US employers are spending up to $20,000 per employee each year on health plans but investing less than $10 per employee communicating those benefits.
John Tournet, senior vice president of benefits consulting at Arthur J. Gallagher & Co. in Chicago, says that imbalance is the central reason employees fail to use the coverage their employers provide, and it is costing both sides dearly.
"It's chronic under-investment in the communications piece," Tournet told Insurance Business Benefits in an exclusive interview.
The benchmark figure, included in a report from Aon, highlights a structural problem that Tournet believes benefits brokers are uniquely positioned to solve.
With the right navigation strategy, he argues, employers can close the trust gap, reduce healthcare waste, and lower long-term costs in ways that were once considered nearly impossible.
Employees encounter the healthcare system at moments of maximum stress such as a diagnosis, an injury, or a billing dispute, when they have the least capacity to figure out where to go or what their plan covers.
Employers who solve that problem, Tournet said, earn something money cannot buy directly.
"Employee surveys for clients who have navigated healthcare well show loyalty to the employer as a direct outcome," he said. "When you simplify that moment for someone, it stays with them."
That loyalty effect matters not just for retention but for the broader business case benefits brokers make to plan sponsors. Research published by the Employee Benefit Research Institute (EBRI) and the Kaiser Family Foundation (KFF) has consistently documented the gap between the richness of employer-sponsored health plans and employees' understanding of how to use them; a gap that fuels unnecessary emergency room visits, duplicate testing, and out-of-network costs that inflate premiums for everyone.
Tournet's solution is to consolidate the employee benefits experience to one phone number, one email, one website, and one real person, with artificial intelligence layered on top to personalize the interaction in real time.
"Clients that have implemented this 'one quarterback' model have seen healthcare costs lower than they were 10 years ago," he said. "That is almost unheard of in US healthcare."
But the AI component Tournet described is not a standalone chatbot bolted onto an existing benefits portal.
It combines claims data, demographic information, provider quality scores, and an employee's current deductible status to generate a personalized, real-time navigation experience at the point of need.
A call about a lost insurance card, for example, can simultaneously flag an unused wellness benefit or schedule a post-surgery follow-up, turning a transactional interaction into a holistic care moment.
Tournet cautioned against the increasingly common practice of embedding AI across multiple fragmented benefit systems.
"If you embed AI across 10 different systems, you recreate the fragmentation," he said. "The effective model is one landing page, within the employer's human resources information system or a separate integrated system, with a single AI interface that can also alert HR to follow-up needs."
Gallagher has made significant investments in this direction. The first is Gallagher Drive, a consultant-facing platform that aggregates claims data, benchmarking, point solution analysis, and network analysis to give advisors a data-driven recommendation tool rather than one built on intuition.
The second is a publicly announced partnership with Avante, which combines Gallagher's data infrastructure with AI-driven navigation and care coordination in a single, employee-facing experience.
The navigation challenge is complicated by the explosive growth of point solutions including standalone programs for pharmacy benefits, musculoskeletal care, diabetes management, infusion therapy, and more.
Employers are adding them faster than they can integrate them, and AI is being retrofitted across these fragmented stacks rather than built in from the ground up.
Tournet acknowledged that retrofitting is currently the norm, not the exception. But he also flagged a likely market divergence ahead: integrated platforms with native AI and narrower scope on one side, and point-solution ecosystems with retrofitted AI on the other, potentially resulting in two parallel AI systems operating within a single employer's benefits stack.
GLP-1 medications, widely used as weight-loss and diabetes treatments, represent a live example of point-solution volatility. Some employers that moved quickly to cover GLP-1s are already pulling back coverage due to unexpectedly high utilization and cost.
Clinical trials, particularly for cancer and infusion therapy, are another under-navigated area where Tournet believes AI and specialty point solutions could help employees in smaller markets find and qualify for evidence-based trials, replacing ad-hoc internet searches with expert, data-driven guidance.
Tournet's message to benefits brokers is to stop thinking in annual cycles and start thinking in multi-year, experience-focused strategies.
"Move clients away from a product-focused, one-year mindset toward a multi-year, experience-focused strategy," he said. "The annual renewal cycle is an inadequate lens for solving systemic navigation problems."
In practical terms, that means starting each engagement by explicitly identifying fragmentation in the client's current benefits stack, mapping more efficient pathways connecting employees to available resources, and building a comprehensive, multi-channel communications plan that accounts for how different generations absorb information, instead of a single booklet or a single website.
Employee preference surveys and engagement data should feed directly into plan design, ensuring strategy reflects what employees actually want rather than what is administratively convenient.
For employers resistant to the investment, Tournet reframes the conversation entirely. Care navigation is not an added expense; it is a cost-reduction strategy. Fraud prevention, administrative error reduction, wrong-provider avoidance, and unnecessary test elimination all reduce the total cost of a health plan over time.
"It's a major cost savings and a morale booster," he said. "The financial case and the human case point in the same direction."
