Healthcare employers say medical bills are workers’ top money worry

Retirement plans show the strain

Respondents said 61 percent of participants contribute just 1 to 3 percent of pay, and only 11 percent contribute more than 7 percent. Automatic enrollment is common, with 77 percent of plans using it, up from 62 percent in 2024. Default rates tend to be low, so thin contributions may reflect defaults as much as financial pressure. The survey does not test whether medical costs are the cause.

Other data points the same way. A Gallagher employee assessment paired with a survey of 3,717 US organizations found 27 percent of workers have no emergency savings and another 24 percent have less than three months. Vanguard reported a median hardship withdrawal of $1,900, with 31 percent taken to pay medical expenses.

SECURE 2.0 lets plans offer non-highly compensated employees a pension-linked emergency savings account of up to $2,500, funded with after-tax Roth contributions, as HRD America reported.

Coverage that goes unused

Cover meant to ease medical bills often goes unclaimed. A Nayya review of 6.7 million medical claims found 1 in 4 enrolled employees leave supplemental benefit payouts unclaimed, with the average unclaimed hospital admission payout at $1,080. Separate research found that more than half of workers with a recent medical event paid at least $1,000 out of pocket. Only 28 percent said they were very prepared to cover a bill that size.

What respondents asked for

Transamerica’s report said survey comments showed a recurring theme. Employees need simpler, more personalized and more accessible planning support.