How employee benefits decision support raises enrollment

In EBRI’s 2024 Consumer Engagement in Health Care Survey, half of privately insured adults spent less than an hour choosing their health plan, and three in 10 spent less than 30 minutes.¹ That decision sets a household’s coverage and costs for the year ahead. The same survey also measured how well enrollees understand the plans they pick.

Only one in four knew that prescription copays vary by drug category.¹

The cause is rooted in something we’ve all talked about in this space: benefits literacy. Employees can’t weigh what the deductibles and cost sharing in front of them actually mean, and plan designs keep shifting into less familiar structures, like HDHPs. When the options don’t make sense, the safest-feeling move is whatever worked last year.

That’s the problem employee benefits decision support exists to solve. And when it’s done well, the numbers brokers and carriers watch actually move: participation, supplemental elections, and the utilization everyone looks at when renewal comes around.

Why employees pick the wrong benefit plans

The evidence on how people choose benefits is consistent, and a little bleak. In Voya’s research:²

• 91% of employed Americans typically re-select the same health plan as the year before
• 49% spend less than 20 minutes reviewing their options
• Just 3% can explain the full benefits of an HSA

One finding shows how little of the choice actually comes down to the plan. When offered a PPO and a high-deductible plan, employees chose the PPO 74% of the time. When researchers removed the words “high deductible” from the plan’s name, the split moved to 52/48, with the PPO only slightly outperforming the HDHP.² One simple label change swung a population’s elections for the full plan year. Framing was doing the choosing, and closing that gap is exactly what guidance is for.

What employee benefits decision support does

Benefits decision support is a guided, personalized plan recommendation. Instead of handing employees a table comparing options and wishing them luck, it meets each person with a recommendation built on their situation. We covered the category in depth in our post on what a benefits decision support tool is; the short version is that it turns a menu into an answer.

Pasito’s Decision Support leads with a proactive, personalized recommendation, removing the lengthy intake forms that kill engagement before it starts. The recommendations draw on a claims database covering 270 million Americans, connect to the client’s HRIS, and span the full package: health, retirement, and voluntary plans.

One clarification worth making, since the terms get blurred: decision support doesn’t replace the enrollment platform. Employees still make their elections in the benadmin. What changes is what they carry into the benadmin system: a clear best-fit answer instead of a guess, which lifts utilization, engagement, and even employee retention.

What happens to enrollment when guidance shows up

Employees want the help. In Voya’s supplemental benefits research, 84% rated a guided, interactive tool that gives customized benefits guidance as important to their decisions.³

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And when employees get the help they need, elections move. Across Pasito’s carrier partners, decision support utilization averages 37%, roughly three times the rate of the incumbent tool it was measured against. Client outcomes follow the same pattern: an e-commerce company running its first open enrollment saw supplemental health insurance elections rise 92% and HSA participation rise 70%, a 2,000-person trades software company lifted FSA contribution volume 68%, and a 200-person smart home technology company more than doubled its FSA contributions year over year.

Why consultants and carriers should care

For brokers

Benefits decision support offers renewal-proof value. It generates outcomes you can put in front of a client: participation, election mix, engagement. It also cuts the question load during open enrollment, since employees who got a recommendation don’t email the consultant asking which plan to pick.

For carriers

Guided recommendations lift the elections that matter to the entire book of business: core health lines, supplemental lines, voluntary lines, HDHP selection, HSA/FSA and retirement contributions, and more. And because employees elect coverage that actually fits, persistency improves. A benefit chosen for a reason gets kept for one.

There’s a data advantage, too. Because your plan offerings show up on the platform, engagement and recommendation data accumulate in real time. Now you can walk into the renewal conversation with real numbers in hand.

Rolling out benefits decision support well

Having launched decision support for thousands of companies, our team has found these three principles guide the most successful rollouts:

Push it where your people operate: A link in your internal portal gets buried quickly. But enrollment campaigns reach employees in their inbox, on their phone, and in Slack or Teams, linking straight to the microsite and decision support.

Pair decision support with easy answers: Benefits often raise questions. Having an AI benefits assistant grounded in the actual plan documents can help you handle those questions 24/7, minimizing the load on HR and the consultant.

Keep benefits support on after the OE window: New hires, qualifying life events, and mid-year plan questions happen all year long, and each situation translates into a benefits decision. Decision support that stays available year-round keeps working for your group long after the open enrollment window closes.

Benefits enrollment follows education

Employees under-enroll (or make the more expensive choice and underuse it) when nobody makes benefits options easy to understand, no matter how good the plans are. Employee benefits decision support clears that confusion, and enrollment follows once employees really know what they’re getting. Pasito turns that principle into numbers consultants and carriers can bring to renewal.

FAQ

Is decision support the same as a benefits administration platform?

No. Enrollment itself happens in the benadmin. Decision support is the guidance layer that comes before it, helping each employee arrive at their election with a recommendation instead of a guess. The two work together.

Does decision support push employees toward the cheapest plan?

Good decision support recommends the best fit for each person. Pasito’s recommendations draw on claims data from 270 million Americans plus each employee’s own situation, and sometimes the right answer is richer coverage.

How much can decision support change enrollment?

It depends on the starting point and the rollout, but among Pasito clients, results have included a 92% rise in supplemental health insurance elections and a 68% lift in FSA contribution volume. Proactive delivery through email and SMS campaigns is what separates those outcomes from a tool nobody opens.

References

1. EBRI and Greenwald Research, “2024 Consumer Engagement in Health Care Survey.” https://www.ebri.org/content/new-health-care-report-of-2-000-privately-insured-adults-surveyed-in-the-united-states-finds-confusion-regarding-basic-aspects-of-health-plan-design
2. Voya Financial, “Majority of working Americans select same health plan from prior year during benefits open enrollment.” https://www.voya.com/news/2024/10/majority-working-americans-select-same-health-plan-prior-year-during-benefits-open
3. Voya Financial, “Survey: More than 8 in 10 employees more likely to work for a company that offers supplemental benefits.” https://www.voya.com/voya-insights/survey-more-8-10-employees-more-likely-to-work-company-offers-supplemental-benefits

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