%20(1).jpg)
In most organizations, benefits strategy still starts with the offering.
What should we add?
What are competitors doing?
Where are we behind?
Those are reasonable questions. But they’re not the ones that determine whether your benefits actually work.
Because once Open Enrollment ends, the strategy changes. Not on paper, but in practice.
Employees stop thinking about benefits as a set of options and start encountering them as real situations. A prescription that costs more than expected. A referral they don’t know how to navigate. A benefit they vaguely remember choosing but don’t quite understand how to use.
That’s where the gap shows up.
Not between what you offer and what you intended. Between what’s available and what actually gets used.
It’s tempting to think the hardest part of benefits is helping employees choose the right plan. In reality, the more consequential moments come later.
They tend to look ordinary on the surface.
Someone is trying to find a therapist and isn’t sure where to start. Someone refills a prescription and doesn’t question the price. Someone puts off a preventive visit because they’re not confident it’s covered.
None of these feel like “benefits decisions” to the average employee, even though benefits leaders know they are.
And they happen in moments when employees are not looking to become experts in their plan. They’re trying to solve an immediate problem and move on.
Even when access is broad, usage patterns vary significantly across employee populations, and many high-value benefits remain underutilized (BLS, 2025). The issue is less about availability and more about what happens when someone actually needs to use what they have.
Most employees are aware that they have benefits, but fall short in understanding how and when to use them.
Understanding coverage often requires piecing together multiple sources of information. Finding the right provider can feel uncertain. And making a decision carries some level of financial risk.
So people make reasonable trade-offs.
They go to the provider they already know. They accept the first option presented to them. They defer decisions that feel unclear.
Not because they don’t value the benefit, but because the effort required to use it outweighs the perceived upside in that moment.
At the same time, expectations are shifting. Employees are increasingly used to experiences that adapt to their context and reduce decision-making effort. That expectation is now extending into how they interact with benefits (Gartner, 2026).
When using a benefit feels complicated, it falls down the priority list quickly.
One of the more persistent habits in benefits communication is treating the workforce as a single audience.
In practice, employees approach decisions from very different starting points.
A parent coordinating care for a child is focused on convenience and timing. An early-career employee may still be learning how deductibles and networks work. A caregiver is often managing multiple appointments, costs, and trade-offs simultaneously.
When all of them receive the same message, it tends to land as background noise.
Segmentation doesn’t require a complete overhaul of your communication strategy. It requires recognizing that relevance drives action. When a message reflects the situation someone is actually in, it is far more likely to influence what they do next.
Distribution is often treated as a secondary decision. It shouldn’t be.
Email remains important, but it is rarely where decisions are made. Most employees do not go back to a benefits email when they are standing at the pharmacy or trying to schedule care.
The organizations seeing stronger engagement are placing guidance in more immediate environments. That can include team-level conversations, internal channels organized around shared experiences, or manager-led reminders that connect benefits to real situations.
The goal is not to increase volume. It is to reduce the distance between a question and a useful answer.
A large share of benefits communication is designed to explain. It outlines what is available, how coverage works, and where to find more information.
That foundation matters, but it is not what drives behavior in the moment.
When an employee needs care, the question is not “what benefits do I have?” It is “what should I do right now?”
That shift changes how communication needs to work.
Instead of expanding on options, it helps to narrow them. Instead of providing more detail, it helps to provide a clear starting point. Instead of assuming exploration, it helps to guide the next step.
In practice, that might mean pointing someone to a specific place to begin their search, clarifying what to check before paying a bill, or highlighting the most relevant option given their situation.
In those moments, clarity and direction tend to matter more than completeness.
Improving utilization does not require redesigning your entire benefits experience.
It usually starts with identifying one moment that is already creating friction.
In many organizations, those moments are consistent. Questions about unexpected costs, confusion around claims, and difficulty accessing care tend to surface repeatedly.
One example we see often is confusion around medical bills.
Employees receive an explanation of benefits, then a bill from a provider, and aren’t sure what’s accurate or what they’re actually responsible for. The result is predictable: they either overpay, delay payment, or reach out to HR for help.
Instead of trying to fix “claims confusion” broadly, narrow it down.
Start with employees enrolled in high deductible plans, since they are most likely to encounter this early in the year.
Then build a simple path for that moment:
“If you receive a bill, here’s what to do first:
Keep it to one screen. Put it somewhere employees can easily find. Reinforce it once or twice through the channels they already use.=
That one change won’t solve every billing question, but it will reduce confusion in one of the most common and stressful moments employees face.
From there, you can repeat the approach in other areas.
Benefits don’t fail because they’re missing. They fail when they’re too hard to use in the moments that matter most.
When you remove that friction, employees don’t need more benefits—they start getting more value from the ones they already have.
