Workplace
benefits trends
EXECUTIVE SUMMARY
2023-2024

TABLE OF CONTENTS

Section 1: The state of workplace benefits and enrollment
6

Steadily rising costs of benefits and claims are driving changes in how
businesses select a provider and deliver benefits to their employees.

10

As employers struggle with rising health care costs, supplemental
insurance remains a core component of a comprehensive benefits
package for employers and employees alike.

14

Similar to 2022 findings, there are significant gaps in how employers
and employees perceive the value of benefits packages.

15

These gaps extend to benefits enrollment, with employers not offering
the seamless digital experience that employees desire.

17

In addition to struggling with understanding what employees want fromtheir benefits plans, organizations are finding it increasingly difficult tofind the time they need to manage these programs.

Section 2: Employee well-being and mental health20

Employee confidence in how much their organizations care for them iswaning and impacting not just mental health, but also job satisfaction.

21

Burnout and workplace stress remain top concerns in 2023, again
disproportionately affecting both women and younger workers.

24

Fortunately, when it comes to mental health, most employees still feelthey have someone they can turn to – often their own managers.

Section 3: Employee financial preparedness
28

Employees continue to experience a high degree of financial fragility,
which causes anxiety about potential future medical events.

30

Inflation continues to significantly impact employees and their financial
situations, forcing them to make difficult choices about their health
care.

33

Employees do not fully understand their policies or their health carecosts, which makes it difficult for them to prepare for an adverse
medical event.

Section 4: The role of AI in benefits administration
38

2

There may be a place for artificial intelligence (AI) in benefits enrollment
and administration, but it will take more work to bring employees onboard than it will their benefits administrators.

WORKPLACE BENEFITS TRENDS

WorkForces Report

The Aflac WorkForces Report is a long-standing resource for tracking
American workers' and employers' health care needs and experiences
as well as benefits administration. The 13th annual report clearly showsthat businesses across various industries face many challenges inproviding benefits to their employees. The continuous rise in benefits
and claims costs has prompted sweeping organizational changes,
driven by ongoing concerns about inflation.
Employers cautiously navigate the balance between cost containment
and maintaining employee satisfaction. More than half (53%) of
employees surveyed in 2023 report they’re at least somewhat likely
to accept a job offer that included slightly lower compensation but amore robust benefits package. Consequently, employers are feeling thepressure to remain steadfast in offering competitive employee benefits
to avoid a talent exodus.
Mental health care remains a top concern with stress and burnout
affecting employees' overall well-being and productivity. Employers
have an opportunity to address these challenges by offering robust
mental health resources, flexible work schedules, personalized support,
and enhancing job satisfaction and retention in today's competitive
work environment.
Financial fragility among employees continues to contribute to highanxiety about potential medical events, further exacerbated byinflation's impact on their financial situations. Younger generations
are particularly vulnerable to the devastating costs of an unexpected
medical event, underscoring the need for supplemental insurance as acore component of comprehensive benefits packages.
The Aflac WorkForces Report highlights the important role benefits
programs play in employees’ well-being and satisfaction. Employers
should work toward understanding their employees' needs, offering
comprehensive support of mental health and financial well-being
and leveraging innovative technology to shape a more resilient andemployee-centric future. By doing so, organizations can help attract
and retain top talent and foster a workplace that prioritizes the wellbeing of its workforce.

2023-2024 AFLAC WORKFORCES REPORT

3

Section 1
The state ofworkplace benefits
and enrollment

Steadily rising costs of benefits and claims are driving changes in how businesses
select a provider and deliver benefits to their employees.
This year, organizations of all sizes across various industries encountered both familiar and unfamiliar challenges
when it comes to giving their employees access to health care benefits. During a period of higher than normal
inflation, historically low unemployment, rising health care costs and increasing voluntary employee turnover,organizations are struggling to meet their employees’ benefits needs while remaining competitive and staying withinbudget. These challenges are limiting employers’ ability to invest in key growth areas and have driven many to makesweeping organizational changes that push some expenses to employees, such as increasing employee deductibles
and increasing employee share of health insurance premiums.
But, these operational changes are not without risk — more than half of the employees surveyed in 2023 reportthey’re at least somewhat likely to accept a new job with a lower salary but more generous benefits offerings. As
employers are faced with making these tough decisions, supplemental insurance remains a core component of acomprehensive benefits package to help attract and retain employees. Supplemental insurance plans help protect
employees in the event of an unforeseen medical diagnosis and provide them with the added financial security they
may need to help cover any gaps in health care coverage that have come from organizations’ operational changes.
6

W O R K P L A C E B E N E F I T S T R E N D S : SECTION 1

Regardless of company size, employers say the biggest challenge they face in 2023 is offering
a competitive benefits package.
Question: When it comes to employee engagement and satisfaction, what are your organization’s biggest challenges?
Offering competitive totalcompensation package

45 %
42 %

Training and development
Implementing technology
solutions to improve productivity

37 %Offering optimal flexible
working arrangements

37 %Mental health andwellness concerns

34

Improving company culture

33 %Creating a diverse andinclusive workforce

33 %

%

Percent struggling with offering
competitive compensation:
42%of employers with
under 100 employees

49%

of employers with
100 to 499 employees

45%

of employers with
500 or more employees

Benefits and claims costs continue
to rise with well over half of all
employers saying they increased atleast moderately.

The impact of delayed medical care, risingprescription drug costs and mental health issues
remain the top culprits of increased benefits costs
for employers.

Question: When it comes to employee engagement
and satisfaction, what are your organization’s biggest
challenges?

