- Key insight: The real reason company leaders are integrating AI tools into this year's open enrollment.
- What's at stake: The thousands of dollars in out-of-pocket savings at stake for employees with medical conditions.
- Forward look: Prepare for AI to have a noticeably larger presence in the weeks ahead.
Source: Bullets generated by AI with editorial review.
As artificial intelligence deepens its imprint into daily lives, this game-changing technology holds great promise for streamlining the upcoming open-enrollment season, erasing confusion, personalizing content, and securing better outcomes.
AI is expected to have a noticeably larger presence in the weeks ahead than it did even a year ago, predicts Robby White, U.S. benefits business line leader for insurance and risk management services provider Gallagher. "The conversation has shifted from experimentation to practical application," he said. "Employers are increasingly looking for ways to simplify benefits decisions, reduce administrative workloads, and improve employee engagement at scale."
Many AI decision-support tools build individual benefit plan participant profiles based on their survey responses to design a benefits package that best fits their needs, explained Dan Thompson, chief benefits officer at HR and payroll provider Vensure Employer Solutions.
"AI tools have shown more positive engagement, and as a result, far greater participation, which helps with retention," he said. "I believe that AI will rewrite the way company leaders approach open enrollment. The outdated processes of employee benefits will make a major leap forward with the development of AI."
AI is fast becoming part of the employee benefits mainstream. Among the areas Thompson noted the technology is moving the needle in meaningful ways: providing more accurate comparisons between insurance carriers, tracking group performance, and educating employees about key differences between emergency room and urgent care visits to help them choose the correct point of service.
Thompson said AI tools also are being integrated into various carrier claims engines to help group health plan members and their families at critical times of need. For example, benefit plan participants who are too distracted during a difficult time would be reminded that they had signed up for accident insurance or a similar worksite plan. Having synchronized AI tools will help trigger a call to action to ensure that plan members are protected.
AI aims to eliminate information overload from OE and explain complex concepts in plain language along the way to personalizing decision support, observed Brandy Thompson, founder and CEO of personalized benefits platform Benefitbay (and of no relation to Dan Thompson).
"Instead of asking employees to sort through dozens of plans and insurance terminology, AI can help narrow choices based on factors that actually matter to them such as physicians, prescriptions, family needs and budget," she explained.
The use of AI for OE also can significantly reduce an employee's out-of-pocket costs. Brandy Thompson recalled how AI helped pave the way for her team to identify a health plan that was projected to save one employee with a serious medical condition more than $8,000 a year. The individual had been paying more than $600 in monthly premiums with a $3,000 annual deductible.
Customized content
AI-powered tools may put an end to the practice of sending all employees the same OE materials, regardless of their life stage, health needs or financial priorities. Instead, communications and educational content, as well as decision support, now can be tailored to an individual's unique circumstances.
White said AI can help employees compare coverage options, estimate costs, answer questions in real time, and connect them with benefits that align with their needs. These capabilities make benefits feel more relevant and easier to understand.
Decision-support tools that are driven by AI help employees understand tradeoffs among medical, dental, vision and voluntary benefit options. "Rather than asking employees to sort through large volumes of information on their own," White explained, "AI can guide them through the decision process and surface recommendations that are more relevant to their circumstances."
At the same time, he said AI significantly improves efficiency for HR and benefits teams by automating routine inquiries and enrollment support, allowing them to focus on more complex employee needs. The potential impact is undeniable: better employee experience, greater confidence in benefits decisions, and stronger engagement.
"Just as important," White added, "digital tools should preserve the human touch by giving every employee a clear, easy option to connect with a benefits counselor or advocate whenever they want personalized guidance or reassurance."
