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The COVID-19 legacy: How the pandemic will influence the corporate employment and benefits landscape

The 2020 COVID-19 pandemic has affected more than people’s health. It has shocked national economies and health care systems, decimated industry sectors, accelerated innovation, fast-tracked changes in digital regulations and licencing requirements and changed corporate models, mindsets and culture.

Workplaces across the globe had to quickly adapt to remote working and heightened health and safety measures. While organisations were able to pivot and adapt quickly in many regards, the shape of their home-working policies, for example, was tied to government updates on mandated travel restrictions, furlough and job retention schemes and financial aid, and virtual health care licencing. In turn, government decisions hang off the progress being made by pharmaceuticals and drug administrations. At the start of 2021, as vaccines first started to be available for public use, many organisations can truly look to the future – a so-called ‘new normal’ after the pandemic. Yet the virulent spread of the pandemic will continue and vaccine roll outs and mass immunity will take time, so the world’s governments will need to continue to adapt their economic and population health strategies at pace, and organisations along with them.

Few people expect the world of work to look and feel as it did before. This article has been created with help from Aetna’s Head of Health Services, Kate Karwelies, and Professor Graeme Leach, CEO of Macronomics, a macro-economic, geopolitical and megatrends research consultancy and author of the 2021-’22 report, ‘Coronanomics’. It examines the change-drivers shaping the long-term economic, employment, occupational health and duty of care landscapes. It uncovers how might leaders respond from a policy and strategy perspective, as well as when, why and how will the ‘new’ become ‘normal’.

In this article, we aim to answer some of today’s burning questions:

  • How can organisations keep pace with the changing health and economic landscape to survive and thrive in the short- and longer-term?
  • What are the key economic, growth and productivity trends impacting businesses of all sizes – jumbo to SME?
  • What do organisations need to consider as they look to balance investment in employee health and wellness, and meet the diversified needs of remote and office-based workers?

COVID-19 and today’s workforce attitudes to health

Before the pandemic, our 2019 survey and report, Tackling polarised perceptions in corporate health and wellness, found that employers thought they were providing a good level of health benefits, but their employees didn’t agree – hence the significant gap and ‘polarised perceptions’ between the two parties. Another of our reports, How organisations can overcome employee health inertia, found that people knew what to do to be healthier, they just didn’t do anything about it – hence ‘health inertia’ impacting people’s short- and long-term health prospects.

The data from our follow up survey in September 2020 showed that employees were demanding better health support – for physical, emotional and mental health needs – and many agreed that their employers had met these demands. While there was still some disconnect between the views of employer and employee, the polarisation – the gap between the two sides – was less pronounced. Was the pandemic the driver behind employees taking their health more seriously? Did the direct and very clear workforce needs highlighted by the pandemic guide employers on benefits to provide?

Health is an important, personal and complex subject. Employees are taking their health seriously and employers are invested in physical and mental health support, but there is still work to be done. Health care provision needs to be regulated for the safety and privacy of individuals. Companies need to create clear, well-informed and tailored policies on key aspects of health care provision and new working practices. They will also need to consider how these changes will impact corporate culture.

The convergence of health tech maturity and health behaviours

Across the globe, the pandemic is widely acknowledged as a telemedicine (virtual health) adoption accelerant. Yet this adoption sometimes required licencing regulators to fast-track new data protection, care quality and legal frameworks to allow for medical diagnoses and prescription issuance, for example, and work with telecoms and health care providers to develop integrated solutions. One example is Dubai’s ’Doctor for Every Citizen’ initiative.

According to Professor Graeme Leach, that’s just the tip of the iceberg when it comes to the convergence of maturing tech platforms: “The enduring legacy of COVID-19 will be quite positive. We’ve already seen trends towards online working, shopping, gaming, learning and health care access. COVID has hastened the day when these changes will become much more mass market.

“From the mid-2020s onwards, we’ll see the convergence, maturity and at-scale rollout of all the big technologies today and at the same time. That’s 5G, the Internet of Things, AI, Cloud, Big Data and Edge computing, all of which will reach a level where they drive and acceleration in growth. Combined with health efficiency and health awareness in the wake of the pandemic, this will trigger a sea change in behaviour. It will also drive a demand for data about all facets of our life and health so that it can be interpreted and then presented back to us, accompanied by the right guidance.”

Employers are focused on bringing their employees convenient access to quality health care and well-being benefits. Digital solutions, apps and a virtual health environment go hand in hand with the topic of data privacy. Yet data privacy also has implications beyond accessing convenient, cost-effective and quality health care online.

Health care data, privacy and reciprocal employer-employee duty of care

“Data is the new oil,” says Kate. One of the most important areas for regulators and employers will be around employee health care data and privacy.

“If companies are taking on more of a role in people’s health care provision, there are privacy implications. For regions with a focus on privacy – such as the EU – there’s going to be a big discussion about how much data people are expected to share.”

