Decades ago, popular culture lionized working women as superheroes who could do it all – a ubiquitous perfume commercial featured a singer proclaiming “I can bring home the bacon, and fry it up in a pan” – or disparaged them as mothers who prioritized career over children. Today, for the most part, those extremes have given way to an understanding that women may work at paying jobs, they may work at home caring for their family, and they may do both.
In the United States, 57.4% of women had paying jobs in 2019, and they held slightly more than half (50.4%) of all jobs, according to the Bureau of Labor Statistics. While the pandemic and the ensuing Great Resignation have made waves throughout the job market – which no doubt will be reflected when new statistics are available – women have been disproportionally affected because they are more likely to hold low-paying jobs, more likely to be unable to work remotely, and more likely to be the parent dealing with childcare issues. All these factors have motivated women working outside the home to open discussions with their employers about their benefits.
Read on to learn more about a number of employee benefits women (and their families) value, and how employers can support women’s health and well-being by offering these benefits.
1. Offer Paid Leave for Illness, New Babies and Other Scenarios
The majority of working women in the U.S. have access to paid sick leave, often in the form of paid time off (PTO) that can be taken for a variety of reasons. However, paid parental leave, family leave, or longer-term medical leaves are offered far less often, according to a recent study by the Kaiser Family Foundation. In addition, women are less likely than men to have access to any or all of these paid days off, the study found, and low-income women and those working part time are less likely than their highly paid or full-time counterparts.
Even when parents have paid sick leave for themselves, they are often not allowed to use it to care for sick children. This carries economic consequences, the study points out, especially for mothers, who are more likely to stay home when a child is unable to be in school. The study found that 75% of low-income wage earners lose pay when they stay home with a sick child, compared with 33% of people with higher incomes.
Paid leave for caregivers, which includes paid family leave, is also rare. The U.S. Bureau of Labor Statistics reported on access to family leave in 2021. It found that 43% of the highest earners – those in the top 10% – had access to paid family leave. Just one in four employees in a middle bracket, with incomes in the top 50% to 75%, had access to paid family leave. Only 6% of earners in the lowest bracket – the bottom 10% – were offered paid family leave.
Parents employed by Cigna have access to up to four weeks of paid caregiver leave during the 12 months following the birth, adoption, or fostering of a child, said Jill Vaslow, vice president, talent strategy and employee well-being. Caregiver leave can also be used to care for a covered family member with a serious health condition, a covered military service member with a serious injury or illness, or for situations that qualify under the federal Family and Medical Leave Act (FMLA).
“At Cigna, we have a commitment to helping people live healthier, happier, and more fulfilling lives – not only our customers and patients, but importantly, our employees. Supporting our employees in all aspects of their life – not only at work – is critical. To that end, we offer many ways to support our employees throughout their lives, including caregiving.”Jill Vaslow, vice president, talent strategy and employee well-being, Cigna
2. Support Behavioral Health Needs
“Women report higher levels of anxiety and depression than men, a dynamic that was in existence before the pandemic and persists today,” said Eva Borden, president of behavioral health at Evernorth, Cigna's health services business. A recent Women in the Workplace study found mothers are twice as likely as others to worry about how their caregiving responsibilities will impact their work, and female executives reported higher levels of burnout when compared with their male counterparts.
Mothers with children under 18 are among the most likely to report the worries they experienced about COVID-19 negatively impacted their health, according the Kaiser Family Foundation's COVID-19 Vaccine Monitor Study. This worry may have been related to the difficulty they had accessing care, with almost 30% indicating they were unable to attain treatment.
As a result, employees increasingly turn to their benefits plan for therapy visits and other forms of mental health care. When that proves futile, they may look elsewhere for employment. In fact, one in every five employees who left a job cited their employer’s failure to support their well-being. The consequences of unmanaged mental health extend beyond employee turnover, however: It also can lead to missed work days and lost productivity.
“Today more than ever, employers should to take an active and visible role in directly addressing the importance of mental health for their entire workforce, along with attending to the unique needs of the women on their staff,“ Borden said. By articulating the importance of building emotional wellness and providing tools to sustain it (such robust employer and behavioral health offerings, coaching programs, Lean In Circles, and educational events), senior leaders can demonstrate the value of nurturing mental health, she said, and measuring the effectiveness of the interventions will help employers chart their path forward as they continue to build their plan for supporting mental health needs.
This is true for employees who are working from home, recently returned to the office, or have been onsite throughout the pandemic. For the latter group, Borden stresses the importance of understanding the unique stressors of essential workers while ensuring adequate supports are in place. “These staff are more likely to report anxiety, depression, substance use, and suicidality,” she said.
As part of supporting workers who recently returned to the office, Borden stressed the need to remain attuned to their needs as they make the transition and to remember their anxiety may be heightened as they adjust their home responsibilities in order to make their way back into the office.
Telehealth and digital resources can expand access to behavioral health care to employees who are working virtually.
“Encouraging leadership to connect with their staff on a regular basis to understand concerns and offer resources is critical, as is coordinating supportive events such an online seminars or virtual employee resource groups that foster connection and resilience.”Eva Borden, president of behavioral health, Evernorth
3. Offer Fertility Benefits
While U.S. birth rates dipped 9 months into the pandemic before rebounding, the majority of women with employer-based health insurance continued their plans to expand their families, a 2021 survey by Evernorth found. Many of the respondents who were undergoing fertility treatments when the pandemic began paused their treatments when medical offices were closed for safety reasons, but the vast majority restarted their treatments quickly or had plans to resume.