Question: You mentioned that your organization’s benefits costs or claims
increased in the last year. Which, if any, of the following best describes why?

25%

50%
22%

21%

= Increased
a lot

40%

= Increased
moderately

34%

2%

3%

Benefits costs

Benefits claims= Stayed thesame= Decreased

60
50
40
30

53 %

47 %
46 %
38 %

31%

20
3%

10

75% of employers in 2023 saybenefits costs have increased at least
moderately, and 61% say the same
about their benefits claims.

0
RisingIncreased An increase Increased
Increasedin chronic substance
medical care prescription mental
healthdiseaseabuseor treatment drug prices
issues/ prevalence or
as it wasincidents
incidents
postponed
previously

Other2023-2024 AFLAC WORKFORCES REPORT

7

Most employers had to make operational changes as a result of the rising costof health care and are opting to shift expenses onto their employees rather
than reduce the benefits they offer — but these decisions could have negative
downstream implications.
While employers are deploying a variety of tactics to cope with the rising costs of health care, increasing employee
deductibles and the amount they contribute to premiums and copays are the most popular. Nearly half of all
employers who are experiencing increased benefits costs indicate they increased the amount of their employee
deductibles or increased the share they required employees to pay in order to offset the rising cost of health care.
Yet, more than half (53%) of employees say they would likely accept a job offer with slightly lower compensation
but a more robust benefits package. This is a strenuous time for organizations that saw unprecedented voluntary
turnover rates in 2022. As employers strike a balance of managing costs while offering competitive benefits
packages, increasing the burden of health care benefits costs on the employee is a risky move as they are likely toseek a job with a better benefits.
46%

45%

Employer question: Have you done anyof the following to control rising health carecosts that you otherwise would NOT havedone if benefits costs remained the same or
decreased?

33%

33%
27%
18%
5%

Increased
employee
deductibles

Increased
employeeshare ofpremium

Increased
employeecopaysReduced
Reduced
Reducednumber ofvalue or
employerhealth plan quality of contribution
options
health plan to benefits
options
options15%

Stopped We haveoffering not madebenefits any of thesechanges
to control
rising healthcare costs

Employee question: How likely would you be to accept a job
offer that included a slightly lower compensation but a morerobust benefits package?

53%
of all employees would be at least
somewhat likely to accept a position
with lower pay but better benefits.
8

W O R K P L A C E B E N E F I T S T R E N D S : SECTION 1

It is unsurprising that cost is among the most important considerations for
employers when choosing a benefits provider.
Employers are nervous about the cost of health care because claims are on the rise and employees may leave if
benefits are reduced. However, brand reputation also is a significant driver in their decision-making process, with
21% ranking it above cost for why they choose a provider.
Question: Rank the following attributes by importance when choosing your organization’s benefits provider(s)/vendor(s).

% ranked
top 3

Brand reputation

21%

Cost

20 %

Longevity

17 %Financial strength

19 %Claims payment reputation

5%

Product ratings

7%

Verified customer reviews

4%

Environmental sustainability

1% 4%

10 %

15 %

Ease of filing claims

1% 4%

5%

11 %

Corporate social responsibility

1% 3 %

Innovative products for myemployees

2%

14%
16 %
14%

11%

46 %
38 %

9%

36 %

16 %

34 %
10 %

16 %
7%

2%

46 %

7%
8%

13 %

11%

33 %

12 %

24 %

7%

11 %

3%

7%

0

= Ranked first10

20= Ranked second= Ranked third

30

40

50

And, interestingly, employers are placing far more emphasis on the importance ofa benefits provider’s reputation in 2023 than they ever have before.
Cost, while still near the top of the list, has been declining in importance since 2021, during the height of the
COVID-19 pandemic. Rising in importance are elements associated with a provider’s renown, such as brandreputation, longevity and claims payment reputation.
Question: Rank the following attributes by importance when choosing your organization’s benefits provider(s)/vendor(s). (% Ranking Top 3;
Only the top 5 attributes are shown)
55 %BC
44 %40%

46 % B

49 %

46 %
34
28

Brand reputation

Cost

%A

38 %AB

44 %C
36 %

%

Longevity

2021 (A)

41 %C

2022 (B)Financial strength

30 %

29 %

34 %B

Claims payment
reputation

2023 (C)2023-2024 AFLAC WORKFORCES REPORT

960

2 in 5 American workers view supplemental
benefits as a core component of acomprehensive benefits program.

50

80% of employers who offer supplemental
insurance believe these benefits help withrecruitment, and 82% say they help withretention.

40

9 in 10 employees believe the need forsupplemental insurance is increasing.

30

Yet only 2 in 5 (39%) employers indicate thatthey offer supplemental insurance options totheir employees.

20

The overwhelming majority (87%) of enrolled
employees say they would recommend that afriend or family member enroll in supplemental
benefits and that their supplemental benefits
help their financial security (88%).

10

Supplemental insurance offers an added layer of financial
protection, helping to support employees in covering
not only out-of-pocket (OOP) health care expenses
not covered by major medical plans, but also everyday
expenses linked to their health care needs.

Dental, life and vision insurance
are the most elected supplemental
benefits.
Question: Which of the following voluntary benefits are youenrolled in through your employer?

0

As employers struggle with rising
health care costs, supplemental
insurance remains a core component of
a comprehensive benefits package for
employers and employees alike.