As Kate explains, health is usually a personal topic. Most aspects of our personal health don’t impact others, but when it involves a highly infectious virus, our personal health can suddenly impact those around us. This is particularly relevant for businesses who could lose many man-hours due to communicable diseases – even the common cold.

What is not yet legislated for with any granularity, is whether someone can be compelled to divulge health details, and whether an organisation can send home someone who refuses. Businesses do, after all, have a duty of care to all their employees – to organise the work environment in such a way that the life and health of the employee is protected to the greatest extent possible. How should organisations balance the need for monitoring and maintaining workforce health with security and privacy?

“This isn’t just a regulatory debate, but an ethical debate,” says Kate. “Have we in fact overprotected privacy? How reciprocal is the sense of duty? If employers have a duty of care to employees, then surely employees have a duty of loyalty to keep themselves from coming to harm. And, in today’s context, does that duty also extend to helping keep their peers and colleagues safe from harm? Either way, making people feel confident in the ownership protocols and safeguards in place around their data, and being transparent about the ways the personal data, which employees do choose to share, can and can’t be used, will be critical to the future of employee health and safety.”

Recent history includes many cases of employees or their family members suing their employers for negligence that impacted their health, from workers exposed to cigarette smoke to those exposed to COVID-19 or asbestos. There are already stories of people suing their employers because they contracted COVID-19 while in the office – and in December 2020 the U.S. government pushed for more bans on COVID-19 lawsuits.

Regulation is needed and it will certainly come, at either international, regional, industry or payer level, but it is a complicated logistical and ethical terrain that we need to navigate with care.

Corporate culture: In with the new and out with the old

Kate is unequivocal in her views on the future of the corporate world: “The workplace has changed. We’re not going back to how things were before.” How and where we work has changed and organisations need to develop and implement well-thought-out policies in response to give clarity to employees, manage expectations and protect the organisation. We’re in unchartered territory with lots of this, but I think we will start to see policies emerge to reflect the new ways of working.”

Culture - Sickness and stigma

“Long-term policy change will be around low-level infectious conditions. We’ve proved that we can work from home and that we will work from home. So, instead of coming into the office with a suspected cold or flu, we can work from home to protect our colleagues without taking unnecessary sick days.”

Mental health stigma is in decline around the world. While the U.S. already had parity of physical and mental health within medical insurance, Kate predicts that insurers in other areas may start to include mental health benefits and treatment where they may not have previously. Our recent data shows the rising demand for mental health support in the workplace – for example, 33% of employees we surveyed said they were concerned about their mental health when working from home. As organisations invest in and develop more mental health support, policy will need to be addressed.

Beyond well-being

Today, many organisations are becoming increasingly decentralised and organisations are challenged to effectively communicate their company culture and engage employees meaningfully in a virtual world.

“Businesses won’t just be focused on office culture, but on the culture of working from home, because not everyone who worked in an office is going back to one,” says Kate. “We will shift from building culture around a group of people who sit and work together, to a digital and remote culture.”

We found that 27% of the businesses we surveyed have already implemented online initiatives to ensure a continued sense of community. Aetna International launched ‘Let’s Get Talking’, where groups no larger than eight met online to discuss anything and everything. “The things that worked during the pandemic will continue,” says Kate. “Especially with global workforces who would never be in a room together anyway.”

Kate recognises two key factors that will help businesses build that culture for remote workers:

  1. “We’re going to rely on video a lot more.”
  2. “Remote working means the lines between work and non-work become blurred. Companies need to recognise the role and importance of people’s personal lives for their well-being. When people are happy and feel supported it can positively impact productivity.”

There is increased talk of moving from a ‘benefits culture’ to a ‘well-being culture’: from companies providing benefits to help talent attraction, retention and external perception, to understanding that well-being is mutually beneficial for employer and employee.

“There will always be companies in each camp,” says Kate. “Some will provide benefits as a tick-box exercise, others believe they will help with recruitment, retention and nurturing more productive employees. The key change is that COVID-19 has made people value their health care benefits and corporate wellness programmes.”

Our survey found that having comprehensive health insurance is more important to 78% of employees now than it was before the pandemic. Also, 87% said that they place more value on access to quality health care.

Kate explains: “Until this year, many saw health care benefits as a nice-to-have, not essential, but 2020 has driven real need and real engagement. Increasing numbers of people will come to expect additional investment in personal well-being companies.”

Organisations now need to be thinking in terms of the tax and compliance implications of remote working, whether that’s cross-country or cross-border.

As Graeme observes, “At the moment, organisations are putting new digital business models in place. Soon, the conversation will turn to the ways in which organisations can source labour to match. Not only will there be urban-to-rural shift, as people can work effectively in any location, there will be global movement - notwithstanding language issues.

“There are clearly structural and very practical influences on the ability to have a workforce spread out around the world. For example, if there’s a shortage of labour in one country, you can source it from another – and you might not even have to pay as much. Companies will be quite mercenary on this. Having overseas workers raises a host of tax issues: There is the potential for tax evasion. It also makes output difficult to measure: what people have produced or done. All of these have striking implications for how governments raise revenue.”

