Whether an employee fully understands or takes advantage of health benefits available to them depends to a significant degree upon their income.

That’s the recurring theme of a report prepared by Aflac. Its 2015 WorkForces study gathered information from nearly 2,000 professionals in benefits-related positions at U.S. companies. As a screen, Aflac considered responses about the tendencies of employees who had a household income of $100,000 or more, comparing them to responses from those with a household income of $50,000 or less.

“Although the Affordable Care Act has provided more Americans with access to major medical insurance, there are still major disparities between higher- and lower-income households in terms of financial preparedness, knowledge about health insurance and benefits enrollment,” the study said. “Not only are those lower-income households less likely to have financial plans in place, they’re also less likely to have funds available to cover unexpected medial costs.”

Those with a lower income feared being badly damaged financially by unexpected medical costs, and felt they didn’t really have a financial plan, mainly because they simply didn’t have sufficient savings. The study found that:

  • 78 percent of lower-income households have less than $1,000 for out-of-pocket costs associated with an unexpected serious illness or accident if it occurred today, compared to 19 percent of higher-income households

  • 74 percent of higher-income households have a financial plan in place, compared with 38 percent of lower-income households

But even aside from financial planning and resources, which one would expect would be a challenge for those with less money, those with lower incomes also struggled with making choices about workplace benefits.

For instance, those with a lower income were far less likely to participate in an employer’s major medical, life and disability insurance programs, and fewer opted for a 401(K).

They were less likely to feel that they had enough information about benefits at open enrollment time, they weren’t as satisfied as those with a higher income with the insurance claim process, and they tended to be less satisfied with their medical appointments as well.

The survey also revealed specific health care trends regarding millennials, boomers and wellness programs. Highlights include these facts:

  • Despite millennials’ confidence about their financial future, more than half at least somewhat agree that medical bills have hindered their ability to save;

  • Boomers are also most likely to report feeling a financial impact from consumer-driven health care, adding further uncertainty to their retirement considerations;

  • Even though 63 percent of employees participate in their company’s wellness program almost the same amount are pessimistic about the influence their companies’ programs have on their health.

“While health literacy and financial preparedness is low among a majority of Americans, socioeconomic gaps are emerging: Higher-income households, or those earning $100,000 per year or more, are more likely to understand and take advantage of their health care benefits than lower-income households, or those earning less than $50,000 per year,” the study said. “Why is this difference in health care literacy and enrollment a concern? Because lower income households are significantly less prepared to cope with financial fallout stemming from illnesses and injuries. These are the households that most need to comprehend and take advantage of the health care benefits available to their families, because many are just one serious medical incident away from economic ruin.”

The full study can be downloaded at the Aflac Workforces Report site.

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.