Dentalinsurance

59 %Life insurance

58 %Visioninsurance

54%

Short-term
disability insurance

35 %Long-term disability
insurance

34%

Accident
insurance

34%

Hospital
insurance

30 %Critical illness
insurance

20 %
11%

Pet insurance
Cancerinsurance
Other specified
disease (e.g.,
heart attack,stroke insurance)

10 %
6%

Two thirds of all employees enrolled insupplemental insurance have used it in the pastyear.
Note: This question was asked of those who
indicated they have access to supplemental“Supplemental insurance helped withmaking sure we are taken care of financiallywhile making sure we’re healthy.”- Male employee, 23, North Carolina

benefits at work. With more than 3 in 5(60%) employees stating they have accessto supplemental benefits through theiremployers, this translates to 37% of all
surveyed employees enrolling in supplemental
dental, 36% enrolling in supplemental life and
33% enrolling in supplemental vision.

1 0 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 1

Employers can further enhance the overall compensation packages they offer
by incorporating differentiated and nontraditional perks and benefits.
Employees are interested in a myriad of nontraditional perks. Given the impact of inflation on employees’ overall
financial stress and financial stability, it is not surprising that 2 in 5 (40%) are interested in having access to afinancial wellness program. Other key areas of interest for employees where employers may be missing the mark
today are access to personal wellness programs with gym discounts, identity fraud protection, access to financial
and legal resources through their employers and access to Medical Bill Saver negotiations.

2023-2024 AFLAC WORKFORCES REPORT 1 1

Hispanic employees are especially interested in nontraditional perks.
Some key differences emerge in Hispanic and non-Hispanic workers’ preferences, giving organizations the chance
to better meet the needs of a growing Latinx population. Specifically, Hispanic workers are more interested thantheir non-Hispanic counterparts in telehealth (43% vs. 37%), health advocacy (36% vs. 28%), student loan repayment
administration (23% vs. 17%) and college prep assistance (14% vs. 7%). Access to telehealth through healthinsurance plans is far more important to Hispanic workers (56%) than non-Hispanic workers (41%). Use of telehealthalso is higher among Hispanic workers (68% have used telehealth vs. 61%); therefore, it is not surprising that thisgroup expresses greater interest in telehealth as an additional benefit.

Employer question: Which of the following does your organization offer to your employees?
39 %

40 %

36 %

38 %

38 %
33

38 %

%

25 %

30 %

35 %

34 %
25

34 %

32 %

35 %

30 %

%

26 %

21%

19 % 18 %18 %8%Financialwellness

Employer

Virtualtelehealthincludingbehavioral
healthPersonal
wellness
with gym
discounts

Identity
fraud
protection

Financialand legal
resources

Employee

1 2 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 1

Medical bill
saver

HealthAccident
advocacy
death and(e.g. service
dismemberment to help youwith travel
express
your wishes,
assistanceconcerns
and needs
to your
health careproviders)

TelephonicemployeeassistanceprogramStudent loan
repayment
administration

College
prep
assistanceSupplemental benefits that directly address employees’ anxieties about the future also arecompelling.
More than half of all employees express a high degree of interest in purchasing supplemental health insurance thatcovers serious illnesses or conditions — such as cancer, heart attack or stroke — if they have family history. This
interest is higher among younger generations than baby boomers and significantly higher among Hispanic workers(62%), compared to their non-Hispanic counterparts (50%).

More than half of all employees are interested in supplemental policies for specific diseases orconditions with a hereditary component.

52%

Question: If offered by your employer, howlikely would you be to purchase insurance toof all employees would be "very" or "extremely" likely
to purchase supplemental insurance to cover a disease
that runs in their families.

Gen Z

55%

help cover costs associated with a serious
illness that you know is in your family healthhistory (such as cancer, heart attack or
stroke)?

Millennial

60%

Gen X

Baby boomers

50%

36%

2023-2024 AFLAC WORKFORCES REPORT 1 3

There are significant gaps in how employers and employees perceive the value of benefits
packages.
Although employers who make sweeping changes to their benefits program are at risk of losing employees due
to voluntary turnover, many state that they simply don’t always know what employees want from their benefits
packages. Additionally, the report finds that employers may be overly confident in their employees’ satisfaction with
their current benefits packages; however, there is a 19 percentage point gap between employers' perceptions of
employee satisfaction with their benefits and actual lived experiences, which has widened since 2021. With manyorganizations planning to make changes to their benefits contributions, it is critical for organizations to help close
this gap and gain a clear picture of their employees’ benefits needs and expectations.

More than half (60%) of all employers say that one of their biggest challenges in benefits
administration is understanding what their employees are looking for.

Employer question: Of the following challenges, which are the top challenges your organization faces when offering benefits?

% ranked
top 3
Better understanding what employees
want when it comes to benefits offerings

31%

Offering robust benefits while staying
within budget/cost constraints

33 %Managing benefits administration andworkforce regulation compliance

9%Understanding the options I haveto control benefits costs

15%

Finding time to dedicate to benefits
selection and administration

5%

14%

Communicating and educating
employees about benefits

4%

8%

21%

33 %

Determining the benefits thatwill meet our employees' needs

4%

7%

10 %

22 %

20 %

11%

23 %

17 %

= Ranked first

1 4 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 1

13 %

60 %

56 %

16 %

48 %

12 %

44 %

17 %

= Ranked second

10 %

36 %

= Ranked third

This lack of understandingis evidenced by employers’
overly positive view of theiremployees’ satisfaction with
their benefits.
Greater alignment between
employers and employees withregard to benefits experiences will
make it easier for employers to riseto the occasion to meet employees’
growing needs during a time ofrising health care costs, inflation andincreased health care complexity.

