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Employees Still Struggle to Understand Health Benefits: How You Can Inspire Benefits Brilliance

Posted by EmployeeChannel on 10.12.2016


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Employees still struggle to understand healthcare benefits. Here's how you can inspire benefits brilliance during Open Enrollment and beyond.

Open enrollment season is almost upon us, meaning your HR staff may soon be flooded with questions about out-of-pocket maximums, per-paycheck costs, and the differences between old and new plans. You’re not alone.

A new study released by United Healthcare sheds light on the extreme confusion around basic healthcare benefits knowledge and the overwhelming tendency for employees to engage a professional rather than seek answers to benefits and open enrollment questions themselves.

The data speaks to a very serious rift between employee needs and the current landscape of benefits education and enrollment resources, emphasizing the need for more engaging, comprehensive, and easy-to-use digital tools.

Dazed and Confused by Healthcare Benefits

Of the 1,011 people surveyed by United Healthcare, only 7% of respondents were able to explain the four basic health insurance concepts: plan premium, deductible, co-insurance and out-of-pocket maximum. These respondents have likely gone through at least one, if not many open enrollment seasons, suggesting that personal healthcare decisions are made without a complete understanding of the terms.

And though nearly a third of respondents are comfortable using the internet or mobile apps to comparison shop for healthcare, they overwhelmingly prefer (78%) to engage a live customer rep on the phone to have their open enrollment benefits questions answered.

Technology is taking a greater role in the benefits and open enrollment experience, but employees still don’t feel they’re given the right tools and resources to make effective personal decisions. Individual needs are clearly not being met with the benefits status quo.

This research supports the survey of HR leaders we conducted earlier this year. 82% of HR executives indicated that healthcare benefits are the number one reason employees contact HR, and overwhelmingy agreed that employees prefer to communicate directly with HR via phone, email, or face-to-face meetings rather than use HR help desks or ticketing systems. 

The research begs the question: Why do so many employees seek one-to-one communications around their healthcare benefits?

The likely answer is that employees want to make requests that require privacy, immediacy, and personalized responses, and no acceptable self-service options are available to them. This problem, coupled with a lack of comprehensive and engaging benefits resources, means employees are rightly confused where to turn for help, and HR must work overtime to address their needs. It’s time to reverse this trend.

Inspiring Benefits Brilliance with the Right Tools and Strategies

Cultivating your team's benefits smarts doesn’t necessarily require a complete overhaul of current processes, but it does demand a clear understanding of ineffective programs and a better sense of how your employees prefer to receive and learn information.

Here are some tips to get started:

Simplify the Experience

Healthcare benefits are inherently confusing to the vast majority of people. As United Healthcare discovered, even the most basic health benefits concepts are not universal truths. Couple this with a healthcare system in constant flux and plans that change from year-to-year, and you have a recipe for turmoil.

Both employers and healthcare providers should do what they can to simplify the process of learning about and applying for healthcare benefits. The traditional benefits booklet, intranet documentation, and kitchen poster are all helpful in theory, but our research shows that employees are still reaching out to HR en masse with benefits questions and requests. 

In fact, resources like this may cause more confusion because they’re often quite meaty, lack an educational component and personalization, and tend to be written in medical or legal jargon. The more focused, straightforward, and easy-to-understand you can make outreach, benefits education, and ongoing benefits support for each employee, the more successful your benefits enrollment strategy will be.

Consider A Year-Round Focus

Open Enrollment season bears the greatest influx of benefits questions, but employees have questions and concerns about health benefits all year that substantially affect their lives, future Open Enrollment decisions, and HR's time. 

Here's a dirty little secret about benefits education: most people aren't interested in learning new rules or concepts until they actually have to use them. 

People tend to be reactive rather than proactive, especially when it comes to something that is not top of mind or that is confusing to them. You can go to great lengths to better educate employees during an Open Enrollment season, but until an employee is actually at the doctor's office confused about a copay or prescription charge, these concepts really don't hit home. 

Benefits tools and resources should be available year-round and immediately helpful in an employee’s moment of need. Making health and benefits understanding a year-round priority will also alleviate some of the stress of Open Enrollment and inspire greater employee confidence in personal benefits decisions. 

Design for User Interaction, Education, and Personalization

Navigating through PDF booklets and intranet documentation is a tedious and often complex process from an employee's perspective. You’re lucky if any employee reads through everything and even luckier if they walk away without questions related to how the information actually pertains to them.

Traditional benefits resources, while thorough, are not designed for interactivity, the ease of anytime, anywhere learning, or the unique needs of individual employees. 

Consider incorporating video in your open enrollment and benefits education resources. It is well documented that video can improve learning results and that visuals are processed significantly faster by the brain than text. Even if your benefits resources are comprehensive and include educational documentation, you may have already lost your employees with text overload.

Processing print isn’t something the human brain was built for. The printed word is a human artifact. It’s very convenient and it’s worked very well for us for 5,000 years, but it’s an invention of human beings. By contrast Mother Nature has built into our brain our ability to see the visual world and interpret it. - Marcel Just. Director of the Center for Cognitive Brain Imaging at Carnegie Mellon University

Personalization can also be an extremely important part of learning and the comprehension of difficult topics. Employees will better grasp healthcare concepts if education is tailored to their unique learning styles, if learning resources are easily accessible and available instantly in their moment of need, and if they can understand these concepts in the context of their own unique situations. 

We’ve built personalization into the EmployeeChannel App, which delivers real time, individualized responses to an employee's healthcare benefits and HR-related questions. The app is a modern, moment-of-need resource for employees, and saves HR considerable time from fielding basic tier 1 questions.

Employees should feel that they're taken care of, and in control of their healthcare and wellness, at all times. A mobile self-service resource that provides critical information (both educational and personal) in an employee's moment of need is a great place to start. 


To inspire benefits brilliance in your organization, the healthcare benefits experience must be simple and straightforward, benefits education must be a year-round priority, and benefits tools and resources must be designed for user interaction, personalization, and moment-of-need availability. 

Want to see how EmployeeChannel inspires year-round benefits brilliance?
Request a demo!

Topics: benefits enrollment, benefits education and decision support, benefits engagement, employee communication

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