcoverageexceptions.Oneimplicationofcoverageforhigher-costtreatmentsisindividualsreachingtheirlifetimelimitsunderinsuranceplans.Forty-threepercentofinsurersgloballyarereportingthattheyhaveseenahigher

frequencyofthisoverthepastfiveyears.

Figure7:Thepercentageofinsurerswhohaveseenanincreaseintheincidenceofindividualsreachinglifetimelimitsduetocatastrophicclaimsclaimsoverthepastfiveyears

43%

Global

50%

Asia

32%

Europe

44%

LatinAmericaandCaribbean

55%

MiddleEastandAfrica

Healthtrends2025:Adaptingplanstooptimizevalue14

Employeractions

2

1

3

Whereallowedbylaw,reviewyourbenefitsphilosophy

relatedtolifetimelimits;whilethesecansupportahealth

plan’sfinancialsustainability,theycanalsoresultin

exhaustionofemployeemedicalcover.

Exploreemergingcancer

riskswithinyourworkforce,especiallyamongyoungerworkers,anddevelop

prevention,detection,andsupportprograms.

Buildastrategyforreducingcardiovascularandmetabolichealthrisks.

Healthtrends2025:Adaptingplanstooptimizevalue

15

c

厂

Part2

Usingnewtechniquestokeep

AI

plans

affordable

$

Healthtrends2025:Adaptingplanstooptimizevalue16

Our

PeopleRisk2024

reportshowedthatincreasing

healthandbenefitscostsisthenumberoneriskforHR

andriskmanagersglobally.However,just31%ofHRandriskmanagersreporthavingeffectivecostcontainmentstrategiestomanagebenefitcosts.

Utilization:

Whilerisingcostsinhealthplansmightbeinevitable,theyarealsomanageable.Threecoreelementsofaneffectivecostmanagementstrategyare:

Health:

Suppliers:

Designcoveragetobalanceeconomics

Improvehealthoutcomesthrough

Drivefinancingandvendor

andempathy.Considereligibility,

data-driveninterventions.Thiscould

managementefficiencies.Workwith

benefitlimits,costsharing,andhow

includebuildingacultureofhealth

vendorsonpackagedfees,bundled

privateplansmaximizepublichealth

intheworkplaceorsupporting

pricing,oralternativefinancing,such

resourcesandofferings.

well-being,preventativecare,andconditionmanagement.

asself-insurance,includingcaptive

insurerfinancing.Carryoutprovider

auditsandensureeffectiveuseof

digitalhealthandcentersofexcellence.

Pre-authorization

focusedonassessingreasonablenessof

procedure/supplycost

Global

61

20

Asia

25

Europe

21

15

15

LAC

87

MEA

69

24

Negotiatedpackagedorbundlespricing

forspecificprocedures

Global

58

22

Asia

31

Europe

60

16

LAC

71

18

MEA

69

24

Healthtrends2025:Adaptingplanstooptimizevalue

Costcontainmentfactors,suchasnegotiatingbundledpricing—forexample,fixedpricingfordifferent

componentsofahospitalstay,includingthecost

ofpotentialcomplications—andprocedurepre-

authorizationarewidelyusedinmostregions,eitherasapartofcoreplandesign,oronrequest.Asiaistheexceptionbecausethesefeaturesarelesslikelytobeincludedasstandard.

Exploringmoreproactiveapproachestoplan

management,suchassteeringemployeestohighqualityvirtual-firstcare,areapartofactiveplan

management.Thereismorethatbothinsurersandemployerscando.

Figure8:Costcontainment(%ofinsurers)

10

9

53

14

8

50

94

33

11

10

47

14

8

15

9

92

33

Nottypicallyincludedbutavailableuponrequest

Typicallyincluded

Notsure

Nottypicallyincludedandnotavailableuponrequest

LatinAmericaand

theCaribbean(LAC).MiddleEastand

Africa(MEA).

