Employers are also offering more educational assistance programs such as tuition aid for existing employees seeking additional education, student loan assistance, college counselors for high school-aged children of employees and spousal education benefits.

"Continuing a trend, we saw last year, employers appear to be supplementing voluntary benefits with additional programs to meet targeted health conditions as well as to support employees based on individual circumstances such as HingeHealth, Milk Stork, VetAdvisor and Sleep.io," the authors write. "With today's employees demanding personalization in all aspects of their lives, this may be a cost-effective way to address employee concerns. That said, employers must avoid overwhelming employees with too many programs, or risk poor utilization."

"Family-friendly" benefits programs are also on the rise, including fertility solutions, adoption assistance, child care assistance, extended maternity and/or paternity leave, flexible scheduling, childcare backup services and dependent care flexible spending accounts.

"Run an internet search on 'most important benefits to employees' and family-focused programs will invariably appear in the top 10, if not the top five," the authors write. "Employers are clearly getting creative in how to meet this increased demand, as seen by the types of programs being offered this year. It may, for example, be time to revisit previous policies of covering infertility diagnoses but not treatment, or to explore low-cost options such as flexible hours, more paid vacation time and work-from-home options."

One notable emerging trend: employers are increasingly making use of new and targeted program offerings to meet specific employee needs, including coverage for DNA tests such as 23andMe or Ancestry Health; music and equine therapy; house calls at no charge; discounted warehouse club memberships; more employers not covering any out-of-network expenses and survivor therapy for sexual assault victims.

Other key findings from the analysis include:

• Wellness programs continue to emphasize data gathering. In general, premium reductions remain by far the most popular reward for employee engagement in wellness activities. Health risk assessments and biometric screenings continue to be the most rewarded wellness behaviors, followed by the broad wellness activities.
• HRAs and HSAs remain stable. Sixty-three percent of employers are offering tax-advantaged reimbursement accounts — either health savings accounts or health reimbursement accounts in connection with their high deductible plans. HSAs are by far the most popular of these accounts, with 69 percent of employers offering HSAs versus just 12 percent offering HRAs. About 19 percent of employers offering accounts offered both an HSA and HRA, because they offered multiple plan options.
• A change in deductible trend. The average in-network individual deductible shot up more than 28 percent, to $1,038, while family deductibles dropped. The median individual deductible dropped 12 percent to $1,672. Median amounts increased as well — by $100 for individual deductibles and $250 for family deductibles.
• HDHPs remain static. While three-quarters of the employers in our database (77 percent) offer at least one high deductible plan, such plans represent only about one-third of all plans offered (39 percent individual and 34 percent family deductibles, versus 41 percent for both last year). The statutory level for high deductible is $1,400 for self-only coverage and $2,800 for family coverage in 2020. Individual deductibles in these high deductible plans ranged from $1,400 to $7,000 and family deductibles ranged from $2,800 to $14,700.
• Despite concerns about drug costs, little change in drug cost-sharing. Median retail deductibles remain static ($10 for generics, $30 formulary brand and $50 non-formulary brand). Network copays for specialty drugs declined slightly from $100 to $95 this year.
• Copays increase for office visits and alternatives. While median copays for retail clinic visits remained static (at $20), copays for primary care office visits increased to $25, those for urgent care clinics returned to $35, and those for emergency room jumped to $150. Median coinsurance for all remained steady at 80 percent in-network. The median copay for telehealth visits also increased—up $5 to $25—while more plans (88 percent) offered telehealth visits as an option, reversing last year's decline.

Read more: 

• Paid family leave benefits employees and employers alike
• Younger workers plan to enroll in voluntary benefits, though they don't understand them
• Voluntary benefits: Control the conversation