Employers remain committed to well-being investments, despite rising health care costs: Survey

Nearly all employers said well-being programs continue to play a role in their overall workforce strategy and that they would maintain funding for these programs at current levels, according to the 15th Annual Employer-Sponsored Health and Well-being Survey, whose findings were announced last week.

More than half of all respondents plan to broaden their well-being strategy in the next three to five years to address social determinants of health; employers also plan to continue providing family-forming benefits and reproductive support in the coming years. Those with global operations report plans to increasingly make benefits more consistent among locations, according to the survey.

Fielded in January-February 2024 by Business Group on Health and Fidelity Investments, the survey had 160 employer-respondents representing an array of industries. More than 60% of the respondents have global operations.

“Multiple, interconnected factors appear to support well-being spending for 2024, which remains steady,” said Ellen Kelsay, president and CEO of Business Group on Health. “Employers are holistically assessing health and well-being investments in the United States and globally and are doing so against the backdrop of expanding employee health needs, mounting concerns regarding chronic conditions and mental health, evolving issues related to social determinants of health as well as overall health care costs, including concerns about affordability.”

More than half (51%) of employers plan to address the impact of social determinants of health (SDOH) on personal well-being in the next three to five years. Social determinants of health are the underlying social and economic conditions within a community that influence health and impact the ability to be productive at work and one’s overall quality of life.

“Addressing social determinants of health may soon be a key aspect of well-being design, ” Kelsay said. “By supporting initiatives that reduce employee cost-sharing or provide child care support and flexibility, for instance, employers enable individuals and their families to boost their overall well-being and achieve other positive outcomes.”

In addition, more than three-quarters of employers (76%) report providing family-forming benefits and reproductive support in 2024, an increase over 2023 (73%). In 2025, 86% of employers said they planned to offer the benefit.

About six in 10 global employers have a globally consistent well-being strategy, the survey finds, with another 18% developing one for the near future. Some 70% of global employers say the biggest challenge in implementing a global strategy for well-being was employee needs differing by country.

Still, 43% of global employers now offer either on-site or virtual counseling services, an increase from 2023 (34%), while 22% of global employers in 2024 offer incentives to participate in their well-being programs, an increase over 2023 (16%). Employers providing financial incentives as part of a well-being program plan to maintain or increase their investment in the near future, according to the survey.

Meanwhile, fewer respondents are considering adopting lifestyle spending accounts (LSAs), employer-funded post-tax accounts that provide employees with a fixed amount to spend on the well-being resources they most value. In 2024, 28% of employers said they were considering offering an LSA, a decrease from 38% in 2023. Administrative cost and program complexity dampen employer adoption of these programs.

LSA-type accounts are more widely used outside the United States, with 19% of global employers offering them. In the United States, 7% of employers said they offered an LSA in 2024.

“Employers have started to pay attention to lifestyle spending accounts (LSAs) in the last few years, with nearly 30% of respondents contemplating offering an LSA in 2025,” said Robert Kennedy, Health and Welfare practice leader at Fidelity Workplace Consulting, which helps multinational organizations design and manage employee benefit strategies and supporting programs. “These flexible, employer-funded accounts cover a variety of expenses not traditionally covered by health benefits, from estate planning to dance lessons. With this ability to personalize benefits, it will be interesting to see how LSAs trend in the future.”

The survey also shows mental health is a continued focus for employers. Nearly all (99%) said they offered some type of Employee Assistance Program (EAP), with 37% of employers providing a newer EAP model. Moreover, on-site services and offerings such as yoga or meditation classes (47%), counseling or therapy (27%), and nutritional labeling in the cafeteria (53%) remain a core component of well-being strategies.