How HR Can Train Employees to Be Smarter Health Insurance Consumers

For years, employee benefits strategy has centered on selecting plans, negotiating renewals, and managing enrollment logistics. But as healthcare costs rise and plan designs grow more complex, a new reality has emerged: Offering coverage alone is no longer enough.

Today’s workforce is being asked to make highly individualized and high-stakes healthcare decisions, often with little understanding of how insurance actually works. Deductibles, networks, coinsurance, formularies, metal tiers, and plan types all influence what employees pay and what care they can access. Yet, most people were never taught how to evaluate these factors. The traditional once-a-year enrollment meeting rarely provides enough support.

This kind of education is becoming more urgent as benefit models evolve. Recent industry research from SureCo found 44 percent of large employers are considering adopting an Individual Coverage Health Reimbursement Arrangement (ICHRA)—a model in which employers provide tax-free contributions employees use to purchase their own individual market health plans—in the coming year. SureCo is a large-group ICHRA administrator.

Instead of an administrative hurdle, leading employers are beginning to rethink benefits as an employee education and development challenge. Training these employees to become informed healthcare consumers before open enrollment is increasingly critical, especially as models like ICHRA give them more choice and responsibility over their coverage. By doing so, HR teams can improve outcomes for both the business and the workforce.

The Challenge: More Choice, More Complexity, Less Understanding

Healthcare has shifted away from standardized, one-size-fits-all coverage toward a marketplace filled with hundreds of plan variations, multiple carriers, and increasingly nuanced benefit designs. While more choice can be empowering, it also raises the bar for decision-making.

In practice, most employees typically understand basic concepts such as deductibles and monthly premiums. Far fewer grasp how networks differ, how prescription drug tiers work, or how plan structures affect access and cost. Without guidance, many employees default to renewing their existing plan or choosing based on superficial criteria such as premium price alone. The consequences include surprise bills, dissatisfaction with coverage, and the perception that benefits are expensive but low value.

Data from SureCo’s 2026 open enrollment period reflects a shift in employee behavior. Among returning members using an ICHRA, 84 percent changed plans in 2026. That was up from 64 percent the prior year. Nearly 30 percent switched carriers altogether. More than half optimized within the same carrier. These figures show that when employees are empowered to compare options, they will.

However, active engagement does not inherently lead to better decisions unless employees understand what they are comparing. Basic familiarity with terms such as “deductible” is often insufficient to navigate questions such as: “How does this plan’s network align with my preferred providers?” “What will my total out-of-pocket expenses be if I need care?” “Does this drug tier impact my regular prescriptions?”

The Solution: Treat Benefits Education as a Core HR Capability

To address these challenges, HR leaders should adopt a proactive education strategy that builds employees’ decision-making confidence well before open enrollment begins. This strategy centers on three key components:

1. Teach concepts that influence costs and access.

Rather than overwhelming people with plan documents, focus on a short list of high-impact concepts:

• Total cost awareness: Help employees understand that premium is only one part of overall cost; deductibles, coinsurance, and expected service use matter significantly.
• Provider network implications: Ensure employees know how to verify whether their doctors, specialists, and preferred hospitals are in-network—and inform them that providers can enter and leave networks at any point throughout the year.
• Drug coverage nuances: Explain how formularies and drug tiers impact out-of-pocket costs.
• Plan type distinctions: Clarify differences between plan structures such as HMO, EPO, PPO, and POS and how they influence coverage flexibility.

These elements influence real-world outcomes more than plan names or one-line summaries.

2. Normalize shopping as the default behavior.

Employees are accustomed to comparing prices for travel, phones, and even groceries, but many still view health insurance as something they “set and forget.”

Employers can reframe this by consistently reinforcing one message: Your best plan last year may not be your best plan this year.

SureCo’s enrollment data reflects a highly competitive marketplace. No single carrier held more than 14.2 percent market share in 2026, and the 10 most popular plans accounted for less than 9 percent of total enrollment. This fragmentation suggests employees choose plans that fit their needs, rather than defaulting to familiar names.

3. Provide tools that support informed decisions.

Digital platforms that allow employees to filter plans, compare costs, and view network and prescription details dramatically reduce friction. The easier it is to explore options, the more likely employees are to engage.

From an HR perspective, deploying such tools means shifting from answering questions on an ad hoc basis to proactive enablement where employees can explore and evaluate independently.

The Results: Informed Choices, Higher Value, Reduced Friction

Employers that invest in benefits education see tangible benefits:

• Purposeful plan selection: In 2026, about 22 percent of SureCo’s returning ICHRA members selected a lower metal tier and 9 percent upgraded, which shows deliberate trade-offs rather than inertia.
• Balance of coverage and cost: Gold and Silver plans accounted for more than 75 percent of enrollments, suggesting that many employees prioritize comprehensive coverage when they understand the options.
• Employee confidence: When employees understand both their choices and the implications of those choices, they are less likely to blame the employer for plan outcomes.
• Reduced HR burden: Clear, ongoing education minimizes last-minute questions and confusion during open enrollment.

Practical Steps for HR Leaders

A comprehensive education strategy does not require large budgets or complex campaigns. Consider the following actions:

1. Start education early: Introduce short benefits learning sessions well before open enrollment.
2. Create simple guides: One-page explainers on networks, metal tiers, and total cost can go a long way.
3. Encourage annual review: Make “shop your plan” a cultural expectation.
4. Leverage decision-support platforms: Offer tools that make plan details transparent and easy to evaluate.
5. Reinforce year-round: Benefits education should be ongoing, not seasonal.

Looking Ahead

Healthcare is unlikely to become simpler anytime soon, but complexity does not have to mean confusion.

HR departments that embrace benefits education as a development function will help employees make more informed decisions, improve perceived benefits value, and reduce confusion during open enrollment periods. In an era when employees are expected to be active healthcare consumers, the most valuable skill HR can cultivate is employees’ ability to understand how to choose, not merely what to choose.