Surcharges, mask mandates: Motivating the unvaccinated?

Delta Air Lines made waves when it recently announced a $200 monthly health insurance surcharge for unvaccinated employees. Now, experts say many other employers may soon follow suit.

New data proves the strategy may be quite effective in boosting vaccination rates among unvaccinated workers.

Nearly three-quarters of unvaccinated Americans say that an extra monthly fee for health insurance could coax them into receiving the vaccine, according to a new survey of 1,000 unvaccinated people from More than four in 10 (43%) would be motivated by a surcharge to get the shot, while an additional 23% say surcharges may motivate them. Thirty-one percent responded that the surcharge would not motivate them.

“Money is a pretty strong motivator,” says health insurance expert Dr. Noor Ali. “If other facts and figures such as global deaths and hospitalizations due to COVID-19 have not yet been an effective motivator, money could be the next best factor.”

Related: Surcharges for the unvaccinated: Will interest grow?

The survey found that 63% of the respondents say that charging an extra $100 a month or less would be enough to convince them, while 17% say they would require more than $200 a month to feel enough pressure to get the shot.

Delta Air Lines became one of the first well-known companies to announce it would penalize unvaccinated employees with health coverage fees–both in hopes of convincing more employees to get the shot and to address the financial risk that comes with having unvaccinated employees. Beginning Nov. 1, unvaccinated employees of the airline who are enrolled in its account-based healthcare plan will pay a $200 monthly surcharge. So far, the airliner’s strategy seems to have worked: There have been no spikes in resignations, and 20% of Delta’s unvaccinated employees have already gotten the jab in just two weeks of the announcement, with hopes of more following suit, according to CNBC.

“This can be an effective strategy for employers because it is very easy to deploy, execute and monitor,” Ali says. “For large corporations, it can be as easy as adding a surcharge to their benefits deductions and a simple survey post-policy to measure the efficacy of the change.”

Although President Biden recently announced plans to mandate all employers with more than 100 workers require employees to be vaccinated or test for the virus weekly, a surcharge still is likely to be a strategy embraced by employers. Although rules aren’t out for Biden’s order yet, it won’t cover all employers, so many organizations will likely develop plans of their own to boost vaccination rates. Meanwhile, other employers can, and likely will, embrace their own vaccine mandate plans–or other strategies, like surcharges–before Biden’s rule goes into effect.

Employers have widely embraced “carrots” when it comes to incentivizing their workers to get vaccinated against COVID-19. But after months of waning vaccination rates, combined with the emergence and rise of the deadly Delta variant, more employers are turning to “sticks,” like surcharges, vaccine mandates and other penalties in hopes of boosting vaccination rates.

The survey also finds that, in addition to surcharges, other rule changes could motivate employees. Of those surveyed, 53% said that a mask mandate solely for unvaccinated employees would maybe or definitely motivate them to get the vaccine, while 56% said that losing paid time off for quarantining after a positive test result would maybe or definitely motivate them.

Experts predict Delta will not be the last company to roll out a surcharge policy. Wade Symons, a partner at Mercer, says he’s fielded calls from a number of employers over the last several weeks who want to discuss the possibility of implementing surcharges for unvaccinated workers. “It’s a conversation that’s on a lot of [employers’] minds.”

“You have to move that needle to get vaccination levels higher,” Symons says. “A lot of your employees don’t want to work knowing they’re around unvaccinated people. It doesn’t make them feel safe and secure.”

Kathryn Mayer
Kathryn Mayer is HRE’s benefits editor and chair of the Health & Benefits Leadership Conference. She has covered benefits for the better part of a decade, and her stories have won multiple awards, including a Jesse H. Neal Award and honors from the American Society of Business Publication Editors and the National Federation of Press Women. She holds bachelor’s and master’s degrees from the University of Denver. She can be reached at