Health insurance is becoming increasingly confusing anddifficult for the average American worker to navigate. The newcomplexity makes brokers’ jobs more important than ever, especiallyduring enrollment.

Before the Affordable Care Act (ACA), brokers primarilysupported the benefits enrollment process for employees bycoordinating plan documents and occasionally making presentationsat group meetings. Such strategic benefits communications is whathelps employees make informed and confident decisions duringenrollment. Although most or all of the ACA may disappear in thenext few years, it has still changed the enrollment conversation byaccelerating the shift by employers — which are now legallyrequired to provide insurance for their workforces — tohigher-deductible medical plans.

Whether employees know it or not, they rely on brokers to helpprotect them from financial hardship due to the out-of-pocket coststhey must pay in the event of an illness, injury or accident. Thosecosts are higher than ever before, yet most employees don’tunderstand how much of their health care expenses they would bepersonally responsible for if they or a loved one got sick orhurt.

In fact, a recent survey, Voluntary Benefits, an Unknown but NeededOption, commissioned by Assurant EmployeeBenefits, now part of the Sun Life Financial family, revealed thatmore than half of employees (54 percent) don’t know their insuranceplan’s out-of-pocket maximum, and one in three (33 percent) don’tknow their deductible. Almost one-third of employees (30 percent)surveyed don’t know either one of these figures. The accompanyingreport, Closing the benefits gap: How to help employeesstrengthen their financial safety net, exploreshow well employees understand their benefits packages and howconfident they are in making related decisions.

Enrollment conversation tip #1:

Help employees understand their options

Given the changing insurance landscape, where more of the burdenof paying medical expenses falls on employees, it’s critical thatthey understand their financial risk — especially because themajority of Americans have limited disposable funds to cover suchcosts. Research shows that more than half of all Americans haveless than $1,000 in savings accounts.

That amount won’t begin to cover the significant expensesrelated to some of the most common afflictions like heart diseaseand cancer. Statistics show that many people will be diagnosed withan expensive condition at some point in their lives. Theseconditions account for some of the largest medical costs of anyillness, and consumers are bearing an increasing proportion of themthrough higher deductibles, co-pays and coinsurance. In fact,annual out-of-pocket medical costs for a critical illness average$7,500, according to research based on stop-loss claimsdata.

That statistic underscores how important it is for employees toknow and understand their out-of-pocket maximums, deductibles andcovered versus non-covered services. Knowing these things makesthem more manageable and less frightening. Answeringquestions employees may not ask but should ask can help. Forexample, provide tools, calculators and written information thatwill help workers calculate how much they would have to spend witheach plan option in different scenarios, such as care after a heartattack or a broken bone.

And discuss these things in person, if possible. The Sun Lifestudy showed that such meetings bolster employees’ understanding oftheir benefits options. Of those employees surveyed whoparticipated in face-to-face benefits meetings, almost all of them(96 percent) found the in-person time helpful.

Studies show that in today’s fast-paced society, people spendonly about 20 minutes per year on benefits decisions — choices thatcould protect or destroy their families’ financial wellness. Yetthey spend an average of 14.4 hours researching which car to buy. A caris something people anticipate using all the time, while theopposite is true for insurance, which is something people hope theynever or rarely have to use.

Tip #2:

Discuss filling the gaps

The key is to help employees see how big of a hit their walletswould take in different health event scenarios. But it is importantnot to scare them. So, the second most important part of theenrollment conversation is providing employees with options thatwill help protect their financial well-being if an illness, injuryor accident strikes.

The Sun Life survey revealed that nearly 2 in 3 employees (63percent) are concerned about how they will pay unexpectedout-of-pocket costs. It also showed that employees are concernedabout gaps in coverage but lack knowledge about supplemental, orvoluntary, benefits:

• A majority of employees (62 percent) agree thatemployer-provided health plans alone are rarely enough to coverunexpected costs.

• While most employees (86 percent) feel the onus is on employersto provide options to fill coverage gaps, few of them (30 percent)are familiar with voluntary benefits, and nearly 4 in 10 employees(39 percent) are not at all familiar with this option.

• Once the term is explained, 3 in 4 employees (72 percent) say itis important for employers to offer voluntary benefits.

• Six in 10 employees (63 percent) agree that voluntary benefitscould be helpful in filling the gaps in their coverage, even ifthey have to pay for the benefits themselves.

Keep these findings in mind as you write materials for and meetwith employees, who have been thrust into an environment where theyhave to take a more active role than ever before in determiningtheir benefits packages. Remember that many of them do notunderstand even the most fundamental insurance basics, let alonethe other options available to them. But they recognize the needfor supplemental options once they have a clearer understanding oftheir benefits landscape.

Tip #3:

Dive deeper to boost customersatisfaction

When consumers pay for something out of their own pockets, theyexpect more from the product or service they’re buying. Withinsurance, though, it’s easy to forget about the customer serviceaspects on the front and back end. Employees often don’t considerthis until something happens and they need to interact with acarrier.

As you communicate with employees about their options, help themthink through what their experience will be like should they needto contact their insurance provider. They should ask questions suchas:

• Is there more information online?

• How and when will I know what my individual cost will be eachpay period?

• How long will it take for me to receive proof of coverage (e.g.,ID cards and certificates of insurance)?

• Who can I call with questions?

• Can I submit claims online?

Since we live in a digital age where everything is nearlyinstantaneous, employees will undoubtedly expect that carrierinteractions will be technology enabled. They are comparinginsurance companies to other service provider relationships thatare likely characterized by technological conveniences. Brokersshould work with carriers that offer the value-added services thatconsumers expect.

Brokers are key to the enrollment process

According to Sun Life research, brokers and employers have anopportunity to help people feel more informed and better about howthey’re spending their money through face-to-face communications about bothinsurance basics and the supplemental offerings that could helpthem avoid financial hardship.

Brokers are a critical conduit to providing employees with allof the information they need to make important benefits decisions.Meeting employees’ needs — and helping them understand what thoseneeds are specific to their situation — is more important thanever. What can help is to approach the conversation with themindset that employees aren’t buying insurance because they want touse those benefits, but rather because they want to protectthemselves and their families. This approach will help keep thefocus on ensuring that employees are mentally and financiallyprepared for any unforeseen medical expense.