Phrases like co-insurance, formulary tiers, out-of-network reimbursement and pre-authorization sound less like benefits terms and more like the names of indie rock bands playing at Coachella. And don’t even get me started on the avalanche of three-letter acronyms: HSA, EOB, EAP, SPD, OOP… it’s like playing alphabet soup roulette. Many employees have no idea what any of this means, but these things absolutely affect how much they pay, which provider they can see and whether their claim gets approved or ghosted.
Yet every year during open enrollment, we expect folks to become part-time insurance brokers. “Please review this year’s 52-page benefits book and look over all of the plan comparisons, decipher the provider network hieroglyphics and choose your future wisely… all by Friday.” Imagine handing someone a list of stock tickers and saying, “Go build a retirement portfolio. You got this!” That’s how benefits feel to the average employee.
