As organizations look ahead to open-enrollment season, there’s no shortage of complicating factors for them to consider in their benefits planning, from legislative attacks on abortion access and trans rights to the ongoing childcare crisis and pandemic-induced burnout.

To understand what employers are prioritizing in their benefits for the coming year, we reached out to Tami Simon, global corporate business leader at the benefits and human-resources consulting firm The Segal Group. Below is a transcript of our conversation, lightly edited for clarity:

You’ve written about the employer-employee social contract. What is that, and what’s the current state of it?

It's actually a pretty simple construct, even though it's got a bit of a technical name. It's really simply: what are the expectations of those two parties towards each other? So what do employees expect of the organization that they're working for, and what do organizations expect of the people that work for them to help meet that organization's goals? That that's really it.

We believe that that social contract is evolving right now. It has evolved throughout history, several times, starting really with the labor movement in this country and even before that. It's going through an evolution right now because of all of the things that are happening in the United States with the pandemic and the Great Resignation and all of those other social, political, economic changes. So we think that that relationship is being renegotiated a little bit, and we've been talking to our clients a lot about, what does that mean for you? Every organization is totally different, and what their workforces need may differ from industry to industry, geography to geography, even within an organization. So what do these changes mean to you and what should you be doing about it? That's really the general construct.

Is the economic downturn influencing that contract at all?

There's no one answer to any of this. It's not an economic downturn for every industry necessarily. There wasn't a Great Resignation for every industry necessarily. Different industries, different parts of the country, different workforces are impacted at different times. Now that the economy appears to be slowing down a little bit—at least if we're going take it in a very generic way—do employers have to think about how that's going to impact them, the businesses that they happen to be in, and the people that work for them? Of course. It’s not the first time this has happened. One thing we know about economics is that the economy is cyclical, so I don't know that there's anything remarkable or unique about this particular new cyclical slowdown.

In addition to that cyclical slowdown, that hopefully leaders of organizations are pretty used to dealing with, they've got a couple other things layered on top, like coming out of a pandemic. But the reality is that every single organization has to think about what their business is, where their business is, who their business is, who their people are to help them run their business, what their goals are, and then how all of this stuff really applies to them. There's really no one-stop shopping or easy answer.

With the tightness of the labor market, to what extent have you seen clients planning changes to their benefits with recruitment or retention in mind?

An organization that doesn't think about comp and benefits at this point, they really do so at their own peril. I'm not just saying that because I'm in this business. I'm saying it because we've seen it. Organizations that aren't aware of what their workforce needs in order to be as productive and as present in their work as possible, they do experience more turnover, lower morale, less loyalty, et cetera, et cetera. Again, I'm making broad generalizations here because every organization is different, but the key drivers that we're seeing right now really relate to flexibility. There’s a lot of conversation going on right now related to paid time off, unpaid time off, different leaves—parental leave versus maternity or paternity. So that's the big, big category.

Obviously compensation is a big one. What's really fascinating, though, is our analysis has shown that benefits themselves are playing such a large role that strong, holistic benefits that really speak to a workforce are often valued more than just cash. Cash is not always king, because there are both very tangible and very intangible benefits that employers need to be thinking about. But comp is always there. And if you're significantly lower than what the market is requiring, that's going to have an impact.

People are talking a lot about mental-health support and access to the types of support networks that people need. Mental health is the one that is really making the news a lot right now, because the country is finally starting to see the impact of having a lack of healthcare providers in the mental-health space. It's something that arguably we’ve needed for a really long time, but we saw it come to a head during the pandemic.

And then also access to various types of healthcare is a very, very big conversation among employers right now. Access to different kinds of providers that the population needs, mental health being one of them. Caregiver support—I can't tell you what an enormous pull that is right now. There are a lot of people taking care of a lot of other people, whether that is parents, kids, other dependents, your spouse, a disabled family member, maybe even a community member, and that is impacting their ability to work. And without a doubt, given the recent Supreme Court case, we've got a lot of employers asking about access to reproductive benefits, access to women's health care, what role their travel policy in their group health plan may or may not play. Most of our clients already had those programs in place for other types of benefits, so just kind of double-checking to see that they are where they want to be.

Then, other than the focus on some of those hot-button issues, there are three fundamental themes that we're seeing this year. Number one: There are all these discussions right now about diversity, equity, and inclusion, and a lot of employers are thinking about, ‘Well, have we really thought about our health plans or our retirement plans through a diversity lens?’ So making sure that your employee benefits actually reflect that DEI policy or strategy that your organization has. A lot of employers are struggling with, how do you even determine that? What does diversity have to do with my health plan? Well, do you have providers in your network that represent your employee population? Do you have enough financial-literacy education to help people properly save for retirement and actually have financial stability and security, if they maybe didn't get that kind of education from home or from their school system?

