There’s nothing I hate more than a one size fits all approach. Modern work is FINALLY in its personalization era and I couldn’t be more excited.
What I mean is, we’ve spent years and years personalizing sooo much of the employee experience from top to bottom. Career development, how people receive feedback/recognition, whether they want to work in an office or at home…virtually all of it!
AND IT’S A GOOD THING!!
I have fought many very exhausting fights to get leaders to understand that employees are individual human beings with lives, perspectives and different lived experiences. To be able to deliver options at work to employees feels like a breath of fresh air and I’ve heard from my team directly that giving them choices is super empowering.
Listen, I’ve won some more serious battles, but I’ve also lost a few. There is one thing in particular that seems more challenging than everything else…
And that’s open enrollment.
Before open enrollment for employees, we’re asked to choose health plans for the entire company, which is still considered totally normal.
Makes perfect sense, because everyone has the same body and the same doctor, right??? 🙄
Employees clearly have some passionate thoughts about all of this!
📣 New research commissioned by Justworks and conducted with The Harris Poll found that 86% of employees care about having flexibility in choosing their insurance provider when they evaluate a job offer. More than half said it was very important. VERY IMPORTANT!!!
This shouldn’t be a surprise at all, considering people have gotten used to personalizing almost every other part of their lives, and they’re starting to expect their health coverage to catch up.
Now, before anyone comes for me, I do want to point out that traditional group plans can work incredibly well!
Plenty of companies offer strong group coverage that genuinely fits their teams. We don’t need to drag one approach to make room for another!
I would simply like benefits leaders to have more than one answer available when circumstances call for it, which is what is on the agenda for today.
👀 Let’s look at a scenario that has almost certainly played out in thousands of small businesses, shall we?
A founder spends weeks comparing health plans. They’re looking at premiums, deductibles, provider networks, and enough acronyms to earn an honorary medical degree.
They’re asking all the smart questions, and eventually choose the plan that seems to offer the best balance for everyone.
Next, enrollment happens, and the founder finally crosses “benefits” off the list and moves on to the other 400 things currently on fire.
Then, a few months later, an employee mentions something during a completely unrelated convo:
🧑⚕️ Their longtime doctor isn’t in the network
💊 A prescription that they rely on costs waaay more than expected
🤔 Their partner’s coverage changed, and now the family’s healthcare math looks like something written on the wall in A Beautiful Mind
By the time the founder hears about it, the employee has already been eating the extra cost for months.
Because telling your boss about a private medical issue sounds like such a fun Tuesday afternoon activity!
The founder feels awful, even though they chose a plan carefully and didn’t feel like they phoned this decision in.
The plan may be a perfectly good plan too, but it simply doesn’t work well for this particular person.
This is where benefits decisions get a lil weird for leaders, because they’re expected to pick coverage for people without knowing the details that would make the choice truly personal. Mind you, they’re making that decision while juggling a dozen other things that need their attention!
👀T hey know where employees live and maybe their ages, but they don’t know about diagnoses, prescriptions, therapy appointments, fertility treatments, or the specialist someone spent six years trying to find.
Nor should they! Obviously, privacy is important, so I want to go on record and say, please do NOT start a company spreadsheet called Everyone’s Secret Medical Business. 🚫
Jokes aside, that leaves leaders choosing coverage with one hand tied behind their backs.
They care about making the right call, yet the information needed to make the perfect call belongs to employees and should stay with employees.
I’ve sat in enough HR convos to know what comes next!
The leader wonders whether they missed a question, and HR reopens the comparison sheet and stares at column G like the answer might reveal itself if they squint hard enough.
❤️ Caring can’t magically make one plan fit every person, though. Once a leader experiences that disconnect, it tends to stick with them.
For a long time, the big benefits question for small businesses was: “Can we afford to offer health insurance?”
That question is still sitting at the table by the way…
💰In the Small Business “Bene-Fit” Gap Report from Justworks, 34% of small business decision-makers named cost and affordability as their biggest challenge when offering health benefits.
But there’s another big question small businesses have to answer too, which is “Does this coverage work for the team we have NOW?”
Today’s teams might be scattered across six states, and many of those teams are caring for children, parents, partners, and maybe even all of the above.
One person needs access to a specific group of specialists, while another is focused on prescription costs.
Someone else moved across the country while keeping the same job, and their current provider network now responds to searches with what appears to be a shrug emoji. 🤷♀️
The report also found that 52% of small business decision-makers worry at least once a quarter that their current health benefits may not fully meet employee needs. Nearly half are concerned that their benefits could make it harder to recruit or retain people.
Leaders already see the gap, because employees are living inside it!
In fact, 89% of small business decision-makers said giving employees more choice in their health coverage matters to them. At the same time, 59% said finding a benefits solution that works across different employee needs is difficult.
See??? Nobody here is twirling a villain mustache and cackling about deductibles.
