On Inclusion and employer benefits
I recently shared about this with a colleague at work who turned out to have experienced a similar problem as she tried to include her niece on her healthcare plan. She encouraged to me share it with others. I took her advice to heart and decided to share it more widely here as I don’t think the issue is specific to me or a few others. I think this affects us all because it is about benefits and Inclusion.
I want to emphasize that this isn’t about my current employer’s (ThoughtWorks) benefits specifically. My limited research tells me that our benefit’s structure at ThoughtWorks (TW) is in several ways living out the values of inclusion that most ThoughtWorkers (TWers) share and aspire to.
Our 401k matching benefit for example is a flat amount a year in the US, whereas most companies in the world offer a salary percentage matching structure which ends up offering more savings to those who already earn more. I feel proud that we offer a flat amount rather than a salary percentage. Our time-off policy and collaborative culture allows TWers who can only be available part-time to join the community. I am a benefactor of that and have met other TWers who have benefited from that too. These are but a few of the examples of inclusion in TW benefits.
So yes, this is not specifically about TW benefits but I will keep referring to the benefits structure at TW because it is what I have had the most experience with and one I am most familiar with.
Sharing Healthcare
My interaction with employer benefits started 8 years ago when I joined TW (Uganda). I was excited to join a group of people who were as passionate about their work and how it impacted the world around them. I was introduced to the concept of medical insurance and agreed to enroll in the medical insurance benefit TW offered. This was my first time getting healthcare through medical insurance, I had always gotten my healthcare by paying out of pocket and I always assumed everyone else just did the same. That benefit also led to another first for me; the first time I saw a dentist.. haha, At 23 years old, I walked into a dental clinic, not because my teeth were hurting or anything. I just showed up to have them cleaned and wow.. the medical insurance benefit paid for it all… Good times!
But my spree of enjoying these benefits soon encountered a hard place when I learned that you could share the benefit with family members and attempted to extend healthcare to my younger brother. Through a series of hard and frustrating conversations, I learned that my relationship with my brother did not match the criteria in place and there wasn’t really much, I or others at TW could do to change that.
My brother is okay today and still gets his healthcare the old fashion way, you know.. by paying for it with cash. But I continued to wrestle with this healthcare benefit I apparently earned by being an employee of TW and was apparently available to other people who are related to me in a very specific way, defined by a council of my employer, an insurance company and probably a national government. I thought it was wonderful that I could share medical insurance benefit with someone else but I still maintain that it is absurd that employers + insurers get to define who is deserving/eligible to share in the benefit.
For full disclosure, I have made no secret about my concerns about any form of insurance. But insurance itself is not where I am seeing the opportunity to advance inclusion here. I understand that we have agreed to provide healthcare to most people in the US through (employer associated) medical insurance. The key thing there is healthcare provision. It’s something we want to make available to more people. 8 years ago, it was my brother and today, well today it’s my aunt. And it’s easy to miss the heart of the problem here because you hear the miss again in my emphasis of those people’s relationships to me as though it was those relationships and not their need that somehow qualifies them for sharing healthcare. I don’t think they deserve healthcare anymore than they deserve food. The point is that they need it because they may be ill, just like a hungry person would need food and if I am, by some means able to share healthcare or food with them, then I want to be able to. Whether they are my children or my spouse or my next door neighbor is in my opinion, irrelevant to the problem.
This issue is indeed much bigger than a single company but because employer provided medical insurance is how more people are receiving their healthcare in society today, I think we (the employed) have the opportunity to make more inclusive our collective ability to share healthcare with those around us who are not as privileged as we are.
I have had several calls with my current insurance provider on this and on the most recent one, they maintain that the exclusions are a company policy that only my employer can change so I have provided this feedback TW and as you can imagine, policy changes in areas so widely rippling require more rigorous discussion and can feel slow. While all this happens, I am still not able to share healthcare with my aunt and I can’t help feel that I can do better as I wait for policies to be changed.
401k matching
I turn now to the retirement savings benefit I praised earlier. I want to repeat that I understand employer benefits are complicated and some of them have an even longer history full of very commendable positive intentions but let us evaluate the current state of 401k matching. Most medium to large companies in the US have a benefit of matching one’s retirement savings up to a certain amount. I learned last month that more TWers claim this benefit every year than those who don’t... which is pretty good I think but when I consider for a moment what kind of TWer doesn’t have $$ to save for retirement with 401k every year, it quickly occurs to me that it’s probably a TWer who is pressed for other daily living costs like food, housing, healthcare, debt, etc. It has bothered me for several years now that our response to that TWer’s plague is to not give them any money to save for retirement.
We are basically saying,
hey, are you well off enough this month, this year to have some money to save on every paycheck? … well, good for you; here’s some more $$ to save. And hey, are you too pressed to save anything this month? well, too bad, hope you have some money to save next time
I will think it would be more inclusive if we gave every TWer the $$ we have budgeted for their savings every year whether or not they save it too and whether or not TW gets tax benefits from it. However, very similarly to the sharing healthcare problem; the issue of saving and what counts as good saving habits are things that are so personal and rightly far removed from companies that a broad policy would not address the problem well. I would rather we simply gave people $$ cash and trusted them to spend it well or recklessly or save it for a rainy day. If they should choose to put it in a retirement savings account or cover an unexpected expense that month; what is that to anyone else?
I think the same of our conference attending, transit, fitness benefits, etc. The idea of giving adults money that is predetermined for specific purposes feels parental to me and a parental relationship ought to be between parents and their children not adults and their employers. But I digress. I think in order to remain alive to the injustice in our communities, individuals need the agency to share their privileges and bear the cost. If benefit policies constrain that individual agency in some way, then I think we should reconsider the purpose of those policies and question whether they indeed advance our shared cause for Inclusion.
Hypocrisy, cowardice and probably desperation
I have thought about why I am choosing to speak up on this now when I have been aware of these issues for almost 8 years now and I have not come to clearer answer except that I feel I could have spoken up sooner. Maybe it’s because it has become unbearably hard for me to cowardly live around those most impacted by lack of healthcare while enjoying my well medically insured, almost ready for retirement lifestyle. Maybe it’s because I recently got my greencard approved which serves as a more secure employment authorization in the US than the L1 visa I had before. Maybe it’s because I encountered yet another people near me who lacked and needed healthcare. It’s probably all those reasons and more.
It’s not lost on me that I am raising concerns about optional benefits I choose to participate in everyday, every year and whose structure has at least provided healthcare and retirement savings for me. I could simply opt-out today so I am considering just that.
In what has felt like a desperate attempt to feel unstack, about a month ago; I asked to have my relationship with TW changed from employer to contractor so I can have more agency in how I share my benefits with those I chose. I don’t think this is a good or scalable solution at all and now I know that it’s unlikely that TW can accommodate for that change given our current priorities as a company and the associated IRS liability issues that would arise from an employee turning into a contractor overnight. It is also not a good solution to the bigger problem of inclusion because it’s also not easily replicable for others but it’s where I am now; seeking a team who will have me as a contractor or independent consultant.
If others have resources specifically on alternatives to medical insurance, please share them directly. Advice, words of encouragement, critic, correction, clarifications are very much welcome. I often joke about how I considered marrying my brother so we could share healthcare benefits.. not everyone finds that joke funny but it helps bring the absurdity in all this into perspective for me. So any stories of others navigating similar challenges are welcome.
Thank you for reading this.
While you are here, I am fundraising to help cover the cost of life saving surgery for my Aunt. If you are able to, please consider donating.
If you enjoyed reading this, please consider sharing it. I appreciate the feedback and encouragement.