Employer question: How satisfied do
you think your employees are with theoverall benefits package your organization
offers them at this time?

78% of employers believe
their employees are highly
satisfied with their benefits,compared to only 59% of
employees who express highsatisfaction.

Employee question: How satisfied are
you with the overall benefits package
offered to you at this time?

50%

43%

34%

27%
16%

17%
1%

2%

Not at all satisfied

4%

5

%

Not very satisfied

Somewhat satisfied

Employer

Very satisfied

Extremely satisfied

Employee

And these gaps extend to benefits enrollment with employers not offering the seamless digital
experience that employees desire.
Remote and hybrid work remain the norm, with most employers offering at least a partially remote work structure,making a seamless digital experience for benefits enrollment and management increasingly important.

Remote work continues to be very common, even in a post-pandemic world. Three-quarters of
all employers have at least a partially remote office structure with nearly a third foregoing the
traditional office altogether.

Question: Which of the following best describes
your organization’s working arrangement overthe last 12 months?

Fully in-person
workforce

Full remote
workforce

25%

30%

75%

of all employers have atleast a partially remote
office structure.

Partially remote or
hybrid workforce

45%2023-2024 AFLAC WORKFORCES REPORT 1 5

Most employers recognize the importance of having a benefits provider that excels in digital technology, and asimilar proportion of employees value the convenience of managing their benefits online. Although many employees
prefer digital enrollment for benefits, it is noteworthy that more than one-third of employers do not support online
enrollment.
8 in 10 employers state that it is very important for their benefits provider to innovate by leading indigital technology.

Just as many (82%) employees stress the importance of being able to manage benefits online.

Yet, 45% of employers do not offer the ability to enroll in benefits online.

Pro tip: Prioritize ease of use. Employers have an opportunity to provide their employees withthe benefits they need and partner with providers that can engage them with technology theyuse in their everyday lives. Having open conversations with employees about their experiencesinteracting with different health care providers and products in the digital landscape can help
provide insight into technology and capabilities that are popular and help narrow their search forproviders who check that box.

1 6 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 1

In addition to struggling with understanding what employees want from their benefits
programs, organizations are finding it increasingly difficult to find the time they need to
manage these programs.
Since 2021, the percentage of respondents who ranked finding time to dedicate to benefits selection andadministration among their top three challenges has jumped by 12 percentage points. This could be, in part, due tooperational changes organizations made over the last year to cut costs as inflation rose and a recession loomed.
With fewer resources dedicated to the selection and administration of benefits, it has been difficult for employers togain a deep understanding of the programs they offer their employees and how those programs might be improved.
Question: Of the following challenges, which are the top challenges your organization faces when offering benefits?
54

59 %A 60 %A
%

59 %B
53 %

56 %

51%A

48 %A
44 %AB

41%
32

%

35 %

42 %C 41%C

36 %%
34 % 35 33 %37 %BC
26 %C

Betterunderstanding
what employees
want whenit comes tobenefits offerings

Offering robust
benefits whilestaying withinbudget/cost
constraints

Managing benefits
administration
and workforce
regulation
compliance

Finding time
to dedicate
to benefits
selection andadministration

2021 (A)2022 (B)

Understanding
the options I
have to control
benefits costs

Communicatingand education
employees about
benefits

22 %Determining
the benefits
that will meet
our employees'
needs

2023 (C)Pro tip: Listen to the experts. It’s understandable that HR departments that have been
whittled down in the last year as part of belt-tightening initiatives might feel overwhelmed byhaving to manage the same benefits programs they did a year ago with fewer resources andless support. Aflac can help provide guidance and insights gleaned from its more than 60 years
in the field to help them understand the changing health care landscape and which options areavailable to them now.

2023-2024 AFLAC WORKFORCES REPORT 1 7

Section 2
Employeewellbeing andmental healthEmployee confidence in how much their organizations care for them is waning
and impacting not just mental health, but also job satisfaction.
In 2021, nearly 60% of employees surveyed said they believed their employers cared about their well-being at least
somewhat. One year later, that number had dropped to 56%, and this year, it plunged another eight points to 48%.
What’s driving this dramatic shift in the way workers perceive how much their employers care about them? And how
can employers regain lost ground?
Certainly, some of this discontent can be attributed to stress and shifting work conditions caused by COVID-19,
rising inflation and the wave of layoffs that rippled through tech and other sectors last year. As inflation cools and the
pandemic continues to ease, employers should look to providers for ways to reestablish the trust their employees
have lost and increase their job satisfaction.
About half (48%) of all employees are
confident their employers care about them.
Question: How much do you believe your employer cares about
your overall mental health?*of all employees

48%

And this belief is associated with job
satisfaction. More than 4 in 5 (84%) of those
who believe their employers care about them
report high job satisfaction, compared tojust a third (32%) of those who don't thinktheir employers care.
Question: Overall, how satisfied are you with your job?*

are confident that
their employers
care about theirmental health.

