If employees aren't engaging with the benefits available to them, what opportunities are being missed? As open enrollment approaches, many brokers focus on what will be offered next year. But before making changes, it is worth asking a more important question: are your clients’ current benefits actually working as intended? For many organizations, the answer is not as clear as it should be.
Why Traditional Plans Don’t Always Work in Practice
Every employer has different priorities when it comes to health benefits. Some are looking to provide comprehensive coverage that encourages preventive care and long-term health management. Others are focused on offering affordable plans that meet compliance requirements while managing costs for a workforce with unique challenges, such as high turnover or hourly employees.
Regardless of plan design, one challenge remains consistent. Employees often do not fully understand what their benefits include or how to access the services available to them. A plan may meet an employer's goals on paper, but if employees don't know how to use the resources it provides, much of its value can go unrealized.
Signs Your Clients’ Benefits May Not Be Working as Intended
There are clear indicators that a benefits strategy may not be aligned with a workforce. Low enrollment may be one of them, but it is only part of the picture. When employees consistently opt out of coverage, overlook services available through their plan, or delay care because they assume it will be expensive or don't know where to begin.
These situations do not necessarily mean the plan itself is inadequate. More often, they highlight an opportunity to improve employee understanding and awareness of the resources already available.
What Low Participation Is Actually Signaling
Low participation is often viewed as an employee decision, but it is usually a reflection of something deeper. Cost can be a barrier. If premiums or out-of-pocket expenses feel too high, employees are more likely to opt out or avoid using the plan. Complexity can also reduce engagement when benefits are difficult to understand or access. In many workforces, especially those with hourly or variable employees, traditional plans may not align with how employees think about or use healthcare. The result is a disconnect between what is offered and what is actually used, while your clients continue to carry the cost without seeing the value in return.
How Better Plan Design Improves Participation and Use
This is where opportunity exists. When employers begin to look at how benefits are actually being used, it shifts the conversation. Instead of focusing only on what is offered, the focus moves to how accessible, understandable, and usable those benefits are in real life. Plans that reduce complexity, lower barriers to entry, and make it easier to engage with care tend to see stronger participation and more consistent use. When employees can access care without hesitation, small issues are addressed earlier and the overall experience improves.
In many cases, gaining this level of insight requires more than just reviewing reports. It depends on having the right tools in place to understand how benefits are being used, where engagement drops off, and where barriers exist. When that visibility is paired with a simple, easy-to-navigate experience, it becomes much easier to turn access into actual usage.
Why This Matters Going Into Open Enrollment
Open enrollment is often treated as a time to renew or make small adjustments, but it is also an opportunity to reassess whether the current approach is working. If employees are not enrolling or engaging with care, offering the same plan again will not change the outcome. Continuing with the same structure often leads to the same results.
Why Benefits Should Be Designed for Use, Not Just Offered
A benefits strategy is not just about what is offered. It is about what is used. Plans that look strong on paper can still fall short if they are not aligned with employee behavior. When that happens, your clients may be paying for coverage that is not delivering the intended impact. Understanding how employees interact with benefits, and where gaps exist, creates the opportunity to design a more effective approach.
The Strategic Takeaway
Before making changes for the next plan year, take a closer look at how current benefits are performing. If employees are not using the plan, delaying care, or opting out altogether, it may be a sign that the structure is not aligned with their needs. Because the goal is not just to offer coverage. It is to offer coverage that people actually use, that removes barriers to care, and that works in the real world. For many employers, that shift starts with rethinking how benefits are designed, not just what is offered.
