Heart disease: The real cost to employers and workers

As we say good-bye to American Heart Month, employers are once again highlighting the importance of cardiovascular disease, the leading cause of death in the U.S. But while much of the conversation has historically focused on awareness, prevention and clinical risk, the financial impact of cardiovascular disease is often overlooked.

We know that cardiovascular conditions don’t just threaten health. They strain workplace productivity through absenteeism, presenteeism and rising claims. Productivity losses tied to chronic illnesses and injuries cost employers an estimated $2,945 per employee per year, according to the Integrated Benefits Institute. And many employers cite cardiovascular conditions as one of their top three health care cost drivers.

At the same time, employer-sponsored medical coverage continues to shift more costs to workers, and high‑deductible health plans have become commonplace. In 2025, the average family premium reached $26,993, with employees contributing an average of $6,850. In this environment, many workers lack the financial cushion to manage the unexpected costs that follow a heart attack.

Put simply: cardiovascular risk is widespread, and today’s cost‑sharing structure leaves many employees underprepared for the financial strain a cardiac event creates. Brokers and employers have an opportunity to highlight the financial side of heart health and position critical illness insurance as a meaningful part of that conversation.

Why critical illness insurance? And why now?

According to LIMRA, critical illness insurance and other supplemental health product sales declined in 2025, falling 7% in Q3 versus the same period in 2024. It’s important to note that this decrease reflects lower employee engagement — not reduced need. In fact, CI continues to play an essential role in helping employees navigate the financial aftermath of a heart attack or stroke.

CI delivers a fast, flexible lump‑sum payment employees can use however they need, whether for medical bills, child care, everyday expenses, transportation, lodging for specialty care or caregiver support. At a time when deductibles are rising and budgets are stretched, that immediate cash can be what helps families stay afloat until their medical and disability benefits kick in.

But even with its value, today’s critical illness coverage wasn’t built for the realities employees face now — higher out‑of‑pocket costs, more financial vulnerability and more complex recovery journeys. That’s why it’s time to rethink how CI is designed and delivered.

Modernizing CI design around moments that matter

Employers can modernize their benefit design to better support financially vulnerable workers and ensure protection truly works when something unexpected happens. In conversations with broker partners and employers, I emphasize that modernization isn’t about adding more products. It’s about designing an integrated system that anticipates risk, connects health events to financial protection and makes benefits simple to use.

Here are five steps employers should consider when modernizing supplemental health benefits such as CI.

1. Start by understanding your population

Employers should analyze plan utilization, absence patterns and underwriting insights to understand how cardiovascular risk shows up across their workforce. Increasingly, employers are using predictive analytics and demographic data to identify where financial vulnerability is highest. Having a modern tech stack allows organizations to remove friction and act on those insights quickly.

2. Connect health events to financial protection

After a cardiac event, the biggest stressor typically isn’t the clinical care. It’s income disruption during recovery, compounded by out‑of‑pocket bills. CI should be intentionally aligned with short-term disability, long-term disability and hospital indemnity coverage to form a cohesive safety net.

3. Simplify the experience at the point of claim

Employees shouldn’t have to piece together what their benefits mean — or which benefits they even have — during a crisis. Ideally, when a health claim is filed, the carrier automatically identifies related benefits that may apply. Behind‑the‑scenes connectivity between CI, STD/LTD, and hospital indemnity is one of the fastest ways to improve outcomes and employee experience.

4. Position CI as a complement to medical and disability insurance

Voluntary benefits exist to supplement, not replace, traditional insurance. Brokers should frame CI as the fast‑cash component that fills immediate, short‑term gaps.

A simple “what if” scenario illustrates this clearly:
If you experienced a heart attack tomorrow and were responsible for a $6,000 deductible plus 25% coinsurance, how would you pay your bills for the next 6–8 weeks?

For employees enrolled in HDHPs or saving through health savings accounts, CI can act as the shock absorber—preserving long‑term savings while covering urgent expenses.

5. Communicate beyond open enrollment and ground messaging in reality

Open enrollment alone isn’t enough. Studies consistently show that employees spend minimal time making benefit decisions and often forget what they selected. Our own consumer finance research found that employees spend 30–60 minutes selecting benefits and 53% regret their choices due to misunderstandings or missed changes.

Year‑round communication is also essential. Employers should use plain‑language scenarios, short videos, one‑pagers and infographics to explain what happens after a heart attack and how CI, medical, disability and hospital indemnity interact. Relatable, real‑life examples resonate more deeply than clinical terminology. In another one of our consumer finance surveys, only 49% of workers initially said they were familiar with CI. But after a simple explanation, familiarity rose to 89%.

It’s time to rethink how benefits work in the moments that matter — when medical and financial stress hit at the same time. When employers align benefits to real health events, connect CI with medical and disability coverage, and communicate in plain language, they make it easier for employees to get support quickly and recover with dignity.

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Stephanie Shields is head of employee benefits at Equitable. Stephanie may be contacted at [email protected].