Most people go through their working lives treating their health plan and other employee benefits the same way: show the card, wait for the bill, and move on.
But Kristen Dougherty, Senior Vice President and Employee Benefits Practice Leader at Philadelphia-headquartered Univest Financial, says that's not just a problem for employees; it's a systemic failure that runs straight back to the broker relationship.
"It never ceases to amaze me that we deal with all types of businesses - blue collar, white collar, gray collar - and most employees don't understand how to use their health plan to the best of their ability," Dougherty told Insurance Business America. "They're just thinking about showing up, showing a card, and then they get a bill in the mail and they don't know what to do with it."
With roughly 25 years in the group benefits industry, Dougherty has a clear view of where employers consistently fall short and why brokers can do more to address the gap.
Mental health resources, employee assistance programs (EAPs), nutrition counseling, digital engagement tools, gamification features, and even gift-card incentives for meeting healthy activity targets, are commonly included in standard medical plan premiums, but are often untouched because neither employers nor their employees know they exist.
"Employers look for solutions outside of what they already have, and strangely enough, a lot of those solutions are embedded in a lot of their plans already," she said. "They're not thinking about the fact that there are wellness solutions that they're already paying for in their premium."
For brokers, Dougherty sees an opportunity. Rather than recommending new products that add cost, something she describes as "bolting on things that are going to sound flashy and have the sizzle," she says the first move should always be a thorough audit of what the client already holds.
"How can we make sure people are taking advantage of those things before we recommend another solution that's going to add to their bottom line?" she said. "That's our fiduciary responsibility as their business partner."
The reason employees don't understand their benefits, Dougherty argues, is that brokers may not have conversations with their clients about the need for structured employee education.
"I think a lot of times people are hesitant to have an uncomfortable conversation with their client to say this is something that's really important," she said. "They're not really pushing, and I think that's a problem."
The consequences show up most clearly during open enrollment. When employers offer both a high-deductible health plan (HDHP) with a health savings account (HSA) and a richer traditional plan, employees routinely choose the higher-premium option assuming it's the better product without running the financial comparison for their own life stage. They end up paying more out of pocket for coverage that may not serve them as well, while the HSA sits underutilized.
"Getting employees to appreciate the differences in health plans and what makes sense for them in their life cycle - thinking about it as a financial product - the basics of something like that are still a challenge for a lot of employees," Dougherty said.
According to the US Bureau of Labor Statistics' Employer Costs for Employee Compensation data, benefits represent nearly a third of total employer compensation costs, the single largest expense after wages.
Dougherty noted that escalating healthcare costs mean that uninformed employee decisions directly affect employer spend, which ultimately feeds back into payroll contribution increases for the very workers making those decisions.
"Getting employees to understand that the decisions they make not only affect them, but also their employer, which ultimately comes back to affecting them when their payroll contributions go up on an annual basis; that's the conversation that needs to happen," she said.
At Univest, Dougherty's team runs what they call a "Did You Know" campaign. It’s a personalized, quarterly communication strategy designed to surface a different plan benefit each quarter, delivered to both employer leadership and their workforce.
The calendar is deliberately thematic. In Q1, the focus is wellness and activity resources to address the post-holiday slowdown. In Q2, the spotlight shifts to mental health resources, timed to Mental Health Awareness Month in May. Q3 covers health insurance basics - HDHP fundamentals, how HSAs work, and how to compare plan options - ahead of renewal conversations. And Q4 opens up the full range of open enrollment options.
Education is delivered across multiple formats: webinars, lunch-and-learns, and on-demand content uploaded to benefits administration platforms so that employees and crucially, their spouses and partners, can access it at any time.
"Extending plan education access to spouses and partners is particularly valuable because they often drive healthcare decisions," Dougherty noted. A spouse who knows what's already covered can prevent an employee from paying out of pocket for something their plan already includes.”
When onboarding a new client, Univest audits existing education activity first before recommending any plan changes. "We don't like to come in and disrupt just for the sake of disruption," Dougherty said. "We like to come in and say: what's working? Where can we find opportunities to make the most out of what you have right now?"
Underlying the education strategy is a broader philosophy that Dougherty believes mid-sized regional brokers are well-positioned to capitalize on, particularly as consolidation by large national firms changes the service model for small and mid-sized employers.
When a regional broker is acquired by a firm the size of Aon or Marsh McLennan, the personalized, community-based relationship that employers with 25 to 250 employees have relied on may disappear. The local contact who understood the business, showed up in person, and knew employees by name could be replaced by someone in another state operating under a different model.
"We go out, we meet with our clients on a regular basis, we're in person," Dougherty said. "That's an opportunity for small to mid-sized regional firms to make sure they're capitalizing on that personal touch."
It also, consistently, wins business. When Univest meets with prospective clients, one of the first questions employers often ask is whether their workers will be speaking to someone local, a live human answering the phone, not an offshore service center or an automated system. The answer is a recurring differentiator in competitive pitches.
The workforce's generational spread adds another dimension. With employees ranging from their 20s through their 70s consuming benefits in different ways, a one-size engagement model fails by design. Meeting employees where they are, rather than defaulting to a single channel, is central to how Dougherty's team thinks about the relationship.
"Some people like digital, some people like email, some people like phone," she said. "The human element is super important. Yes, the digital is important, you want to have that, that's kind of like check the box. But having people behind that, and quite frankly in front of it as well, is really the way to go," she said.
The retention dimension runs deeper than most employers appreciate. Remote employees who lack regular educational touchpoints and feel disconnected from their employer, Dougherty observed, are more likely to leave for a competitor at the first opportunity, even for marginal pay gains. A well-run benefits education strategy, she argues, is also a retention strategy.
"When you have programs and educational opportunities and employees are feeling that connection to their employer; that's where the rubber meets the road. If they don't feel that connection, they're going to take the first phone call from the competition for a dollar more an hour," she concluded.