Number two, it's thinking harder about how new benefits or benefit programs are communicated to different populations. That speaks to the diversity issue, but it also just speaks to understanding where your own people are when it comes to communications. If you're still sending out pieces of paper through the mail, you're going to miss a large chunk of your people. So not only what you're communicating, but how you're communicating it.

And then, lots of laws are changing. Lots of regulations are changing on the federal level, on the state level, locally. So just, you know, keeping up with everything that's required of employers that are offering these benefits, and making sure that whatever they do offer is kosher and compliant with federal state and local laws.

When you mentioned changing laws, were you including the overturning of Roe v. Wade in that?

That's one of many. Laws in the employee benefits and HR industry are evolving and changing constantly. Paid time off is another one. Maternity and paternity leave, all the leave laws that employers have to comply with that are, frankly, such an administrative burden for them, because they have so many different localities they need to be thinking about. Roe made the biggest headlines because it was such a huge issue in this country. But employers that are administering or sponsoring employee benefit programs have always had a litany of laws and regulations that they need to be complying with, under different regulatory-agency authority.

To your point about thinking about how these new benefits are communicated: Are there any best practices there for employers?

More is more. Repetition helps. Using a variety of different communication strategies, just like with any good marketing campaign, is really important: website, text, meetings in person, virtual meetings, little webinars, maybe a blog. Not everybody learns and understands things at the same level or in the same way, so we use all those different communication techniques when we're talking to a variety of different audiences and levels of sophistication. And I am a huge advocate of examples, examples, examples. If you can say it in a chart, say it in a chart, as opposed to words. I'm a huge chart advocate. That's the lamest t-shirt ever, but it's true. And just making sure that you're answering the questions that your people have when they're sitting at their kitchen table with their families, because that's actually what matters.

Has the rise of remote or hybrid work made it harder for employers to effectively get those messages across, or to have an understanding of what employees want?

No, it's just different. It's a different way of interacting as human beings. You and I would have a very different interaction if we were sitting across a table from one another versus through this, you know, this video, but is it better? I don't know. It's just different. I think it's a little bit of a question of, is your glass half full or half empty?

How broadly is mental health generally defined? Does it mostly refer to things like access to therapy, or are employers also including things like PTO and flexibility under that umbrella?

It depends on the sophistication of the organization. Mental health can be a huge, broad umbrella that means a million different things, or it can mean actual psychological or clinical assistance due to some kind of diagnosed condition. Frankly, employers are trying to tackle all of the above. I would try to encourage them to not put everything under the mental-health umbrella, only because that can be a little confusing. Really focus on what it is that you're trying to address. If you're trying to address burnout, that's a workforce resourcing issue, right? So how are your people working? Where are they working? How are they working? What are they doing? Focus it on that from a management perspective.

If you are talking about stress, well, take a look at yourself as an organization, your role in that stress, but then understand that people have entire lives that they're bringing to the office or to the factory. Maybe the stress has nothing to do with you. So making resources available to deal with any of that, if someone's having marital stress or there's been a death or they're terrified of Covid. Maybe the stress is financial, in which case having a financial advisor could be the best thing. You can call a lot of things mental health, but the question is, what are the issues that you're really trying to address? And then thinking about how that impacts your population and making resources available to deal with those issues.

If the organization wants to say, ‘We really want to support you and your family in a variety of ways, so that you can decide as an individual what is the most appropriate support for you. Here are the different resources that we're making available to you, and when you might end up needing them,’ give access to that in a couple different ways.

Let me give you an example. Sometimes people don't think about their benefits until their situation arises. They're about to have a baby or they're about to buy their first house or they're relocating or there's a death in their family. And they have zero idea that they've got access to benefits that relate to that, because they never had to think about it before. Information on your intranet that is about a specific change in status in your life, or a specific event, is super helpful because sometimes you don't know you need it and don't really care until you need it. And then you really care.

However, there might be other people that are just like, ‘I am just completely stressed out. I'm feeling burnt out. I'm exhausted all the time,’ and they start searching for certain words on the intranet. And so you just sort of have this generic page that starts asking the questions: ‘Why are you feeling this way? Well, here are a few different resources, and you can decide whether that actually speaks to you.’ You've got your general big bucket of, ‘Here's everything that we do. Take a look at the table of contents and see if there's anything that's interesting to you.’ So there are lots of different ways to bring something up.

What are you seeing in terms of caregiver support?

