Do you remember thinking about health insurance when you landed your first job? I sure didn't. When I started working at a small event-planning company in Chicago, I was thrilled. The work was fast-paced, exciting, and paid me well. They didn't offer health insurance, but I was in my early twenties, and felt healthy enough, despite a pre-existing condition from a college health scare. That condition made private insurance impossible to get, but I wasn't worried.
When the Affordable Care Act passed in 2010, that condition was erased from my health history. I thought I could finally get coverage and keep my dream job until I saw the cost. Even without that pre-existing condition, getting my own policy was too expensive. I had to make some tough decisions. To afford coverage, I needed a job with benefits. No one was there to guide me, but I got lucky. I landed in the health and benefits industry, where my HR representative sat down with me to explain my health plan options.
Health insurance is even more complicated for young people today than it was for me over a decade ago. That's largely because the cost of healthcare has rapidly outpaced inflation, making plan contributions, copays, and other patient/member responsibilities a large part of their budgets.
On top of healthcare costs, many younger workers feel confused about their options. More than half of Gen Z and millennial workers admit to randomly choosing a health insurance plan, and 45% say they don't know who to ask about open enrollment. Imagine how much harder this makes it for them to anticipate costs and make good choices about care.
Employers must take generational differences into account and deliver relevant messaging about insurance coverage and benefits to all employees. This could have an enormous impact on whether younger workers even go to the doctor.
Read more: Lyra's new AI-powered platform provides benefit managers with immediate ROI
Onboarding Gen Z with more support
While more than half of 18-to-24-year-olds report having received a diagnosis and/or treatment for a mental condition, they're also the most likely to report being unable to afford mental health services. Even though 63% of Gen Z employees expect their employers to offer mental health benefits, they may struggle to find the available support because of confusion around selecting a plan and associated costs.
One recent study found that 57% of Gen Z workers rely on their parents' advice for choosing a healthcare plan. 2025 is the first year that Gen Z will outnumber the Boomer generation in the workplace. For many Gen Z workers, the first week on the job doesn't involve a personalized onboarding experience. Instead of a one-on-one onboarding session with HR, many companies now conduct onboarding through online and group sessions, making it difficult for younger employees to ask specific or personal questions about cost and coverage.
How many of us knew what a "deductible" or "copay" was on our first day of work? I would wager not many. Today, only 1 in 4 Gen Z adults can define these terms. For too long, we've relied on the same jargon to educate workers about their health insurance. Yes, they can always "Google it," but having a trusted expert available to answer those kinds of questions goes far in building trust with a new employee.
Read more: Why Fidelity Investments has offered a workplace volunteer program for decades
What's the cost of confusion around coverage?
Gen Z is entering the workforce acutely aware of how costly the basics are: adults under 27 spend more on housing, gas, and car insurance than any other age group. This generation has lived through a global pandemic, rising inflation, and layoffs in many of the most visible, lucrative industries. They're worried about how expensive adult life is, and 36% of insured young adults have skipped or postponed a visit to the doctor because of cost.
When an employee asks, "How do I pick a plan that covers therapy?" or "What does my insurance really cost?" employers need to be ready to answer. We're already seeing the consequences when people don't have personalized onboarding and navigation. Nearly 2 out of 5 Gen Z men do not have an established primary care provider. That means they're missing out on preventative screenings for blood pressure, cholesterol, and cancer and setting themselves up for higher costs down the road.
Too often, younger employees don't have a clear understanding of what their insurance covers and that confusion can lead them to costly urgent care or emergency room visits because they're missing annual visits with a primary care provider.
Read more: How this school district saved on healthcare without sacrificing benefits
Benefits selection shouldn't be the hardest part of a new job
Forward-thinking employers engage workers in decision making about their healthcare coverage options, regardless of age. Personalizing onboarding is a start. Cutting through the jargon and offering personalized human guidance requires a long-term commitment. Beyond HR, benefit experts and health advocates can help employees make informed health choices, even after onboarding.
Supporting a new generation of workers means changing how we discuss health insurance, from plan selection to mental health costs. We can't assume everyone will be equipped to navigate the tangle of health insurance — I certainly wasn't.