Does not believe
employer cares
Believes employer
cares somewhat
Believes employer cares*Figures represent the highest two responses selected.
2 0 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 2

32%
53%
84%

Further, it’s causing them to look for a new job.
Employees feel it is vital that their employers care about their well-being, and many are willing to act. Of
employees who say they believed their employers didn’t care about their well-being, 60% are at least somewhat
likely to look for a new job in the next 12 months. Again, employers need a way to regain trust in 2023.
Question: How much do you believe your employer cares about your overall mental health? Overall, how satisfied are you with your job?
And it’s critical for employers to address burnout among their employees before the employees start to And it’s
37 %

34 %
29 %

23 %
18 %

26 % 26 %

19 %

21 %
13 %

Not at all likely

Not very likely

Does not believe employer cares

13 %Somewhat likely

13 %

10 %

7%

Very likely

Employer cares somewhat

11 %Extremely likely

Believes employer cares

Burnout and workplace stress remain top concerns in 2023, again
disproportionately affecting both women and younger workers.
Consistent with 2022 levels, more than half (57%) of all American workers state that they are currently
experiencing at least moderate levels of burnout. Further, we see high levels of workplace stress among
employees, with three-quarters reporting at least a moderate level of stress. Heavy workload is the primary
culprit for workplace stress, though there are other contributing factors.
How employees experience burnout varies widely depending on demographics, especially age. Gen Z andmillennials are more than twice as likely as baby boomers to experience high or moderate burnout. Women are
vulnerable, too, with 75% reporting burnout at work as opposed to 58% of men. Providers have an opportunity
here to help employers identify vulnerable populations and provide them with tools and resources to better
cope with stress to stay well ahead of burnout.
Question: How would you rate your current level of burnout?

Very highHigh
Moderate

7%

57% compared to
52% in 2021

15%
35%

Question: How would you quantify the amount of workplacestress you experience?
Very highHigh
Moderate

Low

27%

Low

Very low27%

Very low

12 %
21 %
41

74%

%

19 %
7%

Well over half, 57%, of all American workers
are experiencing at least moderate levels ofburnout. This remains significantly higher
than what was seen in 2021.

Total employees

We also see high levels of workplace stress, but ameaningful proportion of employees appear to beable to cope with stress without getting burned out.
2023-2024 AFLAC WORKFORCES REPORT 2 1

And it's critical for employers to address burnout among their employees before the employees start to experienceother more severe symptoms. This year, the percentage of employees who report having trouble sleeping jumped 6
percentage points from last year. On top of that, employees who experience burnout were more likely to experienceanxiety and depression while dealing with sleep issues. Employers have an opportunity to intervene with proactive
care up front that will help employees mitigate these issues before they worsen.

The overwhelming majority (89%) of employees who report high levels of burnout havealso suffered other mental health challenges over the past year — most commonly anxiety,depression and trouble sleeping.
60%
51%
47%

24%

Anxiety

50%
42%

41%
32%

26%

Troublesleeping

Low/no burnout

Question: Have you
experienced any of thefollowing in the past 12
months?

28% 29%15%

15%

Depression

Weight gain

Moderate burnout

23%

12%

11%

Posttraumaticstress

None

%
5% 8

High burnout*Only displaying options thatwere selected by at least
5% of respondents.

Pro tip: Help ease employee stress with the option of supplemental insurance. In scenarios
where providing a salary increase might not be feasible, offering supplemental insurance may be agood solution. Supplemental insurance offers employees added reassurance, helping to give themfinancial security in the event of an unforeseen medical event. Further, given that many plans are
employee-funded, this approach can help employers effectively manage their expenses. For instance,
56% of American workers were negatively impacted by high medical bill costs with reasons including
missed credit card payments, affected credit scores, and missed rent or mortgage payments, among
others. These were key contributors to their financial stress and mental distress.
2 2 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 2

Not addressing burnout also may have downstream implications on an organization’s workforce — namely
diminished job satisfaction and work-life balance among those suffering from burnout, as well as a higher likelihoodof looking for a new job over the next year.

Job satisfaction*

Likelihood to look for a new job*

77%
56%

48%

44%
23

%

12%

Low/no burnout

Moderate burnout

High burnout

Low/no burnout"I believe my employer cares about my overall mental health."

Moderate burnout

High burnout

Work-life balance*
84%

64%

61%

34

Low/no burnout

Moderate burnout

48%

38%

%

High burnout

Low/no burnout

Moderate burnout

High burnout*Figures represent the highest two responses selected.

Burnout is, unsurprisingly, associated with lower job satisfaction and loyalty,

as well as one’s impressions of work-life balance and how much an employer
cares about their well-being.

2023-2024 AFLAC WORKFORCES REPORT 2 3

Fortunately, when it comes to mental health, mostemployees still feel they have someone they canturn to — often their own managers.
It would seem to contradict the fact that many employees
don’t believe their organizations care about their well-being
while they also feel confident they have someone in theorganization to talk to about their own mental health struggles
and even ask for PTO. One explanation for this could bethat while they view their organization overall as not caring
enough about their well-being, there are individuals within theorganization — namely, their supervisors — whom they trust
and are willing to confide in.
Of note, while employees across all generations would
feel comfortable talking to a manager about mental healthstruggles in the workplace, it is the younger generations who
are willing to turn to their peers for support. While nearly halfof all Gen Z (46%) and 40% of millennial employees trust theircolleagues with this information, far fewer Gen X (28%) or
baby boomer (17%) employees feel comfortable discussing
such matters with their peers.

Managers

48%

Colleagues/work
friends at mysame level

Seniorleadership23%

HR
representatives

21%

Other

Question: Who, if anyone, in your workplace do you feel comfortableasking for help or time off should you need it as it relates to your mental
health? / To what extent would you say your organization’s employees feel
comfortable asking for help or time off should they need it as it relates totheir mental health in the workplace?

Pro tip: Empower individuals, notinstitutions. When it comes to something as
personal as mental health, how employees
deal with it and who they confide in can varyfrom person to person. Rather than fighting
this by prescribing rigid programs that require
everyone at work to deal with something that's
very subjective, organizations should empowersupervisors to take the lead in conversations
about mental health and give employees theresources they need to choose their own path.

