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.

Open Enrollment Blog Image.

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.

  • Solution. While it may seem that a simple solution to this challenge would be to provide some training around healthcare terminology, studies show that employees rarely retain this information when making benefits decisions. Additionally, employees have difficulty throughout the year as they utilize the benefits they selected. Instead, benefits advisors should consider using a partner that provides tailored health benefits education to each member. Offering this kind of on-demand support can act as an extension of the HR and benefits team by providing members with clear answers to their questions. Employees can get a detailed overview of the health plans available to them, a consultation about which plan best fits the healthcare needs of themselves and their families, and guidance on how to make their plan selection. 

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. 

  • Solution. While HR and benefits leaders usually communicate all benefit options via company resource pages, videos, and infographics during open enrollment, they should continue to stress their benefits packages throughout the year as new employees join, in addition to the months leading up to open enrollment. Regardless, many employees don’t educate themselves on specific benefits until it comes time to use them. That is why a single source for benefit information, like a healthcare navigation solution, can help employers during open enrollment and beyond. If an employer offers care navigation, employees just need to remember to go to one solution for health benefit support. 

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. 

  • Solution. The reality is, much of the disconnect here is merely a communication barrier. The solutions that employers provide may very well address the needs of their people, but they just don’t have a full understanding of how. Instead of generalizing health benefit options to the entire workforce, employers should show that they understand different employee segments, targeting members based on those specific needs across mental, physical, and financial health. To relieve the HR and benefits teams of the sole responsibility of communicating how they can tailor health benefits, they can implement a care navigation partner that educates employees on plan options and provides personalized support based on their anticipated needs and preferences. 

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.

  • Solution. HR and benefits teams can simplify their benefits communication approach by identifying the most important information that they want to get across in advance of open enrollment. New health benefit information should be communicated throughout the year, long before open enrollment even starts. For new employees, employers should start benefits education during onboarding. Empowering employees with benefits support when they first join helps them develop a greater understanding of what health plan options are available, minimizing questions to HR during the fourth quarter.

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.

  • Solution. Empowering their teams with an external partner who can provide one-on-one guidance is something HR and benefits leaders should think about. It’s important to ensure that the partner they select can provide ongoing and proactive communication with employees throughout their care journey. These partners offer coordination of care and can help members resolve billing issues, find high-quality providers, and provide clinical guidance to optimize their health outcomes. Open enrollment is a great time for employees to build a relationship with their health guide, giving them a clear place to start when they need healthcare assistance. 

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.

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