A new survey from Justworks and The Harris Poll offers a detailed look at how Zillennials — the combined cohort of Gen Z adults and younger millennials — navigate the increasingly complex process of choosing health insurance. The findings reveal a group that is highly cost-conscious, often underprepared, and turning to unconventional research methods during the annual open enrollment period.
Pricing drives anxiety
As premiums continue to rise — with ACA Marketplace rates expected to jump another 26% in 2026 — Zillennials are feeling the pressure. Cost is the leading worry for 26% of respondents in this age group, making it their top concern when selecting a plan. Other common concerns include finding sufficient coverage (18%) and uncertainty about whether they are choosing the “right” plan (12%). Notably, Gen Z expresses more anxiety than millennials: 14% say they are unsure how to pick the right plan, compared to 10% of millennials.Confidence is low and experience is limited
The report suggests that many young adults lack the experience needed to feel confident in their health insurance decisions. About 1 in 5 Zillennials (21%) say they are not confident in their ability to choose a suitable plan. The gap is especially pronounced for Gen Z adults: 55% admit they know very little about choosing insurance because they have never been responsible for selecting a plan before. Despite annual enrollment cycles, many are not improving with practice — nearly 40% report having had problems with their most recent selection, and 44% of Gen Z say they do not feel prepared to handle more complex decisions in the future.
Related: Health plan executives prioritize cost control, technology investment for 2026
Research methods are shifting
Even with mounting concerns, most Zillennials are not investing significant time in research. Nearly 60% spend an hour or less evaluating their options. When they do consult outside resources, the generational split is clear. Millennials rely heavily on search engines, while Gen Z is more likely to call their parents for advice. Zillennials also stand apart from older generations in their comfort with technology: more than 3 in 5 have used AI tools for medical or insurance information — double the rate of Gen X and boomers.
A growing knowledge gap
The survey highlights substantial gaps in understanding key benefits. While 80% of Zillennials are aware of FSAs and HSAs, only 19% both use and understand these accounts. Millennials demonstrate far greater familiarity than Gen Z, underscoring a widening generational learning curve.
The solution
According to David Fienberg, SVP of risk and insurance at Justworks, companies should change their communication style to better help younger employees:
“The biggest barrier is that we've made health insurance feel foreign and scary, when it's really just another financial decision similar to ones you’re already making. For Gen Z, it can be even more intimidating the first time or couple of times, because they don't have the muscle memory to lean on yet. When you pair that inexperience with overwhelming terminology and limited time spent researching (nearly 60% spend an hour or less) it's no surprise confidence is low. The solution is meeting them where they are: use plain language, draw comparisons to decisions they're already making (like choosing car or renter’s insurance) and give them digital tools that feel intuitive. Employers who invest in proactive, year-round education rather than cramming everything into November will help close that confidence gap and turn 'planxiety' into empowerment.”
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