33%

1%

I don't feel
comfortableasking for help
in the workplaceabout my mental
health22%76%

of all employers are confident
that their employees are veryor extremely comfortableasking for support or time off
to address mental health.

2 4 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 2

Outside of increasing pay, employers have many options for helping
to improve employee stress and burnout. Of the options presented,
1 in 3 (33%) employees surveyed ranked increased time off as theirfirst choice for addressing burnout. Options to work from homeand self-care programs also top employees’ lists for practical ways
employers can offset the extra strain.

To address burnout and prevent their mental healthfrom further deteriorating, employees want moretime off.
Question: Which of the following would be most useful with helping you deal withburnout or personal mental health concerns?
% ranked top 3

66 %

52 %

48 %

48 %

38 %

22 %

15 %

12 %

9%

25 %
16 %
21 %

10 %

11 %
18

%

14 %

33 %
17 %

27 %

16 %
14 %

17

%

9%
7%

10 %

8%

5%
3%

Increasetime off

Self-careprograms

Offer
options
to workfromhome

Mentalhealthcare= Ranked first

Employeeassistanceprogram= Ranked second

Familysupportservices

4%

3%

1%

1%

TelehealthvisitsWearabletechnology
to help
monitorhealth= Ranked third2023-2024 AFLAC WORKFORCES REPORT 2 5

Section 3
Employee financial
instability

Employees continue to experience a high degree of financial fragility, which causes anxiety
about potential future medical events.
The report found several bright spots related to individuals’ financial security. More employees have additional cashon hand to cover a medical emergency and many are finding comfort in what their insurance plans cover. Still, thestate of financial wellness among Americans remains fragile. The survey finds that just half (51%) have the resources
to pull from savings for a medical bill. This is slightly up from last year (45%) but still concerning because 50%
couldn’t afford more than $1,000 in OOP costs, while the average deductible for a single person in an employer
health plan is $2,004, according to the Kaiser Family Foundation. Employees are understandably nervous about
inflation and the economy and afraid of the financial impact of an unexpected medical diagnosis. Americans
are increasingly turning to crowdfunding sites like GoFundMe to support not just their medical bills, but also thesecondary day-to-day costs related to being sick and needing to take time off work. In fact, GoFundMe hosts morethan 250,000 medical fundraisers each year, with health care-related fundraising as one of its largest categories.

Half (51%) of all employees saythey would pull from a checking
or savings account to coverunexpected medical bills — morethan would have been able to do soin 2022 (45%).

51%

Question: How would you pay for high out-of-pocket
expenses associated with an unexpected serious
illness or accident?

Half (50%) of all employees would
not be able to pay more than
$1,000 in out-of-pocket costs for an
unexpected medical event; over aquarter (27%) cannot afford a $500
expense.
Question: How much would you be able to pay forout-of-pocket expenses if an unexpected serious
illness or accident occurred today?

2 8 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 3

Less than $500

Between $500 and $999

would be able topull from checking
or savings for an
unexpected cost.

27%

23%

Between $1,000 and $4,999

26%$5,000 or more

24%

Financial instability disproportionately impacts Hispanic workers.
Hispanic workers are more financially fragile than their non-Hispanic counterparts. Nearly two-thirds (66%) of all
Hispanic workers could not go more than a month without a paycheck (compared to 51% of non-Hispanic workers).
More than half (57%) could not afford $1,000 in unexpected OOP health care-related costs, compared to 49% of
non-Hispanic workers. When faced with an unexpected medical expense, Hispanic workers also would be more
likely to have to rely on family or friends (29% vs. 24%) or seek a second job for supplemental income (26% vs. 18%).
They are less likely than their non-Hispanic counterparts to be able to pull from a checking or savings account tocover these expenses (43% vs. 53%).

Half of all American workers have high anxiety about health care costs beyond what theirinsurance covers — though this is a decline compared to 2022 levels (57%).
Question: How much anxiety do you feel about health care costs beyond what is covered by your health insurance?
of employees who

50 % have high anxiety.
33 %
26 %

11 %

Very low

17 %

13 %

Low

ModerateHigh

Very high2023-2024 AFLAC WORKFORCES REPORT 2 9Younger generations are particularly hard hit by these anxieties, as they are less financially secure than their older
counterparts.

Gen Z, who have not yet had the timeor salary increases to build theirsavings, are the most financially fragile— nearly three-quarters (72%) cannot
afford to pay $1,000 in out-of-pocket
health care expenses.

This rise in financial instability
contributes to increased anxiety
among these groups.

Question: How much would you be able to pay for outof-pocket expenses if an unexpected serious illness or
accident occurred today?

Question: How much anxiety do you feel about healthcare costs beyond what is covered by your healthinsurance?

Percent of Employees Who Cannot Afford
a $1,000 OOP Expense

Percent of Employees Experiencing
High Anxiety About Health Care Costs

72%

Gen Z

Millennials

51%

Millennials

Gen X

49%

Gen X

Baby boomers

33%

63%

Gen Z

Baby boomers

56%

47%

33%

Inflation continues to significantly impact employees and their financial situations,
forcing them to make difficult choices about their health care.
Although the annual inflation rate in the U.S. slowed to 3% in June 2023, the 9.1% inflation rate in the year prior
has had a measurable impact on employees' financial well-being. As inflation continues to cool and consumer
confidence continues to grow over the coming months, it will be important for organizations to understand theimpact the economy is having on employees’ state of mind and confidence in handling future medical expenses.

