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Guiding employees through the top 5 challenges of open enrollment with care navigation.

By Sophie Schamp

By implementing a care navigation solution, employers can remove the stress of navigating members through open enrollment, leading to a better employee experience.

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As a result of the pandemic, employers started to see the needs of their workforce drastically shift. Employees are now placing greater importance on their health and well-being and demanding better healthcare benefits from their companies. As employers expand benefits packages to meet the changing demands of their teams, they’ll likely need additional planning and execution for a successful open enrollment period.

The fourth quarter is the busiest time of year for HR and benefits professionals as they support their employees in navigating through the open enrollment process. 35% of employees admit that they don’t have a general understanding of their health benefits or what plans their company offers, and rightfully so. But, HR and benefits teams don’t need to go into crisis mode as they prepare for open enrollment. Many of the challenges employees face through open enrollment are manageable with a little extra planning. Becoming aware of the challenges members face during open enrollment helps employers better engage with their teams to help them choose the health benefits best suited for their needs.

1. Challenge: Employees don't understand basic healthcare terminology.

Studies show that most consumers have low healthcare literacy, with 96% of Americans not understanding basic health insurance terms like deductible, coinsurance, copay, and out-of-pocket maximum. When employees don’t have a general understanding of these healthcare terms, they are unable to effectively compare health plans. This knowledge gap can have outsized consequences during open enrollment, causing an employee to select a plan that may not be the best fit.

2. Challenge: Employees don't understand what health benefits are available to them. 

Employees don't have a good understanding of what health benefits their employers offer. For instance, only 42% of employees know whether they are eligible for a health savings account (HSA) under their current plan. To further add to the complexity, health benefits can change each year as plan sponsors add new or alternate options that they roll out to their teams. 

3. Challenge: Employees don't feel that their health benefits address their personal needs. 

HR leaders are constantly trying to ensure that the benefits they offer meet the demands of their people. However, 92% of employees have expressed that their employers could do more to address their individual wants and needs. With all the new requests of the HR function, HR and benefits teams don't have the time or resources to pick out health benefits tailored to each employee's personal needs. 

4. Challenge: Employees don't have time to read healthcare benefits-related materials and communications sent during open enrollment.

The influx of communications, presentations and benefits overview guides sent during open enrollment can overwhelm employees, forcing them to balance their time between work, personal responsibilities, and benefits selection. While HR and benefits teams work hard to educate employees during open enrollment, 46% of employees believe that their employer doesn’t communicate with them about their health benefit options before the start of open enrollment, leaving them scrambling to read relevant materials in too short of a timeframe.

5. Challenge: Employees don't know who to go to for healthcare benefits related questions after open enrollment.

Employees are confused about what happens after they choose their health benefits and who to reach out to for any questions they may have after they’ve selected a plan. Some of the questions employees might ask are, “can I change my benefits after open enrollment”, “how do deductibles work”, and “is my current doctor still in-network”? The complex healthcare landscape leaves employees struggling to find answers to their questions, leaving them to seek additional guidance from their HR and benefits teams whenever they need care.

A single hub to navigate employees through open enrollment.

HR and benefits teams work hard to set up their people with a positive open enrollment experience and that starts by understanding the challenges teams face during the process. As an employer, understanding these challenges can help transform the open enrollment process for teams.

In a complex industry with confusing terminology and a matrix of health benefit plan options, care navigation can provide employers with a solution to ease some of the pain points of open enrollment. High-touch, high-impact platforms powered by health guides can provide actionable guidance, optimizing health outcomes and lowering healthcare spend while supporting employees through the benefits decision process. Health guides can educate employees about the health benefits available to them that are best suited to their needs and increase adoption and utilization, transforming the member experience. 

By implementing a member-first care navigation solution, employers can remove some of the stress of navigating employees through open enrollment, leading to happier, healthier, and more productive employees.

Ready to guide your employees through a better open enrollment? Let’s talk.

Personalized support creates healthier members.

Learn more about our care navigation and PBM solutions.

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