Everest, a global provider of reinsurance and insurance products, has built its business on managing risk. Reducing employee health risk was a factor in the company’s decision to incorporate genetic testing into its comprehensive benefits portfolio in 2018.
And for good reason: According to the National Cancer Institute, nearly 40% of Americans will develop some type of cancer in their lifetimes; yet, the American Cancer Society finds that 45% of cancers are linked to genetic or modifiable factors and could be prevented, or mitigated. And of particular concern to business leaders, cancer treatments were the top healthcare cost for employers in 2022, according to the Business Group on Health.
To date, 455 Everest employees (25% of its U.S. employee workforce) have taken advantage of the one-time genetic test developed by Color Health, a company specializing in health-related testing for large and diverse populations. Other Color Health member organizations include SAP, GE, Salesforce, and the city and county of San Francisco.
In addition to testing for cancer risks, the Color Health saliva test also identifies risks for heart disease, problematic medication responses (for instance, less-than-optimal reactions to blood pressure or anti-depressant medications) and other potential health risks.
See also: How to help employees handle a cancer diagnosis
The employee cost of the test is around $50, although the price drops dramatically during twice-a-year promotions. (Employees can cover the cost through the company’s annual HSA contribution of $500.) Everest subsidizes the remainder of the full cost—and pays only for the testing actually performed. Currently, the benefit is limited to Everest’s U.S. employees and their families because of shipping-related challenges.
If a test uncovers any kind of risk or medication issue, the employee is immediately connected with a trained genetic counselor who can further explain the test results in detail; discuss any lifestyle changes needed; outline next steps; and if needed, discuss how to share test results with the employee’s healthcare providers. The counseling is at no additional charge.
Certainly, from a dollars and cents standpoint, the offering makes sense, according to Jennifer Chalupa, benefits manager for Everest. When diagnosed early, most cancers can be treated at significantly less cost than in later stages; experts estimate early-treatment costs can be 50%-90% less, depending on the type of cancer. And, when discovered early, survival rates are also high. According to Color’s reporting, 10% of Everest employees who have taken the Color Health test were found to be at increased cancer risk due to genetic mutations or family history, and eight cancers have been discovered as a result of the testing. (Names and other identification information are kept confidential and not disclosed to employers.)
But Chalupa stresses that cost savings isn’t the only reason for the benefits offering.
“There’s a strong diversity and inclusion component to this benefit,” she says. Not only do genetic cancer risks differ among ethnic groups, but understanding of risks and access to testing also vary. Democratizing access to health testing, increasing employee engagement in their personal health and creating a healthy work environment are also among Everest’s goals with the offering.
The genetic test rounds out other health-related benefits provided by Everest, which include infertility treatments, preventive care programs for chronic health conditions, mental health support and lifestyle savings accounts. Chalupa and her team are also looking into financial health benefits for 2024.
“When it comes to benefits, we take a holistic and family-focused approach,” she says. “We also try to look at everything from a diversity and inclusion perspective.”
Care delivered where and when convenient
Bringing greater access to health testing is something Jacob Adams, senior vice president of Color Health, is passionate about.
“Our medical system is so fragmented that, even if various screenings are covered by a person’s commercial insurance, there can be many obstacles in the way,” she says.
For instance, she notes, most cancer screenings require an order from a primary care physician, and only about 20% of Americans actually have a named PCP. And even if you have an order, usually the onus is on the patient to find and book an appointment at a time and location that’s convenient. Long wait times are the norm, and it’s proven that the longer the wait, the higher chance that the patient will cancel.
“And, too often, if a test comes back with concerning results, many people struggle to take action—whether out of fear, denial or financial concerns. We want to create a seamless experience for people that bridges the gaps in our medical system and provide support in the event that a serious illness is detected—or just to help a person fully understand test results,” says Adams. In addition to the company’s team of counselors, called care advocates, Color Health can connect employees and their families with support groups, specially tailored for cancer patients, cancer survivors and those with high-risk diagnoses.
It also offers in-person and virtual workshops and educational materials to raise awareness among employee populations. Not only do these resources save benefit teams significant time, but they also encourage uptake.
“We have created a wealth of marketing assets that members can take advantage of. Rather than pushing employees, we focus on education,” Adams says. “We want people to understand that having data can help them make better, informed health decisions and help them live better lives.”
Adams emphasizes that privacy is of paramount importance (something echoed by Chalupa). The company’s technology platform is HIPAA-compliant with built-in layers of security. In past years, Color Health did COVID testing for multiple federal and state agencies that required proven data security. (Of note, the Genetic Information Nondiscrimination Act of 2008, the Americans with Disabilities Act and the Health Insurance Portability and Accountability Act of 1996 serve as federal protections to prohibit discrimination using genetic information for health insurance and employment status. Some state laws further protect against discrimination in the areas of life insurance, housing and emergency medical services.)
At Color Health, each member company gets a unique URL that employees can use to request testing, as well as a unique telephone hotline. As Adams points out, many blue-collar employees don’t have easy access to email or the internet.
The people factor in early-disease detection
Early-disease detection is proven to reduce healthcare costs. For instance, according to the National Library of Medicine, the treatment cost for Stage 1 breast cancer is around $82,000, compared to about $135,000 for treatment at Stage 4.
But, as Chalupa and Adams both emphasize, there’s no way to monetize the benefit of helping people take more control of their health and, when needed, providing professional and personalized support to navigate any identified health issues.
“While Color’s test does result in some cost advantage, that’s not the decision driver for us,” says Chalupa. “The ability to detect risk early and improve the health and overall wellbeing of our employees are the primary reasons we’ve added it to our holistic benefits portfolio.”
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