Since the start of the pandemic, employees have begun realising they can work effectively from the corners of their country or the globe. They have also become far more aware of the needs of their own families, perhaps because of being surrounded by loved ones, day-in, day-out due to the need to work from home, sickness or home-schooling. They have become far more aware of their own vulnerabilities and the importance of their own health and quality of life. People’s horizons have broadened. Their priorities are changing.

“From an employee perspective, people will still tend to migrate to where they know there’s a community or network or a group they can naturally assimilate with,” says Graeme. “Some economies will  benefit because of the lifestyle available and how much tax you pay. If you can now work somewhere else, even if it’s across borders, then it will magnify the attraction of expat communities in places such as the United Arab Emirates and parts of Asia Pacific.”

Corporate investment: Big business to lead the way

Investment in corporate wellness has been increasing over the last few years, and during the pandemic, may companies upped their game:  63% of the employees  we surveyed believe that their employers should be spending more on health care benefits and resources. The pandemic has proven the power and value of wellness benefits, so should we expect accelerated investment into 2021?

“It seems inevitable that there is a recession coming,” explains Kate. “And many companies may find it hard to find the money. Organisations will be pushing for return on investment (ROI) – results will need to be more measurable than ever. Programmes need to drive engagement or it’s a waste.”

Through the perennial ups and downs of economies, the long-term trend is increased investment in corporate wellness. And, as Kate states, the largest businesses will lead the charge, driving change and blazing the trail for smaller businesses to follow.

“Jumbo business has the money to invest in corporate wellness and workplace well-being programmes. It’s also easier for larger businesses to show ROI – which will always make them more attractive and more sustainable. Jumbo businesses will drive these new wellness strategies, but the work on how to scale those strategies for SMBs will have to be done by well-being providers.”

This is mirrored in the findings of our survey, which found that the largest businesses are most likely to have improved support. On average, just 5% of employers  we surveyed had made no improvements to health care services since the onset of the COVID-19. This falls to 1% for businesses with over 1,000 staff but rises to 19% for those with fewer than 200 employees.

In the short-term, Covid is having a negative impact on many sectors and business growth, which in turn will impact the investment organisations can make into protecting the health of their people. But what about the longer-term road to economic recovery, productivity and growth?

Graeme states, “We’ve seen the sharpest economic decline in 200 years and that has to have consequences. But what we we’re not seeing yet is post-lockdown recovery because that requires vaccines to be rolled out across the world and the emergence of herd immunity. Once complete, there will be a recovery. It’s going to take a lot longer in some places than others, but the high-level review tells us that there will be an upturn in the world economy in the second half of 2021. We do have a big question mark across the world: will the future of the world economy look like the Roaring 20s in U.S. in the wake of the Spanish Flu? Or will it look more like the more mundane, drab 1920s we saw in the UK? It’ll probably be a different model to either of those, but it just goes to show that the legacy of pandemics can differ quite markedly across countries.”

Cost containment: The long-term challenge

Aetna International’s Dr Hemal Desai, Global Medical Director, explained that many people had not been seeking medical attention during the pandemic due to fears about contracting the virus. For example, the CDC in the U.S. reported that in the 10 weeks following declaration of the COVID-19 national emergency, emergency visits declined  23% for heart attack and 20% for stroke, suggesting sufferers of serious illness had stayed away.

Our own  Expat Family Wellness Survey 2020  revealed that 1 in 10 expats will not go to hospital for a medical emergency during the pandemic. Of those who attended a medical appointment, more than half admitted that they felt ‘worried’ about doing so.

With fewer people seeking care,  claims on insurance fell significantly. While this might initially seem to have benefited insurance providers, the reality is that insurers – like employers and their employees – want people to be healthy, and that means getting treatment when it’s needed. Many people who avoided care or even regular check-ups may be more at risk to increased symptoms further down the line. Early intervention can save lives.

“Fewer people have chosen elective surgeries,” says Kate. “The important thing to watch is the impact of those people who have delayed check-ups and preventative care such as mammograms. Medical bodies are predicting long-term impact to the health and survival rates of those managing conditions due to postponed health screenings as resources have been diverted to cope with the pandemic. Will we see a long-term uptick in non-communicable diseases for the swathe of people who didn’t get their regular preventative health screening or check-up this year?”

While there may be a cost saving for insurers (savings which insurers usually seek to pass on to clients to remain competitive), this may be short-lived as unmanaged, unchecked and untreated conditions tend to require more investment in the long-term. Add to this the wide-reaching impact on people’s  mental health and muscular-skeletal  problems from inadequate remote working stations and cost containment could be a challenge in the future.

The key to success for businesses is to work closely with their providers to guide well-being policy and supply products and services to support it. Challenge your provider on the topics in this article to ensure they’re able to deliver what you and your employees need to build and maintain healthy lives.

Why not contact us to see how Aetna International can support your employees’ physical and mental health now and after the pandemic? Get in touch in your region.

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