I don't know that any of this is brand new, but maybe more awareness. I think that elder caregiving is becoming much more prevalent. We're starting to see some organizations including access to benefits for the caregivers of the elderly. So one example is a lot of EAPs, employee assistance programs, have got some legal benefits that are made available. Often something that is extremely time-consuming is when a child becomes the executor of their parents' estate. That might not have been covered under those legal benefits in the past. And now there are some employers that are expanding those benefits to say, ‘We know how time-consuming this is, and we want to give you a benefit, because first of all, it's going to benefit us. You're going to be more productive at work, because you're not going to have to deal with this as much.’ How many people know what it even means to be an executor of an estate? They need help.

Caregiving in terms of kids is another biggie. We have had a childcare crisis in this country for a really long time. The pandemic certainly highlighted that crisis at a new level, and organizations are realizing that parents need help on a variety of fronts. So those are two tactical ones.

Cost of education would probably be in third place. We're talking to people about every form. We're talking about childcare accounts where you can put money away, helping the people that have student loans, the student-loan relief under 401k plans, opening or helping provide seed money for 529 plans so that parents can start to save for their children's college education. Name a way, and I could probably name some employers or clients that are thinking about it.

For childcare, we're seeing a lot of different things. We're seeing childcare subsidies. One of the things that I would love to see from a public policy perspective is for the dependent-care limit, which is currently $5,000, to go up. If, as a country, we believe that putting money away to pay for childcare expenses is a worthwhile cause, then those dollars should keep up with the cost of childcare. Also having access to emergency daycare, if something happens with your initial daycare provider or they get Covid. Or if your kid is sick, what do you do if you send them to a daycare center? They're not allowed to go. So that goes along with flexibility for the individual, more PTO for purposes of childcare needs. It’s not just dollars. It's also the flexibility and understanding by their manager that sometimes stuff happens, and we all need to support one another when that kind of stuff does happen. Dollars help, though. Dollars absolutely help.

In what ways is this year different from years past in terms of how companies are thinking about benefits?

Am I allowed to disagree with the premise of the question? I don't know that it is different, other than having a global pandemic and still dealing with the long-term impact of what that means and what this new normal is or isn't. None of the issues that we're dealing with should be a surprise. If people were paying attention, we have had a childcare crisis in this country for decades. We've had an elder-care crisis in this country for decades. We as a nation have not been saving to have a secure retirement for decades. The 401k plan was never meant to be your only retirement vehicle. Our healthcare insurance program in this country does have holes. We've had a dearth of mental-health providers and primary-care providers for decades.

So I think that what is not different, but what is unique about this time is that the pandemic just intensified the results of all of those things that have been going on. The fact that you're dealing with all this stuff now is what you get for not having constructively dealt with it all those years that we were warning you that there's a problem. It's almost like it takes an emergency for people to wake up and go, ‘Oh, wow, this is a problem.’

It’s much like the arguments that are being made right now on climate change. Let's hope that it doesn't take a volcano coming through your backyard or a flood or a horrible earthquake to make people wake up and go, ‘Actually, what's happening up in the North Pole is important.’ I hope that it is a very humbling wake-up call that we as an American society, and certainly employer society, realize that there's a lot we could be doing to mitigate some of the long-term and even the short-term impact of some of these social, political. and economic issues that really shouldn't be that surprising to a lot of us.

You said that most of your clients already had healthcare-related travel benefits in place before the Supreme Court decision. Has Dobbs brought any new challenges in terms of how they communicate those policies to their workforce? Or the way they communicate things like fertility benefits or miscarriage leave, for those that have it?

Let's take them one by one. When it comes to miscarriage, I think a lot of employers are still struggling with that and trying to figure out what to do about it. Something that I know a lot of in our clinicians at Segal are very, very worried about, especially in states that outlaw abortion, is the access to women's reproductive healthcare providers, even if abortion is not the reason why they need that access. You can have a miscarriage and need a D&C. So I think that there's a real concern there, and I don't think it's an employer's job to solve this provider issue—a lot of employers are just trying to figure out how to best support their particular population.

That’s assuming that that employer agrees with this issue in particular. A Chick-fil-A is going to take a very different position than an Amazon. Within the belief system of an organization, they have to do what's right for their population. Some of this stuff is a little bit of a wait and see, because things are still evolving.

That said, fertility. Generally speaking, at least in my experience for corporate America, fertility benefits have been on the rise. Most of the data that we have from our health plan survey show that fertility benefits have been increasing for quite some time. What is meant by fertility benefits? That is the area that's very, very interesting. It really reflects a lot of how progressive the particular employer is, and also their location. What fertility benefits mean for an employer in California might be quite different than what fertility benefits mean for some employers in, for example, the South. But I certainly think overall we're seeing an increase in fertility benefits. Also support for gender reassignment surgery. And that's all support—it's not just time off or health benefits, but also mental health benefits, prescription drugs. It's very holistic.

