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Trends for Open Enrollment 2022-2023: What Every Employer Needs to Know

Enrollment Trend Drivers 2023

Key drivers for open enrollment trends 2022-2023 include:

  • The COVID-19 Pandemic
  • Labor shortages
  • Popularity of hybrid and remote work
  • Focus on emotional well-being
  • Implementation of the No Surprises Act

Due to these forces health benefits have become one of the top three drivers of employee attraction and retention (WTW’s 2022 Global Benefits Attitudes Survey). At no other time in the last decade have employees placed more importance on health and retirement benefits.

Because of the new importance placed on employee health, open enrollment this fall 2023 will be a unique opportunity to share the value of benefit packages to help stem high turnover rates. Many employers are already aware of the importance of health plans to employee retention as two-thirds of employers plan to enhance health and benefits offerings in 2023 to improve attraction and retention or better meet employee needs (Mercer’s Survey on Health and Benefit Strategies for 2023). In addition, 85% of employers are prioritizing employee physical, financial, social and emotional wellbeing (WTW research 2022).

Supplemental Benefits Enrollment

46% of employees are willing to pay more out of their paycheck each month for a more comprehensive healthcare plan.

Karen Sturdivant, benefits director with LandrumHR, an HR services firm in Pensacola, Fla. explained how fear is the main driver for increased demand for supplemental benefits including hospital, accident, critical-illness and legal policies.

“Now more than ever, employees are looking to be protected in the event of illness and to protect their loved ones,” Sturdivant says.

As well, many employers are adding surprising new features to existing plans or offering new benefits that fall outside the scope of traditional healthcare but enhance protection.

Mental Healthcare

“Beyond health insurance, employees are looking for emotional support [and] resources to bolster their resilience and financial protection,” Aldrich and Hauch say.

52% of large employers are planning to offer virtual mental health care in 2023 (Mercer).

Employers are also expanding their behavioral services through employee assistance programs and by offering self-help tools at little to no cost.

Financial Education

An employee’s finances are intricately tied to employer benefits.

Due to high inflation and a potential looming recession employers are starting to build out holistic financial well-being educational programs to add to benefit packages.

Abortion & Medical Travel

The recent Supreme Court abortion decision is impacting employee benefit decisions this upcoming year. Access to abortion services are harder to find or no longer available, causing many people to travel out of state.

  • 35% of employers now offer travel and lodging benefits for abortion services (WTW poll).
  • 16% of employers are planning to offer abortion travel benefits next year.
  • 21% of employers are considering offering abortion travel benefits next year.
  • 86% of employers provide the same travel and lodging benefits for those seeking abortions as those seeking other procedures like transplants.

Medical-travel benefits not only support employees seeking abortion services, but also can benefit those requiring care at centers of excellence for cancer treatment.

Affordability & Customization

High deductible health plans have been growing in popularity the past few years, but employers know they are not the best choice for every employee.

  • 41% of employers next year will provide a low-deductible medical plan option or a no-deductible plan with just premiums and co-pays.
  • 11% of employers next year will offer free employee-only coverage for at least one medical plan option

Affordability of health plans is important for low-wage workers and those with chronic medical conditions.

Although 29% of small employers already offer coverage to workers at no cost, it is a newer approach for large organizations.

Driven by an increasingly diverse workforce and greater hybrid work, offering customized choices for employees to select is imperative.

  • 49% of employers added greater choice in all benefits
  • 23% of employers are planning or considering adding greater choice to all benefits in the next year.

Providing more customizable healthcare options like a lifestyle spending account or adding culturally sensitive care programs are gaining traction.

Family Forming Benefits

Fertility treatment coverage and adoption and surrogacy benefits are expected to become increasingly popular in 2023, as one-third of large employers are slated to offer access to these services next year.

As well, 37% of all employers will provide at least one specialized benefit to support reproductive health.

Reproductive health benefits and resources include support for

  • High-risk pregnancies
  • Lactation
  • Pre-conception family planning
  • Pregnancy loss
  • Family-planning support during menopause


With increased consumerism increasing demand for one-click purchases, instant food delivery, virtual ordering and self-checkouts has led to accessibility expected in healthcare as well.

Accessibility features include flexibility in where care is delivered. More than half of all employees are working hybrid or full-time remote. Healthcare is expected to be provided from anywhere, at any time and from any device.

As well, employers are enhancing accessibility by customizing the enrollment process for those who are neurodiverse, colorblind, or suffer from decision-making anxiety.

  • 52% of employers have enhanced their enrollment experience
  • 34% of employers are planning to enhance their enrollment experience