A Compelling Argument for Accident Insurance in California

by Dan Schmid

As employers shift more health care costs to workers, offering voluntary benefits has become an increasingly important way to offset health insurance coverage gaps. But employers need advice on what voluntary benefits to offer; and workers need help deciding what benefits to purchase.

This creates growing demand for benefit brokers to provide the products and guidance that benefit everyone involved. Benefits brokers can take a more consultative sales role by using data to provide insights into the needs of demographic groups in the workplace.

Take accident insurance. Instead of starting a conversation with employers about the product features (something that employers could glean from a brochure), what if you could present a vivid picture of the scale, nature, and costs of accidents in the state or states in which they do business? Accident insurance generally covers a variety of circumstances ranging from sports mishaps to automobile collisions, and data on California team sports participation and injuries can help employers analyze the needs of a large part of their workforce: employees who are parents of school age athletes and are themselves physically active.

Sports injuries are a part of life for parents with active children. In fact, more Californians participate in each of five popular team sports — baseball, basketball, softball, soccer, and volleyball — than do residents in any other state, with nearly half the participants being age 22 and younger. Californians make over a quarter of a million annual ER visits (approximately 290,000) due to participation in seven popular team sports, according to a recent Sun Life Financial study. Throw in other sports — lacrosse, cheerleading, skiing, rollerblading, and skateboarding — and the number of emergency room injuries in the Golden State is even higher.

What Are The Odds Of a Team Sports Injury?

At first glance, the risks of a sports injury may seem modest: A household playing two sports (baseball and basketball) has a 28% chance of sustaining an ER injury in five years. But add a third sport and the risks rise significantly: A family has a more than fifty-fifty chance of experiencing an ER injury in five years if the household has at least one participant playing football, basketball, and soccer each year.

The Growth of High Deductible Health Insurance Plans Are Adding To the Costs of These Injuries 

The average emergency room injury from a team sport hasn’t traditionally posed a financial burden on a family covered by medical insurance. Though emergency room injuries average $3,000 to $4,000 nationally depending on the sport, medical insurance has typically picked up over 80% of the cost for treatment, whether sports related or otherwise, according to Sun Life estimates.

Yet, one-fifth of the U.S. workforce has high deductible medical insurance, a five-fold increase in seven years. If that adoption rate continues, nearly half of the U.S. worker population could soon have high deductible health insurance. Since the average cost of high deductible health insurance plans is about $4,000 per year for aggregate family plans and about $2,000 per year for individual plans, many workers could end up paying for most — or even all — of the costs of a sports injury. For example, if your insurance carries a $4,000 deductible, and your son winds up in the ER with a football injury, you could pay $4,000 of the estimated $4,500 cost of a football injury.

And if the worker is the one to experience the injury, they could also face the financial impact of lost wages, if they have to take time off from work.

The following estimates provide a clearer picture of California sports injury risks and costs:

• Basketball is the most popular of the seven team sports in California, with approximately 2.85 million participants — the largest basketball participation level of any state in the nation. Although its national ER injury rate (4%) is not half as high as football’s (8.5%), basketball’s popularity means the sport is projected to send the most Californians (approximately 114,000) of the seven team sports to the emergency room this year, at an average estimated national per player cost of $3,700.

• Football is not even half as popular as shooting hoops in California. But since the gridiron’s injury rate is over twice that of basketball’s, football causes the second highest number of ER visits (approximately 62,000) of the seven team sports, at an average estimated cost of $4,500.

• Soccer is projected to send the third highest number of Californians (46,000 out of 1,600,000 players) to the emergency room, at an average estimated cost of $4,200.

• More Californians participate in rollerblading (647,000) than do residents in any other state, at an average estimated ER medical cost of $4,200.

• Downhill skiing annually attracts over half a million Californians (670,000), more than in any other state except New York. The typical California skier hits the slopes for only four days a year, but that skier triggers the costliest average ER visit of thirteen team sports and recreational activities: an estimated $7,000.

Starting an accident insurance conversation with employers by outlining sports injury incidence rates that are relevant to their workforce can reshape how employers approach their benefit plan design and how they perceive your role as a consultative partner.

When diving deeper into a group’s voluntary accident benefits with employers, the following questions can help evaluate and provide clarity on the appropriate solutions:

• Are coverage benefits for spouses and children equal to those for employees?

• How wide is the range of coverage options?

• Are urgent care facilities covered?

• Are prescription drugs related to the accident covered or optional?

• Is the plan portable?

The act of selling products can be commoditized. But the most effective benefit carriers will provide not only product solutions but also the data, tools, and insights to help you become indispensable to employers in a competitive world.

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Dan Schmid is Vice President and the Western U.S. Market Leader for group benefits at Sun Life Financial. Sun Life Financial is a leading international financial services organization providing a diverse range of protection and wealth accumulation products and services to individuals and corporate customers. The Sun Life Financial group of companies operates under the “Sun Life Financial” name strictly as a marketing name, and no legal significance is expressed or implied. In the United States, Sun Life Financial, through its member insurance companies, provides a range of products and services to employers and their employees, including group and voluntary accident, critical illness, dental, disability, life, and stop-loss insurance products. Visit ­
www.sunlife.com/us for more information.