The Centers for Disease Control (CDC) estimates that close to 2% of the babies born in the United States each year are conceived via in vitro fertilization (IVF). As women age, the likelihood they will need medical intervention to get pregnant increases. Without fertility coverage, the cost can be prohibitive: The medical costs of a single cycle of IVF, which includes stimulating the ovaries to produce eggs, retrieving and fertilizing eggs, and transferring the embryo, can range from $10,000 to $25,000. The majority of women who get pregnant as a result of IVF undergo multiple cycles, although the specifics vary with age.
People contemplating pregnancy or assisted reproduction may be keenly aware of these costs, which don’t include medications. A recent study shows that workers are more loyal to employers who provide fertility coverage, and a third of all women would change jobs or encourage their partner to change jobs for better maternity, fertility, and adoption/surrogacy benefits.
Patients with limited or no coverage can wind up in serious debt to achieve their goal of having a family. More than half of IVF candidates have used credit cards to cover treatment expenses. Others have taken out personal loans or tapped into retirement accounts. This financial stress can even impact productivity on the job. Employees who are bringing financial worries to work lose about a month of productivity in a year.
Additionally, finding quality providers can be challenging. That scarcity adds to the challenge of identifying a clinic that can handle complex procedures, including top-notch laboratories to carry out complex tests and other specialized tasks.
A well-designed fertility benefit – such as Evernorth’s FamilyPath – will offer a vetted network with proven clinical effectiveness, along with features such as medical benefit management, dedicated fertility advisors to manage the patient experience and help navigate coverage, and emotional support throughout the customer’s journey.
Another crucial component is a dedicated fertility pharmacy.
“When a woman is taking fertility medication, a delay of even a few hours can significantly decrease her odds of conceiving. Most of the time, dosing schedules are predictable. When that’s not the case – such as when a doctor orders a new medication that must be administered within hours – patients need access to a pharmacy that goes above and beyond.”Kajaal Patel, RPh, director for Evernorth’s Freedom Fertility pharmacy
In 2020, for example, Freedom Fertility coordinated 2,700 same-day courier deliveries.
4. Support Expectant and New Mothers
Expectant and new mothers need care and support, but it often isn’t easy to find. Almost half of the counties in the U.S. lack a practicing obstetrician-gynecologist, especially rural areas. Even if a doctor is located in the next county, transportation can be a key barrier to care, Cigna has found.
Insufficient access to quality maternal care can have catastrophic consequences for women and their families. One in 10 babies in the United States is born too early, and these premature births, coupled with low birth weights, account for about 17% of infant deaths. In 2020, 23.8 of every 100,000 new mothers in the U.S. died as a result of childbirth, a huge jump from 2019’s already high maternal mortality rate of 20.1 per 100,000 live births. The rate of Cesarean sections is also high in the U.S., with close to one in three babies delivered surgically in 2020, increasing the risk of maternal death along with the child’s chances of obesity and autoimmune diseases later in life.
While employers can’t do anything about a shortage of providers, they can offer remote monitoring and virtual care solutions to augment trips to the see the doctor. Taking steps to assure access to prenatal care can be the key to early identification of gestational diabetes, hypertension, behavioral health issues such as depression, and other concerns. After they deliver their babies, new mothers have medical needs and often need help with breastfeeding. All too frequently, however, they leave the hospital overwhelmed and without access to the continuing care that will help them strive.
Cigna Ventures, the strategic venture fund of Cigna Corporation, has invested in Babyscripts, a virtual care platform that provides customized content across the maternal health care continuum, throughout pregnancy and as long as a year postpartum. The Babyscripts platform also helps providers automate and streamline care delivery, making it possible to identify patient risk and deliver risk-specific solutions.
By giving employees access to Babyscripts or a similar solution, employers can help families adjust to parenthood while avoiding distressing – and expensive – health issues or catch them early on.
“Babyscripts has a data-driven, innovative approach, and that's aligned with our commitment to enabling better and easier access to end-to-end maternity care for all mothers.”Tom Richards, senior vice president and global leader of strategy and business development, Cigna
5. Support Women in Their Careers
When employers help women succeed and advance on the job, everyone benefits. Job satisfaction correlates with behavioral and physical health. Financial wellness – which is tied closely to career success – also correlates with personal health.
To provide the support women need and deserve in their careers, employers must strive to provide fair pay and opportunities for all employees, regardless of gender and other demographic factors. For example, Cigna has joined the United Nations Women’s Empowerment Principles and partners with organizations including the Women Business Collaborative and Paradigm for Parity (P4P) as part of our commitment to these goals. We also publish an annual Diversity Scorecard Report that identifies key areas of opportunity and tracks our progress.
Providing a workplace culture that empowers women is another essential component of career support. Employee resource groups (ERGs), sometimes known as enterprise resource groups, can drive change while enabling people from across the organization to work together. Cigna’s numerous ERGs include WIN (Women Influencing and Networking), which provides opportunities for networking, mentoring, personal and professional development, and community service.
Working women – and all women – needed support before the pandemic, and the events of the last two-plus years have increased those needs, sometimes greatly. Providing the resources their employees need is a win-win for workers and employers alike.
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