3 0 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 3

In fact, more employees in 2023
state that inflation has negatively
impacted them compared to 2022
— and more than a quarter (28%)
have been burdened with highhealth care costs.
Question: What, if anything, affected your finances
negatively in the past 12 months?

67%

Inflation

High healthcare costs

28%

Medical costs notcovered by major
medical insurance

21%

Changes to my
employment (e.g.,layoff, salary
reduction, reduction
in hours)

Other

18%

2%

2023-2024 AFLAC WORKFORCES REPORT 3 1

Nearly a third of all American workers had to make a difficult health care decisionin the past year — whether being able to afford a treatment or prescription, or
choosing between paying medical and other bills..
Question: In the past 12 months, have you experienced any of the following due to rising costs (groceries, gasoline, etc.)?

49 %employees had to make a difficult health care
30% ofdecision
due to the rising cost of consumer goods.

31 %

21 %

Had to delay goingon vacation

Had to delay
house repair(s)17 %Had to choose
between healthcare of paying
a bill

3 2 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 3

14 %

14 %

Had difficulty
affording aprescription

Had difficulty
affordinghealth carerecommended to
you by a doctor or
specialist

None of the above

And employees do not fully understand their policies or their health care costs,
which makes it extremely difficult for them to prepare for an adverse medical
event.
A disconnect is emerging between how well employers believe their employees understand medical costs and how
well they do. Nearly 4 out of 5 (79%) employers think their employees understand the total annual costs of theirhealth care “well.” When asked the same question, only 48% of employees agree. This disconnect presents anopportunity for providers equipped with the right solutions and capabilities to help employees better understand thecosts of care and how to prepare for the unexpected.

Employers think their employees understand health care costs better than they do.

79% of employers think
employees understand costs well.

Employer Question: Thinking about health care-related expenses,
how well do you think your employees understand their total annual
costs for health care?

48% of employees say they
understand costs well.

Employee Question: Thinking about all of your health care-related
expenses for you and your family, how well do you understand yourtotal annual costs for health care.
Employer

49 %
39 %

Employee

34 %

30 %

17 %
11 %
1%

3%

Not at all well

13 %

4%
Not very wellSomewhat well

Very well

Extremely well2023-2024 AFLAC WORKFORCES REPORT 3 3

Since reaching a high in 2021, the percentage of employees who say they understood their annual health care costs
has dropped by 11 percentage points. What could be causing this trend? For one, with health care costs steadilyon the rise, employers are looking for new ways to offer their employees the same benefits but they now come at ahigher cost. This can result in complexities that employees can’t be expected to fully grasp without some education.
Providers have a clear opportunity to step into the role of educator and facilitator, helping employees better
understand their benefits and how supplemental insurance options work.

Employee understanding of medical care costs is getting worse, not better.
Question: Thinking about all your health care-related expenses for you and your family, how well do you understand your total annual costsfor health care?*

59 %ABCDFG

53 %ACG

51 %AC

52 %ACG
48 %

46 %A
42 %

2017 (A)2018 (B)2019 (C)2020 (D)2021 (E)*Figures represent the highest two responses selected.

3 4 W O R K P L A C E B E N E F I T S T R E N D S : SECTION 3

2022 (F)2023 (G)American workers are woefully underprepared to weather the storm in the event of a major medical diagnosis. Most
workers expect the out-of-pocket costs in the 12 months following a cancer diagnosis to remain under $2,000 andfew (24%) could support $5,000 in out-of-pocket costs. This difficult environment places providers in a position
to offer employers ways of easing employee fears about future bills and helping them stay healthy. Supplemental
insurance helps cover care in the event of certain diagnoses that regular plans typically don't.

Nearly three-quarters (72%) of all employees expect that the out-of-pocket costs in the 12months following a cancer diagnosis would be less than $2,000.

Less than $2,000

72%
5%$2,000 and $4,999$5,000 and $9,999

7%$10,000 and $14,999

6%$15,000 and $19,999

1%$20,000 and $24,999

2%$25,000 or more

Question: To the best of your knowledge,
how much do you expect the average
American with health insurance pays
out of pocket for medical care andprescription medications for the 12months following a cancer diagnosis?

7%

Many (41%) employees state that they would not know where to turn for support in the eventof a serious medical diagnosis.
Question: Do you know where to turn to for information and resources if you or a loved one were diagnosed with a serious illness suchas cancer?

41%

of employees would
not know where toturn for support.

Pro tip: Supplemental support should be morethan financial. Supplemental insurance serves as
an added safety net, lessening the financial strain ofa serious medical diagnosis by helping cover OOP
expenses and providing added peace of mind. But
beyond financial support, it also should offer invaluable
informational resources that aid patients and families inunderstanding and coping with the diagnosis. By helping
combine financial protection with empathetic guidance,
supplemental insurance can become a crucial tool innavigating the challenges of medical conditions, fosteringresilience and helping enable individuals to focus on theirhealth and well-being.

2023-2024 AFLAC WORKFORCES REPORT 3 5

Section 4
The role of
AI in benefits
administration

There is a place for Artificial Intelligence (AI) in benefits enrollment andadministration, but it will take more work to bring employees on board than it will
their benefits administrators.
Claims management and processing can be made more efficient using AI and machine learning. In fact, in 2022,
Aflac rolled out an AI-driven platform designed to streamline claims processing. This platform leverages both AI
and machine learning to automate routine claims processing, with the primary benefit being faster payments to
Aflac customers. With the advent of more advanced AI, it is important for employers and benefits administrators tounderstand the practical uses and concerns surrounding AI.
Generally speaking, employers are more engaged with AI than their employees, which makes it unsurprisingthat they see a role for AI in managing benefits. Employees, on the other hand, remain far less convinced that AI
will replace them entirely or even start to do some of the tasks associated with their jobs. They are also far lessconvinced of AI’s potential role in benefits enrollment or management.

