Serving up coverage for a high turnover, frontline workforce

Layer those demographics onto industry realities — turnover rates that typically range from 30 to 35%, unpredictable schedules, part-time or variable-hour employment, and limited flexibility to seek care during business hours — and the result is a population that is more likely to delay care, rely on the emergency room or disengage from available benefits altogether.⁵ For employers, brokers and consultants, the message is clear: Building effective health plans for retail and service employees requires a different lens — one grounded in how, when and where these employees actually work.

That context matters, especially as employers across industries continue to face rising medical costs, ongoing labor challenges and increasing pressure to demonstrate value from their health benefit investments. For retail and service organizations, thoughtful benefit design isn’t just a cost consideration, it’s a retention, productivity and workforce stability strategy.

For many retail and service employees, establishing an ongoing relationship with a primary care provider can be difficult, if not unlikely. Irregular schedules and limited time away from work may lead employees to rely on emergency rooms for issues that could be addressed earlier, and at lower cost, elsewhere.  Employers can help change that pattern by pairing education about appropriate care settings with benefit designs that reinforce primary care as the first point of contact, which may help navigate employees toward more convenient, lower-cost options.

Affordability remains a factor in whether retail and service employees enroll in and engage with health coverage at all. For workers paid hourly wages, even modest cost-sharing can discourage participation or delay care. Employers looking to improve benefit utilization may consider strategies that reduce out-of-pocket exposure, making coverage feel more predictable and manageable. Copay-based plans, such as Surest®, which show employees their actual costs before they receive care, can provide greater transparency and help eliminate financial guesswork. Supplemental health benefits — including critical illness, accident and hospital indemnity coverage — may also play a role, offering added financial protection against unexpected medical expenses that can otherwise create significant strain for frontline workers.

One of the most persistent challenges retail and service employees face is accessing care that fits their schedules and financial realities. Hourly work, variable shifts and limited paid time off can make it difficult to schedule primary care appointments during traditional office hours. Expanding access to virtual care and telehealth services can help close that gap, offering care options that align with nontraditional work hours. For this workforce, convenience and clarity are often just as important as coverage itself.

With 42% of retail and service employees between the ages of 16–24 and the majority of them women, employers often support employees who are navigating family planning, maternity and early adulthood health needs.^{2, 3}Benefit strategies that include contraception coverage, maternity programs, doula support, fertility support and neonatal resources can better align with this demographic profile. However, offering these benefits alone isn’t enough. Targeted, easy-to-understand education is critical to help employees recognize what’s available and how to use it, particularly in an industry where benefits literacy may be low and tenure may be short.

Retail and service employees routinely manage emotionally charged tasks: handling complaints, navigating understaffed shifts and adapting to unpredictable customer demand. These pressures, combined with irregular schedules and work-life balance challenges, can contribute to elevated stress. Modern behavioral health benefits — such as virtual therapy options, enhanced Employee Assistance Programs (EAPs) and digital mental health tools — can provide accessible support without requiring employees to step away from work for extended periods.

Unlike desk-based roles, many retail and service jobs involve repetitive motion, heavy lifting, prolonged standing and physical exertion. Not surprisingly, musculoskeletal (MSK) conditions are one of the most prevalent health challenges in this workforce, contributing to missed workdays, presenteeism and, in some cases, workers’ compensation claims.⁵ Employers can help mitigate these risks with benefit designs that include access to physical therapy, ergonomic support and digital MSK programs — helping employees address discomfort before it escalates into more serious, and more costly, conditions.