Traditional benefits education often fails because it’s delivered at the wrong time and in the wrong way. Most education happens during open enrollment, when employees are asked to absorb complex information months before they actually use their benefits. As a result, employees don’t realize they’re confused until a claim is denied or an unexpected bill arrives. At that moment, enrollment guides and past emails feel inaccessible and irrelevant.
Confusion most often arises around cost-sharing concepts (deductibles, copays, coinsurance, and out-of-pocket maximums) especially in high-deductible health plans. Employees may understand individual terms but not how they interact in real-world scenarios. From the employee’s perspective, their issues feel like system failures; from the plan’s perspective, they are standard outcomes.
When stress is high, more employee education doesn’t help, not by itself. What employees need in these moments is interpretation: clear, empathetic, real-time guidance that explains what’s happening, why it’s happening, and what to do next. Without that support, benefits questions spill over to HR, providers, and carriers, draining time and eroding trust. Closing the gap requires shifting from traditional benefits education to ongoing, situational support that meets employees when it matters most.
See the full article on EBN for more information.
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