With conversations about considering DEI in choosing health plans, are you seeing more questions about how to incorporate LGBTQ+ issues and gender-affirming care into those considerations?

Employers are certainly curious about it. It is really determined and decided on a case-by-case basis by the employer, in part based on their own philosophical belief systems and also their own workforce and workforce needs. Some workforces are progressive. Some are more conservative. There's no right or wrong answer here. It's dependent on the organization—that seems to be a theme here. Let me sum up the way I described it to my kids when I was talking to them about some of this stuff: The really interesting thing, but the complicated thing, about human resources is that the first word is ‘human.’ Humans are messy, and we run the gamut in terms of what we need and what we're willing to give.

That is really the essence of the employer-employee social contract: that there are two parties in this conversation, and they want to figure out how to best work and collaborate with one another so that both parties get what they want out of that relationship. That is an organic relationship, and it has some peaks and valleys every once in a while. And I think that's what we're seeing right now: a peak. Forgive me for the ‘it depends’ answer, but that's actually what makes all of this so hard and interesting all at the same time.

We're certainly getting questions about it, because HR is PR. What's happening out there in TV land impacts the workplace, whether employers like it or not. At the very least, they have to be aware that those questions are coming, and they should be prepared to answer them to the extent their organization is ready to answer them. Saying something will impact them. Saying nothing will also impact them. So they need to be aware.

That raises a different point. One of the general themes that I'm seeing across a lot of our clients is, they realize that HR is definitely PR and vice versa, and so what they put out for their open-enrollment season gets out into the public. People, buyers, analysts, investors, etc., they see what organizations are standing for and hold them accountable. And so the distinction between internal and external communications is also becoming less and less. People other than your workers are starting to hold you accountable. I would encourage organizational leaders to be both internally and externally consistent.

Is there anything else that you wanted to touch on?

One other issue that I'm hearing more conversations about going into this open enrollment season is, how do you engage people who have just picked the same benefits or evergreen into the same thing year over year over year? Like, ‘As long as some major thing hasn't changed, I'm just going to click the rinse and repeat button.’ And the answer is, maybe rinse and repeat is just fine, because you're offering what that particular population needs. But if you're really enhancing your benefits, or if you're doing something where you really need them to pay attention, be really thoughtful. If you don't want them to rinse and repeat, then you shouldn't either in the way you're reaching out to them and trying to get their attention. Because this stuff is complicated. It takes a lot of energy. A lot of people just like to think about it one time when they are first onboarded and then forget about it after that. And you know, these are important. So being thoughtful about that is something else that we're hearing a lot about. Without overwhelming people, because I think everybody's got information overload right now.

Does that include promoting underutilized benefits, in addition to getting people to just pay more attention overall?

Absolutely. If my communications folks were on the phone right now, what they would say is, let's say you sell widgets, and you've got a widget that isn't doing very well in the market. But you're like, ‘It should be. This is a really important widget. A lot of people want the widget once they know about the widget, but nobody's buying the widget.’ They would do a marketing campaign around that widget and really focus on, who are the buyers that this widget is going to help the most? Maybe they're not aware that the widget even exists. And so why treat your own employee benefits differently? Put a campaign around those underutilized benefits that you can see from other data sources, like employee surveys or manager feedback or your attrition numbers, that people need the support and don't feel like they're getting it from you, even though you're offering it.

Well then, how have you told them about it? Have you told them about it? Is it the right benefit? Maybe the ones that you have suck and you need a new provider or solution. If things are AM/FM, if they're on different frequencies, employers should figure out why. You absolutely should make a point of focusing on particular needs of the population. I'll give you one example. I went to a client recently, and—I thought this was so flipping clever—they had a specific benefit described on the inside of their toilet stalls. First of all, captive audience, right? But it was also something that apparently was only in the women's stalls, because it was related to access to some women’s healthcare issues. And I thought, ‘Well, this is where one's thinking about it. So I guess that really makes sense.’ Right now people aren't at the office as much, but I just thought that that was a very clever and incredibly practical way to go about getting the message across. So that's just one silly example of a way to kind of reach people where they are. People are tired and you can't expect them to come where you are. You have to meet them at their kitchen table, wherever that might be.

What would the toilet-stall equivalent be for remote workers?

That's a great question. I don't know. I guess it depends on the remote worker. It's a technology-based answer, right? We've been talking to one client about having  ticker tape run across their screen. At one of my prior employers, they actually created, they pushed out a screensaver with the message that they wanted to get across, about a certain training, for example. The screensaver worked, because it wasn't going away until you did what you were supposed to do. But I think that's up to much more creative people than me.