17

Healthtrends2025:Adaptingplanstooptimizevalue18

Steeringmembers

tohighqualitycare

(e.g.,narrownetworks,centersofexcellence)throughplandesign

incentives

Global

32

Asia

36

Europe

31

LAC

58

MEA

52

38

Employersandvendorscanworktogethertoencourageplanmemberstomakecost-effectivedecisions,usingtechniquessuchasincentives,navigation,oradvocacy.Thismayresultinmoretargetedcareandbettercost

management,andensurethatpeoplegetthebest

qualitysupportfortheirneeds.ThisisrarelydoneinEuropeandAsiainparticular,sothereissignificant

Steeringmemberstoqualitycare

(e.g.,narrownetworks,centersofexcellence),throughanavigationoradvocacyservice

Global

28

22

Asia

34

29

Europe

21

LAC

56

31

MEA

48

31

opportunitytobetterusethesestrategiestoinfluencememberbehaviorintheseregions.

Educatingplanmemberstobesmarterhealthcareconsumersisfundamental,butonly46%ofinsurersgloballycurrentlyincludethisbydefaultintheir

standardplans.

Steeringmembers

awayfromunproven

orunnecessarytreatments

ortechnologies

Global

49

21

Asia

Europe

49

22

LAC

60

MEA

59

28

Typicallyincluded

Nottypicallyincludedbutavailableuponrequest

Educationtomakeplanmembers

smarterconsumersofhealthcare

Global

33

Asia

43

Europe

32

LAC

31

MEA

76

Nottypicallyincludedandnotavailableuponrequest

Notsure

LatinAmericaand

theCaribbean(LAC).MiddleEastand

Africa(MEA).

24

40

16

12

26

26

12

41

16

12

7

11

37

37

12

27

10

32

29

18

94

1010

15

15

40

27

18

14

15

15

7

18

16

77

46

1010

44

58

38

1515

42

189

213

Figure9:Steeringmemberstoeffectivesolutions(%ofinsurers)

Tieredcoinsurance/copays(claimssharing)for

preferredvs.non-preferredtreatmentsorproviders

Global

24

Asia

44

Europe

2237

15

LAC

49

33

11

MEA

38

21

Tieredcoinsurance/copays(claimssharing)to

incentivizevirtual-firstcare

Global

31

Asia

40

34

Europe

29

29

LAC

36

29

MEA

48

24

Healthtrends2025:

Adaptingplanstooptimizevalue

19

Atieredapproachtocoinsuranceandcopayscanhelpensuremembersmaximizetheircoverageiftheyoptforpreferredtreatments,providers,orvirtual-firstcare.Thiscanalsohelptomanageplancostsandstreamlineprovidersovertime.

Figure10:Coinsurancestructures(%ofinsurers)

32

34

10

26

22

8

26

7

34

7

22

33

14

10

16

24

18

29

7

21

7

Nottypicallyincludedbutavailableuponrequest

Typicallyincluded

Notsure

Nottypicallyincludedandnotavailableuponrequest

LatinAmericaand

theCaribbean(LAC).MiddleEastand

Africa(MEA).

Healthtrends2025:Adaptingplanstooptimizevalue20

Spotlightonvirtualcare

Virtualcare—thediagnosis,treatmentand/or

monitoringofhealthconditionsthroughdigitalchannels—isevolvingfast.Accordingtoour

HealthonDemand

research,45%ofemployeesratetelemedicineashelpfulforthemselvesandtheirfamilies;85%ofinsurersoffertelemedicineoptions.

Incentivizingplanmemberstoaccessvirtual-firstcare

istypicallyincludedinaround22%ofplansgloballyandavailableonrequestinanadditional33%.Thiscould

includesuchthingsasarequirementorincentivethroughcoinsuranceorcopaystousetelemedicineaheadofanin-personvisit.It’simportantthatvirtualcareusedinthese

arrangementsistrulyeffectiveanddoesnotleadtooutcomeslikerepetitionofcareorinappropriatere