Small businesses care about their employees, and so many leaders desperately want to offer top-tier coverage.
🤯Unfortunately, they’re trying to solve a deeply personal equation with broad workforce data and a budget that keeps getting bullied by rising healthcare costs.
The person selecting the plan has the fullest view of the business and the tiniest glimpse into each employee’s healthcare reality.
We have somehow centralized the one decision where the decision-maker is supposed to have the least personal information! 😒
(Who designed this? I’d love a quick chat.)
The traditional approach asks leaders to find a plan that works reasonably well for the largest number of employees.
For many companies, that still makes complete sense, but a modern benefits strategy can consider a wider question: Which coverage model gives this particular team the best mix of quality, affordability, support, predictability, and choice?
That shift sounds small when you say it quickly.
In practice, it can change who gets to make the most personal parts of the decision!
One option available to businesses is an Individual Coverage Health Reimbursement Arrangement, or ICHRA.
Apparently, the benefits industry looked at the existing acronym collection and said, “We have room for one more, y’all!” 😑
With ICHRA, the employer determines a monthly contribution, and eligible employees use those funds to purchase qualifying individual health coverage.
📝 Healthcare.gov has a useful overview of how the model works and what employers and employees should know.
Okay, benefits class dismissed.
Let’s talk about what changes for actual humans! 🤝🏽
Employers can establish a predictable benefits budget while employees compare coverage based on their doctors, prescriptions, preferred networks, and family needs.
The business is still investing in healthcare, but now, the leader simply isn’t being asked to guess which coverage details matter most to every person.
Justworks helps small businesses evaluate and administer benefits approaches, including traditional group plans and individual coverage options.
Some orgs will look at their workforce and decide that a group plan gives employees exactly what they need. Great! Other businesses may realize that an individual coverage model offers the flexibility their team has been asking begging for.
When workers were asked how employer-supported health coverage should function, 29% preferred an employer-selected plan or group of plans, while 27% preferred receiving a monthly contribution and choosing their own plan. The largest share, 33%, said either approach could work depending on cost and quality.
🙏 Translation: “Please give me good coverage that works for my life.”
Of course, more choice also means employees have more decisions to make!
Unfortunately, shopping for health insurance doesn’t suddenly become cute because we added autonomy.
People still have to compare networks, premiums, deductibles, and coverage terms apparently written by an ancient society that hated clarity.
Employees need all the education and guidance they can get. They need someone available when the phrase “out-of-pocket maximum” makes their eyes glaze over, and their spirit leaves their body.
Still, 69% of workers in the survey said flexibility was the most appealing part of an individual coverage model.
Yes, there’s effort involved, but many employees appear willing to make that trade because they value having a say in coverage tied to their own bodies.
A leader’s responsibility changes in this type of model. Now, the leader chooses an approach, sets the company’s investment, provides support if necessary, and helps employees navigate the process without forcing anyone to earn a PhD in Coinsurance.
Honestly, that still sounds like taking care of people to me. Maybe even a more realistic version of it!
Think about all the tasks that employees are trusted to do every day!
They manage client relationships, hire people, approve budgets, make calls that affect revenue, and decide which projects deserve more investment versus which ones need to be lovingly escorted to the idea graveyard.
Many of them can even select their own laptop, despite that one employee who requested a gaming computer for “performance” reasons.
🏆 These are whole ass adults making consequential decisions all the time. 🏆
When the model and available support make it practical, choosing health coverage can be one of them.
Leaders have more ways to care for their teams now. Which one makes sense for yours?
A traditional group plan may give your workforce the provider access and terms they need. An ICHRA may give the company cost predictability while letting employees shop around their own priorities.
The answer might shift as the business grows and inevitably reaches that stage when every benefits renewal arrives as a 74-page PDF nobody remembers requesting!
Optionality gives leaders room to respond to the company they’re running TODAY.
And, my god, do they want that room. Justworks and The Harris Poll found that 55% of small business decision-makers would rather do almost anything than choose a health plan for their company.
14% would rather wait at the freaking DMV!!!!
Another 14% would rather process payroll manually for a month, which feels less like a survey response and more like someone begging to be rescued???
The point is, benefits carry enormous stakes for both employees and employers. Thankfully, leaders now have more ways to meet those stakes while preserving what matters to their teams.
Choosing for people used to be the only practical route available. Today, there are other options!
I’ve only covered a handful of data here, but the full Small Business “Bene-Fit” Gap Report from Justworks digs a lot deeper into what employees value, what small business leaders are struggling with, and how greater optionality could help close the gap between the two.
📚I highly recommend reading it, then looking at your own team.
Consider what support they need and the promises your company makes every time it tells a candidate that you take care of your people.
Does your current benefits approach fulfill that promise in the best way available?
If it does, beautiful! Keep doing what works.
But if you hesitated for a even second…well, I’d probably start there.
