SUN-694 Relationship Between Obesity Diagnosis & Employee Retention in Self-Insured Employer Health Plans

Abstract Disclosure: J. Naber: None. M. Kuester: None. L. Chmura: None. Background: The 2017-2018 National Health and Nutrition Examination Survey (NHANES) estimates that over 40% of U.S. adults have obesity. Employers are increasingly considering weight loss treatments in health benefits and wellness programs but need to weigh key factors such as employee turnover. While promoting employee health is beneficial, it is unclear whether obesity impacts employee retention. This study explored the relationship between employee retention and obesity among subscribers of self-insured employer health plans. Objective: To determine the 10-year retention of subscribers with and without an obesity diagnosis among those with commercial health coverage through self-insured employers. Methods: This longitudinal, retrospective cohort study used the Milliman Consolidated Health Cost Guidelines™ Sources Database Plus (CHSD+). The study analyzed commercial medical claims and enrollment data (2014-2023) from self-insured employers, representing 15.8 million subscribers (employees) over the study period. Only subscribers whose plan enrollment start date was observed during the study period were included. Diagnoses of obesity and other conditions were identified using ICD-9 and ICD-10 codes. Retention rates were produced by the Kaplan-Meier estimator. Results: The study identified 3.2 million subscribers with an obesity diagnosis and 12.6 million without an obesity diagnosis in the claims data. Retention rates were significantly higher for subscribers with obesity than those without (49% vs. 26% at 5 years, 30% vs. 14% at 10 years, p<0.0001). This trend was consistent across age groups, gender, and industries (p<0.0001). Subscribers aged 30-49 with an obesity diagnosis showed the highest long-term retention among age groups (52% at 5 years, 32% at 10 years). Subscribers with obesity-related comorbidities (type 2 diabetes, arteriosclerotic cardiovascular disease, obstructive sleep apnea, osteoarthritis, generalized anxiety disorder or depression, chronic kidney disease, or chronic heart failure) demonstrated higher retention rates than the overall cohort of subscribers with obesity. Conclusions: Subscribers with an obesity diagnosis enrolled in self-insured employer plans demonstrated significantly higher retention rates than those without an obesity diagnosis. These findings suggest that employees with obesity, or obesity and a comorbidity, remain with employer health plans longer than their peers without an obesity diagnosis. Presentation: Sunday, July 13, 2025