Empowering Healthcare Choices During Open Enrollment
Understanding the Challenges of Open Enrollment
During open-enrollment season, as Business Insider reports, Reddit users flood the platform's health insurance and personal finance forums daily. They seek guidance on choosing the best health-insurance plans. For instance, a recently unemployed married woman in Texas wondered whether to enroll with her husband's employer or stick to COBRA. Another married person needed advice on coverage during pregnancy in 2025. In California, employees navigated dental-plan options with costs ranging from $0 to nearly $440 annually. Open-enrollment season typically runs from October to December, with companies having their own periods. Employees must look back at past healthcare utilization and anticipate future events while dealing with changing insurance options and family situations. This process can be extremely confusing, as Dan Beck, president and chief product officer of SAP SuccessFactors, explains.Employees are tasked with reflecting on whether they maximized their benefits in the past year based on healthcare system usage. Simultaneously, they need to anticipate health-related events such as having a child or major surgery. The complexity is further compounded by life changes like moving to a new state or employer or a company changing insurance providers. Keeping track of life events that could change coverage, including moving, having a baby, or adopting a child, is also crucial. There is a special enrollment period outside of open enrollment, but it has a limited time for making changes and retaining coverage.
Employer Initiatives to Simplify Enrollment
Increasingly, employers are encouraged by their employees and HR-benefits companies to share more digestible benefits information. Karen Frost, a senior vice president at Alight, a cloud-based employee-benefits vendor, told BI that employees need help during enrollment. Some employers are partnering with third-party companies to handle payroll and health benefits and build software with clear step-by-step prompts. This helps workers make confident healthcare elections.For example, in Alight's 2024 annual survey of 2,500 employees in the US, UK, France, Germany, and the Netherlands, 63% felt confident about their most recent health-plan election. However, there are generational splits, with 70% of Gen Z and 72% of millennial workers wanting personalized support compared to just 46% of baby boomers. Despite the decline in paper-packet methods, the enrollment process remains overwhelming due to life changes.
Mobile Apps and Generative-AI in Open Enrollment
To assist employees during open enrollment, some healthcare startups are leveraging mobile apps and generative-AI chatbots. Alight aims to learn about employee preferences and family needs through Q&A and make recommendations. It provides clear definitions of complex benefits like health savings accounts. For instance, if an employee picks a high-deductible health plan, Alight guides them to an HSA and explains its benefits.SAP SuccessFactors, with customers like McDonald's, L'Oréal, and Delta Air Lines, is focusing on developing its mobile app targeted at workers under 40 and frontline workers. It uses generative-AI chatbots to answer policy questions and improve the user experience. In the future, the company plans to automate some open-enrollment processes. To enhance its capabilities, SAP bought WalkMe earlier this year for $1.5 billion to provide real-time website navigation for healthcare and other tasks.AI-based virtual assistants are also gaining popularity. Alight has Ask Lisa, SAP SuccessFactors uses Joule, and Workday uses Wex. These tools allow employees to get automatically generated responses to their benefits questions. Workday's senior vice president, Ben Carter, emphasizes catering to all generations. AI-enabled tools like Workday Wellness integrate with insurance providers and help employers understand which wellness benefits are used and which ones need more investment.
"It brings a nice story," Carter said. "If I'm going to invest another $20 million in my benefits programs next year, I know where to go or where to double down."