Employers possess a stronger
understanding of AI, with 49%
saying they are very familiar with it,compared to only 32% of employees
saying the same.
Question: How familiar would you say you are withartificial intelligence?

And many (54%) employers use AI intheir roles at least on a weekly basis,
whereas employees, with different
roles, are less likely to do so.
Question: How frequently, if at all, do you personallyuse artificial intelligence (e.g., ChatGPT, Bard, Motion,etc.) as part of your job?
21%

Daily
9%

33%

Once a week
15%

32%
49%

Employers

Employees

Once ortwice amonth
Less often
than monthly
I don't use AI
in my job

Employers

3 8 WORKPLACE BENEFITS TRENDS: SECTION 4

19%
11%
11%
10%
17%
55%

Employees

Employers see value in AI for their employees withthree-quarters saying it will be important to become
comfortable with AI in the future to be competitive inthe workplace. Employees, on the other hand, are not

75 %It will be important tobecome comfortablewith AI to compete intoday’s marketplace56 %as positive on the future of AI in the workplace, with
only 56% (nearly 20 percentage points lower than theiremployers) agreeing that it will be important to leverage
AI to stay competitive. And under 2 in 5 (38%) employees

73 %AI can be used to
improve the customer
service experience

49 %believe they can improve their job performance byleveraging AI.

Employers are far more likely than are theiremployees to see a role for AI in the future
workplace.
Question: Using the scale below, please rate your level of agreementwith each of the following statements about artificial intelligence (AI).

56 %The growing use of AI
scares me

48 %

67 %

Artificial intelligence
will do more goodthan harm

41 %*Only asked among employers.
I will be able to use
AI to improve my job
performance

My organizationencourages me to use
AI where I can

My employees areworried/I am worried
about job functions
being replaced by AI

69 %

38 %

65 %

26 %

52 %

24 %

I expect that atleast some of myorganization's job
functions will be
replaced by AI*

Employers

55 %Employees

2023-2024 AFLAC WORKFORCES REPORT 3 9

Given the clear need for better understanding of employee benefits, it’s safe to say that providers will be looking
for AI-enhanced tools in the future to help with this task. Interestingly, given the lack of employee understandingof medical costs and benefits, employers say they see potential for AI to take on some of the burden of educating
employees. Nearly half (48%) say that the use of AI in benefits administration could help employees better
understand their policies. It’s important for organizations to introduce AI slowly, providing ample support andeducation for their employees who are less comfortable with these tools.

It is unsurprising that employers see a role for AI in benefits enrollment, management andadministration, where employees are far less likely to be on board.

48 %

47 %

45 %
38 %

37 %

38 %

36 %

45 %

33 %

31 %

31 %
11 %

Understanding mypolicyEmployers

Enrolling in
benefits

Filing a claim

Contacting
customer service
with a question or
problem with mybenefit

Getting
personalizedrecommendations
on what benefits
to chose

I would not be
comfortable
offering/working
with artificial
intelligence forany of these steps

Employees

Pro tip: If introduced appropriately, AI can significantly impact benefits administration for
employers and employees alike. Through intuitive chatbots and personalized recommendations,
AI can streamline the enrollment process, simplifying plan selection. AI-powered analytics canhelp employers optimize benefits offerings based on employee needs and preferences, enhancing
satisfaction and retention. Automated claims processing can ensure swift reimbursements, reducing
administrative burdens and benefiting employees through faster claims payments. Moreover, AI-driven
insights can empower employees to make informed decisions, improving overall well-being. With AI
as a strategic ally, benefits programs will become more efficient, tailored and user-friendly, fostering ahappier and healthier workforce.

4 0 WORKPLACE BENEFITS TRENDS: SECTION 4

2023-2024 AFLAC WORKFORCES REPORT 4 1

About the Study
The 2023-2024 Aflac WorkForces Report is the 13th
annual Aflac employee study examining benefits trends
and attitudes. Conducted by Kantar on behalf of Aflac,
the employer survey took place online between June 2
and June 25, 2023, and the employee survey took place
online between June 2 and June 27, 2023. Throughout thisreport, some percentages may not add up to 100% due
to rounding. The surveys captured responses from 1,201
employers and 2,000 employees across the United States.
For more information, visit aflac.com/awr.
Aflac and Kantar are members of the Insights Association
governed by The Insights Association Code of Standards
and Ethics for Marketing Research and Data Analytics.
Individual coverage is underwritten by Aflac. Group
coverage is underwritten by Continental American
Insurance Company (CAIC), a wholly owned subsidiary of
Aflac Incorporated. CAIC is not licensed to solicit businessin New York, Guam, Puerto Rico or the Virgin Islands. For
groups sitused in California, group coverage is underwritten
by Continental American Life Insurance Company. For
individual coverage in New York or coverage for groups
sitused in New York, coverage is underwritten by Aflac New
York.
The content within provides general information and does
not constitute legal, tax or accounting advice regarding any
specific situation. Aflac cannot anticipate all the facts thata particular employer will have to consider in their benefits
decision-making process.

WorkForces Report
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